[Space distribution of tuberculosis in Spain by geostatistical methods].
BACKGROUND
Tuberculosis incidence has been associated with many factors, both epidemiological and social. In Spain, tuberculosis is a statutorily notifiable disease requiring individualised reporting. During the last few years rates of respiratory tuberculosis show a steady decline. This study sought to assess respiratory tuberculosis morbidity and mortality in association to socio-economic and epidemiological covariates and estimate its spatial distribution across the country, using geo-statistical methods.


METHODS
Respiratory tuberculosis incidence rates were standardised by age and sex with the data of the National Epidemiological Surveillance Network (RENAVE, Red Nacional de Vigilancia Epidemiológica) for 2006. The following socio-economic variables were included in the study: socio-economic status, educational level, overcrowding rate, population density, standardised immigration rate by sex, unemployment rate and average spending per person in euros. The epidemiological variables included were, such as, AIDS rate and the influenza incidence rate. To assess the association of covariables a multivariate analysis was performed using a Generalised Linear Model assuming Poisson distribution. The goestatistical method co-kriging was adjusted with the significant variables to built the spatial distribution of risk.


RESULTS
The statistically significant covariates were overcrowding rate, standardised immigration rate by sex, educational level, unemployment rate, average spending per person in euros, AIDS rate and the influenza incidence rate. The geostatistical method shows spatial variability of the risk with higher risks in the northwest and southeast of the peninsula.


CONCLUSIONS
Results prove that the co-kriging method is a useful tool to show the spatial distribution of risk. Alternatively, tuberculosis is associated with both social and epidemiological covariates.
Gómez-Barroso
Diana
D
Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública - CIBERESP, España. dgomez@iscii.es
Rodríguez Valín
Elena
E
Flores Segovia
Víctor
V
Ramis Prieto
Rebeca
R
Barrio Fernández
José Luís Del
JL
Simón Soria
Fernando
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*; D055815:Young Adult