title: Clustering of Pulmonary Tuberculosis in Hamadan Province, western Iran: A Population Based Cross Sectional Study (2005-2013).
abstract: BACKGROUND
  This study was conducted to detect clusters of pulmonary TB cases in Hamadan Province, west of Iran.
  
  
  METHODS
  All patients with pulmonary tuberculosis recorded in the surveillance system from 2005 to 2013 were studied. The spatial scan statistic was used to detect significant clusters in status of unadjusted and adjusted for age, sex and location residence variables.
  
  
  RESULTS
  Clusters with high rate for both purely spatial and space-time analyses were seen in the same geographical areas composed of four city of Asadabad, Bahar, Toyserkan and Nahavand. Adjustment for mentioned variables did not change location of detected clusters with high rates.
  
  
  CONCLUSIONS
  Findings revealed evidence of significant clusters in Hamadan Province. Study results may help the health system to develop effective public health interventions and extend preventive interventions. However more study are needed to better explain of detected clusters due to limited access to effecting factors.
authors.affiliation: Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran. ol.meysam92@gmail.com.
authors.forename: Meysam
authors.initials: M
authors.lastname: Olfatifar
authors.affiliation: Research Center for Health Sciences , Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Manoochehr
authors.initials: M
authors.lastname: Karami
authors.affiliation: Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Syed Mehdi
authors.initials: SM
authors.lastname: Hosseini
authors.affiliation: Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Masoud
authors.initials: M
authors.lastname: Parvin
mesh_terms: D000328:Adult; D000368:Aged; D002947:Cities; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D011634:Public Health; D062211:Spatio-Temporal Analysis; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*
keywords: Epidemiology; Pulmonary Tuberculosis; Spatial Analysis