The spatial epidemiology of tuberculosis in London

• Main Author: Atkinson, Philip John
• Published: Birkbeck (University of London) 2004
• Subjects: 614.54209421
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.408658

Tuberculosis is a large and growing problem in London. The number of notifications increased from approximately 1500 to almost 3000 in the period 1987-2000, a rise of almost 200%. Nearly half the national cases are now reported from London, with the rate in the capital far above the national average. Despite significant professional and public concern, very few studies have examined the geographical distribution of this disease and there is no evidence that anyone has studied the geographical pattern of individual cases of TB across the whole of London in recent years. This thesis attempts to fill this gap by examining the spatial epidemiology of TB in London using a number of different late 1990s data sets. ill particular, it focuses on the pattern of the disease, its attributes and relationships with specific risk factors. Traditional methods of mapping individual case locations are fraught with problems that are exacerbated with infectious disease data. Drawing on recent advances in local spatial statistics, the work adopts and develops appropriate methods to address these difficulties. The results show substantial variation in the incidence of TB at the local level across London, highly variable characteristics in different areas, and varying relationships with risk factors across the capital. These findings add to our understanding of this disease and its recent resurgence, and help focus efforts for effective intervention and control