Spatial dynamics of TB within a highly urbanised Asian metropolis using point patterns

Das, Sourav, Cook, Alex R., Wah, Win, Win, Khin Mar Kyi, Chee, Cynthia Bin Eng, Wang, Yee Tang, and Hsu, Li Yang (2017) Spatial dynamics of TB within a highly urbanised Asian metropolis using point patterns. Scientific Reports, 7. 36.

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Singapore is a high-income country in a region with a high prevalence of tuberculosis. The Singapore Tuberculosis (TB) Elimination Program (STEP) was set up in 1997, and the better surveillance and clinical management practices initiated under STEP led to a decade-long decline in the incidence levels. However, incidence rates started to rise again since 2008. The reasons for this rise are unclear. This study involved a spatial analysis of the epidemiology of TB among Singapore residents. More than 30 000 cases reported during 1995–2011 and their residential addresses were analysed for spatial risk and spatial clustering, using spatial point pattern methodology. The principal factor responsible for the increasing resident TB incidence in Singapore is the changing age profile of the population. In particular the burgeoning population aged above 65 years accounts for the increase in reported cases. Singapore’s population has one of the world’s lowest fertility and mortality rates, and the elderly population is projected to grow substantially over the next few decades. Tuberculosis rates may therefore continue to rise even with static or improving case management and surveillance.

Item ID: 59175
Item Type: Article (Research - C1)
ISSN: 2045-2322
Copyright Information: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit
Funders: National University of Singapore (NUS), Singapore TB Elimination Program
Date Deposited: 12 Aug 2019 01:07
FoR Codes: 49 MATHEMATICAL SCIENCES > 4905 Statistics > 490511 Time series and spatial modelling @ 25%
49 MATHEMATICAL SCIENCES > 4905 Statistics > 490502 Biostatistics @ 25%
42 HEALTH SCIENCES > 4202 Epidemiology > 420205 Epidemiological modelling @ 50%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 100%
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