Title
Geographic accessibility to health facilities predicts uptake of community-based tuberculosis screening in an urban setting
Date Issued
01 July 2022
Access level
open access
Resource Type
journal article
Author(s)
Jenkins H.E.
Ayuk S.
Puma D.
Brooks M.B.
Millones A.K.
Galea J.T.
Becerra M.
Keshavjee S.
Yuen C.M.
Publisher(s)
Elsevier B.V.
Abstract
Objectives: Annually, more than 30% of individuals with tuberculosis (TB) remain undiagnosed. We aimed to assess whether geographic accessibility measures can identify neighborhoods that would benefit from TB screening services targeted toward closing the diagnosis gap. Methods: We used data from a community-based mobile TB screening program in Carabayllo district, Lima, Peru. We constructed four accessibility measures from the geographic center of neighborhoods to health facilities. We used logistic regression to assess the association between these measures and screening uptake in one's residential neighborhood versus elsewhere, with quasi-information criterion values to assess the association. Results: We analyzed the screening locations for 25,000 Carabayllo residents from 49 neighborhoods. Pedestrian walk time was preferable to Euclidean distance or vehicular time in our models. For each additional 12 minutes walking time between the neighborhood and the health facility, the odds of residents using TB screening units located in their neighborhoods increased by 50% (95% CI: 26%–78%). Females had 9% (95% CI: 3%–16%) increased odds versus males of using a screening unit in their own neighborhood. Conclusion: Placing mobile TB screening units in neighborhoods with longer pedestrian time to access health facilities could benefit individuals who face more acute access barriers to health care.
Start page
125
End page
131
Volume
120
Language
English
OCDE Knowledge area
Sistema respiratorio
Enfermedades infecciosas
Geografía económica y cultural
Subjects
Scopus EID
2-s2.0-85129895259
PubMed ID
Source
International Journal of Infectious Diseases
ISSN of the container
12019712
Sponsor(s)
This work was supported by the National Institutes of Health (grant number 1DP2MD015102 to CMY). The screening program whose data were analyzed was funded by the Harvard Medical School Center for Global Health Delivery and grants from TB REACH and Johnson and Johnson Global Public Health. The funders had no role in the design, analysis, or writing of this study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The Mass General Brigham Institutional Review Board determined that the study constituted exempt human subjects research (protocol 2019P002416).
Sources of information:
Directorio de Producción Científica
Scopus