Incorporating patient reporting patterns to evaluate spatially targeted TB interventions

Isabella Gomes, Mehdi Reja, Sourya Shrestha, Jeffrey Pennington, Youngji Jo, Yeonsoo Baik, Shamiul Islam, Ahmadul Hasan Khan, Abu Jamil Faisel, Oscar Cordon, Tapash Roy, Pedro Suarez, Hamidah Hussain, David Dowdy

Research output: Contribution to journalArticlepeer-review


Purpose: Tuberculosis (TB) is geographically heterogeneous, and geographic targeting can improve the impact of TB interventions. However, standard TB notification data may not sufficiently capture this heterogeneity. Better understanding of patient reporting patterns (discrepancies between residence and place of presentation) may improve our ability to use notifications to appropriately target interventions. Methods: Using demographic data and TB reports from Dhaka North City Corporation and Dhaka South City Corporation, we identified wards of high TB incidence and developed a TB transmission model. We calibrated the model to patient-level data from selected wards under four different reporting pattern assumptions and estimated the relative impact of targeted versus untargeted active case finding. Results: The impact of geographically targeted interventions varied substantially depending on reporting pattern assumptions. The relative reduction in TB incidence, comparing targeted with untargeted active case finding in Dhaka North City Corporation, was 1.20, assuming weak correlation between reporting and residence, versus 2.45, assuming perfect correlation. Similar patterns were observed in Dhaka South City Corporation (1.03 vs. 2.08). Conclusions: Movement of individuals seeking TB diagnoses may substantially affect ward-level TB transmission. Better understanding of patient reporting patterns can improve estimates of the impact of targeted interventions in reducing TB incidence. Incorporating high-quality patient-level data is critical to optimizing TB interventions.

Original languageEnglish (US)
Pages (from-to)7-10
Number of pages4
JournalAnnals of epidemiology
StatePublished - Feb 2021


  • Tuberculosis heterogeneity
  • Tuberculosis in Dhaka
  • Tuberculosis patient-level reporting

ASJC Scopus subject areas

  • Epidemiology


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