A Space-Time Scan Statistic for Detection of TB Outbreaks in the San Francisco Homeless Population
December 2006
Brandon W. Higgs, The MITRE Corporation
Mojdeh Mohtashemi, The MITRE Corporation, MIT Department of Computer Science
Jennifer Grinsdale, TB Control Section, San Francisco Dept. of Public Health
L. Masae Kawamura, TB Control Section, San Francisco Dept. of Public Health
ABSTRACT
San Francisco (SF) has the highest rate of TB in the US. Although in recent years the
incidence of TB has been declining in the general population, it appears relatively
constant in the homeless population. In this paper, we present a spatio-temporal outbreak
detection technique applied to the time series and geospatial data obtained from extensive
contact and laboratory investigation on TB cases in the SF homeless population. We
examine the sensitivity of this algorithm to spatial resolution using zip codes and census
tracts, and demonstrate the effectiveness of it by identifying outbreaks that are localized
in time and space but otherwise cannot be detected using temporal detection alone.

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