Early Detection of Tuberculosis Outbreaks Among the San Francisco Homeless: Trade-offs Between Spatial Resolution and Temporal Scale
March 2007
B.W. Higgs, The MITRE Corporation
M. Mohtashemi, The MITRE Corporation
J. Grinsdale, The MITRE Corporation
L.M. Kawamura, The MITRE Corporation
ABSTRACT
San Francisco has the highest rate of tuberculosis (TB) in the US. Exact locations of
patients' primary residences at the time of diagnoses are routinely collected as part of the
TB surveillance program. It has been shown for syndromic surveillance data that when
exact geographic coordinates of individual patients are used, higher detection rates and
accuracy are achieved compared to when data are aggregated into administrative regions
such as zip codes and census tracts. Here, we examine the effect of varying the spatial
resolution in the TB data on the San Francisco homeless population, on detection
sensitivity, timeliness, and the amount of historical data needed to achieve better
performance measures.
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