Seasonality of tuberculosis in New York City, 1990-2007

Christina M. Parrinello, A. Crossa, T. G. Harris

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

SETTING: Several non-US-based studies have found seasonal fluctuations in the incidence of tuberculosis (TB). OBJECTIVE: The current study examined patterns of TB seasonality for New York City verified TB cases from January 1990 to December 2007. DESIGN: Autocorrelation functions and Fourier analysis were used to detect a cyclical pattern in monthly incidence rates. Analysis of variance was used to compare seasonal mean case proportions. RESULTS: A cyclical pattern was detected every 12 months. Of the 34 004 TB cases included, 21.9% were in the fall (September-November), 24.7% in winter (December-February), 27.3% in spring (March-May), and 26.1% in the summer (June-August). The proportion of cases was lowest in fall (P <0.0001) and highest in the spring (P <0.0002). CONCLUSION: Possible explanations for seasonal variations in TB incidence include lower vitamin D levels in winter, leading to immune suppression and subsequent reactivation of latent TB; indoor winter crowding, increasing the likelihood of TB transmission; and providers attributing TB symptoms to other respiratory illnesses in winter, resulting in a delay in TB diagnosis until spring. Understanding TB seasonality may help TB programs better plan and allocate resources for TB control activities.

Original languageEnglish (US)
Pages (from-to)32-37
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume16
Issue number1
DOIs
StatePublished - Jan 2012
Externally publishedYes

Fingerprint

Tuberculosis
Incidence
Latent Tuberculosis
Fourier Analysis
Vitamin D
Analysis of Variance

Keywords

  • New York City
  • Seasonal variation
  • Statistical models
  • Trends
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Seasonality of tuberculosis in New York City, 1990-2007. / Parrinello, Christina M.; Crossa, A.; Harris, T. G.

In: International Journal of Tuberculosis and Lung Disease, Vol. 16, No. 1, 01.2012, p. 32-37.

Research output: Contribution to journalArticle

Parrinello, Christina M. ; Crossa, A. ; Harris, T. G. / Seasonality of tuberculosis in New York City, 1990-2007. In: International Journal of Tuberculosis and Lung Disease. 2012 ; Vol. 16, No. 1. pp. 32-37.
@article{67aa5de32f4545d1965c17a570840b7d,
title = "Seasonality of tuberculosis in New York City, 1990-2007",
abstract = "SETTING: Several non-US-based studies have found seasonal fluctuations in the incidence of tuberculosis (TB). OBJECTIVE: The current study examined patterns of TB seasonality for New York City verified TB cases from January 1990 to December 2007. DESIGN: Autocorrelation functions and Fourier analysis were used to detect a cyclical pattern in monthly incidence rates. Analysis of variance was used to compare seasonal mean case proportions. RESULTS: A cyclical pattern was detected every 12 months. Of the 34 004 TB cases included, 21.9{\%} were in the fall (September-November), 24.7{\%} in winter (December-February), 27.3{\%} in spring (March-May), and 26.1{\%} in the summer (June-August). The proportion of cases was lowest in fall (P <0.0001) and highest in the spring (P <0.0002). CONCLUSION: Possible explanations for seasonal variations in TB incidence include lower vitamin D levels in winter, leading to immune suppression and subsequent reactivation of latent TB; indoor winter crowding, increasing the likelihood of TB transmission; and providers attributing TB symptoms to other respiratory illnesses in winter, resulting in a delay in TB diagnosis until spring. Understanding TB seasonality may help TB programs better plan and allocate resources for TB control activities.",
keywords = "New York City, Seasonal variation, Statistical models, Trends, Tuberculosis",
author = "Parrinello, {Christina M.} and A. Crossa and Harris, {T. G.}",
year = "2012",
month = "1",
doi = "10.5588/ijtld.11.0145",
language = "English (US)",
volume = "16",
pages = "32--37",
journal = "International Journal of Tuberculosis and Lung Disease",
issn = "1027-3719",
publisher = "International Union against Tubercul. and Lung Dis.",
number = "1",

}

TY - JOUR

T1 - Seasonality of tuberculosis in New York City, 1990-2007

AU - Parrinello, Christina M.

AU - Crossa, A.

AU - Harris, T. G.

PY - 2012/1

Y1 - 2012/1

N2 - SETTING: Several non-US-based studies have found seasonal fluctuations in the incidence of tuberculosis (TB). OBJECTIVE: The current study examined patterns of TB seasonality for New York City verified TB cases from January 1990 to December 2007. DESIGN: Autocorrelation functions and Fourier analysis were used to detect a cyclical pattern in monthly incidence rates. Analysis of variance was used to compare seasonal mean case proportions. RESULTS: A cyclical pattern was detected every 12 months. Of the 34 004 TB cases included, 21.9% were in the fall (September-November), 24.7% in winter (December-February), 27.3% in spring (March-May), and 26.1% in the summer (June-August). The proportion of cases was lowest in fall (P <0.0001) and highest in the spring (P <0.0002). CONCLUSION: Possible explanations for seasonal variations in TB incidence include lower vitamin D levels in winter, leading to immune suppression and subsequent reactivation of latent TB; indoor winter crowding, increasing the likelihood of TB transmission; and providers attributing TB symptoms to other respiratory illnesses in winter, resulting in a delay in TB diagnosis until spring. Understanding TB seasonality may help TB programs better plan and allocate resources for TB control activities.

AB - SETTING: Several non-US-based studies have found seasonal fluctuations in the incidence of tuberculosis (TB). OBJECTIVE: The current study examined patterns of TB seasonality for New York City verified TB cases from January 1990 to December 2007. DESIGN: Autocorrelation functions and Fourier analysis were used to detect a cyclical pattern in monthly incidence rates. Analysis of variance was used to compare seasonal mean case proportions. RESULTS: A cyclical pattern was detected every 12 months. Of the 34 004 TB cases included, 21.9% were in the fall (September-November), 24.7% in winter (December-February), 27.3% in spring (March-May), and 26.1% in the summer (June-August). The proportion of cases was lowest in fall (P <0.0001) and highest in the spring (P <0.0002). CONCLUSION: Possible explanations for seasonal variations in TB incidence include lower vitamin D levels in winter, leading to immune suppression and subsequent reactivation of latent TB; indoor winter crowding, increasing the likelihood of TB transmission; and providers attributing TB symptoms to other respiratory illnesses in winter, resulting in a delay in TB diagnosis until spring. Understanding TB seasonality may help TB programs better plan and allocate resources for TB control activities.

KW - New York City

KW - Seasonal variation

KW - Statistical models

KW - Trends

KW - Tuberculosis

UR - http://www.scopus.com/inward/record.url?scp=84555194796&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84555194796&partnerID=8YFLogxK

U2 - 10.5588/ijtld.11.0145

DO - 10.5588/ijtld.11.0145

M3 - Article

VL - 16

SP - 32

EP - 37

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

SN - 1027-3719

IS - 1

ER -