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 language | English (US) |
---|---|
Pages (from-to) | 32-37 |
Number of pages | 6 |
Journal | International Journal of Tuberculosis and Lung Disease |
Volume | 16 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2012 |
Externally published | Yes |
Keywords
- New York City
- Seasonal variation
- Statistical models
- Trends
- Tuberculosis
ASJC Scopus subject areas
- Pulmonary and Respiratory Medicine
- Infectious Diseases