Conglomerados geoespaciales de alto riesgo de tuberculosis pulmonar en Cali, Colombia: un análisis espaciotemporal

Introduction: Identifying high-risk areas for pulmonary tuberculosis (PTB) allows for directing public health interventions towards the most vulnerable groups and locations with higher transmission. Objective: To determine the spatiotemporal distribution of individuals aged ≥15 years affected by PTB in Cali, Colombia, and describe their epidemiological characteristics. Methods: Observational and ecological study. Subjects with confirmed active PTB between 2010 and 2017 were included. Geographic information analyses were conducted in ArcGIS Desktop, presenting heat maps with Kernel Density analysis, and Gi* Getis-Ord was used for hotspot analysis. Additionally, their epidemiological characteristics are described. Results: TBP affected people throughout the Cali area, but high-risk clusters that persisted over time were identified in the central and east-central regions, where most cases of loss to follow-up and mortality were also concentrated. The average incidence was 40.2 cases/100,000 inhabitants, with a therapeutic success rate of 72%. Males (63.3%) and the age group 19 to 69 years (76%) were the most affected. 16.5% of patients were lost to follow-up, 1.9% experienced treatment failure, and 5.2% died. Conclusion: Two critical areas of PTB concentration (center and center-east of Cali) were identified, where social vulnerability converges. Additionally, a low treatment success rate compared to the 85% target was observed. We recommend implementing comprehensive strategies throughout the city, prioritizing the critical areas.