@article{fdi:010078025,
  title = {{D}oes sunlight drive seasonality of {TB} in {V}ietnam ? {A} retrospective environmental ecological study of tuberculosis seasonality in {V}ietnam from 2010 to 2015},
  author = {{B}onell, {A}. and {C}ontamin, {L}ucie and {T}hai, {P}. {Q}. and {T}huy, {H}. {T}. {T}. and van {D}oorn, {H}. {R}. and {W}hite, {R}. and {N}adjm, {B}. and {C}hoisy, {M}arc},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {T}uberculosis ({TB}) is a major global health burden, with an estimated quarter of the world's population being infected. {T}he {W}orld {H}ealth {O}rganization ({WHO}) launched the "{E}nd {TB} {S}trategy" in 2014 emphasising knowing the epidemic. {WHO} ranks {V}ietnam 12th in the world of high burden countries. {TB} spatial and temporal patterns have been observed globally with evidence of {V}itamin {D} playing a role in seasonality. {W}e explored the presence of temporal and spatial clustering of {TB} in {V}ietnam and their determinants to aid public health measures. {M}ethods {D}ata were collected by the {N}ational {TB} program of {V}ietnam from 2010 to 2015 and linked to the following datasets: socio-demographic characteristics; climatic variables; influenza-like-illness ({ILI}) incidence; geospatial data. {T}he {TB} dataset was aggregated by province and quarter. {D}escriptive time series analyses using {LOESS} regression were completed per province to determine seasonality and trend. {H}armonic regression was used to determine the amplitude of seasonality by province. {A} mixed-effect linear model was used with province and year as random effects and all other variables as fixed effects. {R}esults {T}here were 610,676 cases of {TB} notified between 2010 and 2015 in {V}ietnam. {H}eat maps of {TB} incidence per quarter per province showed substantial temporal and geospatial variation. {T}ime series analysis demonstrated seasonality throughout the country, with peaks in spring/summer and troughs in autumn/winter. {I}ncidence was consistently higher in the south, the three provinces with the highest incidence per 100,000 population were {T}ay {N}inh, {A}n {G}iang and {H}o {C}hi {M}inh {C}ity. {H}owever, relative seasonal amplitude was more pronounced in the north. {M}ixed-effect linear model confirmed that {TB} incidence was associated with time and latitude. {O}f the demographic, socio-economic and health related variables, population density, percentage of those under 15 years of age, and {HIV} infection prevalence per province were associated with {TB} incidence. {O}f the climate variables, absolute humidity, average temperature and sunlight were associated with {TB} incidence. {C}onclusion {P}reventative public health measures should be focused in the south of {V}iet {N}am where incidence is highest. {V}itamin {D} is unlikely to be a strong driver of seasonality but supplementation may play a role in a package of interventions.},
  keywords = {{T}uberculosis ; {S}easonality ; {M}eteorological ; {S}unshine ; {V}ietnam ; {VIET} {NAM}},
  booktitle = {},
  journal = {{BMC} {I}nfectious {D}iseases},
  volume = {20},
  numero = {1},
  pages = {art. 184 [11 p.]},
  year = {2020},
  DOI = {10.1186/s12879-020-4908-0},
  URL = {https://www.documentation.ird.fr/hor/fdi:010078025},
}