Mapping Geographical Coordinates for Paediatric Tuberculosis Cases in Ukraine

Background: The incidence of tuberculosis in Ukraine is the second highest in Europe, but increasingly affected pediatric populations have received relatively little attention. In 2015, the Ukrainian government mandated universal reporting of TB using the “e-TB Manager” database.

Objective: Our aim is to analyze the geographic distribution of pediatric tuberculosis patients using Geographic Information System (GIS) to identify hotspots in Ukraine. This will serve to identify areas with increased incidence so as to appropriately direct efforts to reduce disease burden and prevent spread into European Union member states.

Methods: We identified all children

Results: Our assessment of the spatial distributions of pediatric tuberculosis cases has revealed significant heterogeneity, including several areas of notably increased incidence. These population-density-adjusted clusters include Ukraine’s central-southern districts, with the exception of the capital of Kyiv. The strikingly low disease burdens in several eastern districts overlap with areas of inconsistent national government control and raise suspicion for lack of reporting in separatist-controlled regions.

Conclusion: Owing to now universal reporting of pediatric tuberculosis cases in Ukraine, GIS technology may be a useful tool for identifying specific areas of high rates of transmission. We believe that determining which areas are at increased risk for future outbreaks will allow for effective, targeted interventions that may decrease morbidity and mortality in vulnerable pediatric populations. This in turn may prevent the spread of pediatric tuberculosis from Ukraine to Poland, Germany, and other EU Members.