TY - JOUR T1 - Spatial and temporal projections of the prevalence of active tuberculosis in Cambodia JF - BMJ Global Health DO - 10.1136/bmjgh-2018-001083 VL - 4 IS - 1 SP - e001083 AU - Kiesha Prem AU - Sok Heng Pheng AU - Alvin Kuo Jing Teo AU - Konstantin Evdokimov AU - Ei Ei Khaing Nang AU - Li Yang Hsu AU - Vonthanak Saphonn AU - Sivanna Tieng AU - Tan Eang Mao AU - Alex R Cook Y1 - 2019/01/01 UR - http://gh.bmj.com/content/4/1/e001083.abstract N2 - Introduction Cambodia is among the 30 highest burden of tuberculosis (TB) countries. Active TB prevalence has been estimated using nationally representative multistage sampling that represents urban, rural and remote parts of the country, but the prevalence in non-sampled communes remains unknown. This study uses geospatial Bayesian statistics to estimate point prevalence across Cambodia, and demographic modelling that accounts for secular trends in fertility, mortality, urbanisation and prevalence rates to project the future burden of active TB.Methods A Bayesian hierarchical model was developed for the 2011 National Tuberculosis Prevalence survey to estimate the differential effect of age, sex and geographic stratum on active TB prevalence; these estimates were then married with high-resolution geographic information system layers to project prevalence across Cambodia. Future TB projections under alternative scenarios were then derived by interfacing these estimates with an individual-based demographic model.Results Strong differences in risk by age and sex, together with geographically varying population structures, yielded the first estimated prevalence map at a 1 km scale. The projected number of active TB cases within the catchment area of each existing government healthcare facility was derived, together with projections to the year 2030 under three scenarios: no future improvement, c ontinual r eduction and GDP projection.Conclusion Synthesis of health and geographic data allows likely disease rates to be mapped at a high resolution to facilitate resource planning, while demographic modelling allows scenarios to be projected, demonstrating the need for the acceleration of control efforts to achieve a substantive impact on the future burden of TB in Cambodia. ER -