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-9 : 96-08880755 : 6578876 : : :. : () ma.karami@umsha.ac.ir : 95/05/0 : 95/0/8 :. :. - 9 - - 4 :. / ( ). - :.. : - () - ).(6-4) (SaTScan -.(4) ( ).(7).() 05 ) / / 0-0 / 04 ) ( 48000.() ( (MDR) ١ Multi Drug Resistane; MDR

/ -. c C c : c C c I = I ( c ) C (c) c C (c). C-. [c]. ) P-value ( 4 Simulation#+١ R.(7)... ٢ Covariate ٣ Most likely cluster or primary cluster R P = ٤ + # simulation..(8) (). /. ) 057 (. 9//9 84/0/0 7. SaTscan SaTScan ver9. -... 90 85. (GIS) SaTScan ) ( ١ Geographic Information System; GIS

/4.(7) 84-9. - (9) ) (. /. :(0) ( ) % *00 ( ) P PAR P = + SaTscan. : (C) (c) C I C c C =. -. ().... 666 9) ( 7 / -... - /5. ) ( /08 4/86 = ) (. / /5. ).(

5/ - / - - 7/87 4/86 /5 7/4 6/ 8/47 /5 9/79 /576 0/9488 4/689 /770 4/099 5/9 /80 /08 /69 /65 / /97 /44 44/87 7/66 66/79 0/46 45/9 /84 7/96 79 06 75 94 4 00 86*89 89*9 86*89 86*89 87*90 86*89 86*89 () 64/99 54/9 5/80 ( ) 4 / 8/0 54/9 4/65 5/80 ( - -) (PAR%) - ( - -) /

/6 ) (. 89-9 88-89 86-89 ).( / 86-89 ).( ) (. / 0/9 / /. /. Yuhui (). Yiannakoulias.(8) SaTScan.().. - (). : (4). (5) ) (..(0-6) 85-90.().

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9/ - Iranian Journal of pidemiology Spring 07; (): -9. Original Article Spatiotemporal Analysis of Pulmonary Tuberculosis in Hamadan Province Using Population Attributable Risk Olfatifar M, Hosseini SM, Bahrami M, Karami M, Parvin M - Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran - PhD, Modeling of Non-Communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran -DDS Student, Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran Corresponding author: Karami M, ma.karami@umsha.ac.ir (Received 6 April 06; Accepted 0 Augest 06) Background and Objectives: One of the applications of population attributable risk percent (PAR%) is to estimate the disease burden in a population exposed to several risk factors. Therefore, this study was conducted to estimates the PAR% of the space-time clusters of pulmonary tuberculosis. Methods: In this study, the data of pulmonary TB cases were obtained from the health department of Hamadan University of Medical Sciences. After detecting significant clusters using the spatiotemporal scan statistic, PAR% was used to analyze the clusters and to detect the location of clusters more accurately. Results: Four primary space-time clusters and three secondary spatiotemporal clusters were detected for patients with pulmonary tuberculosis and 9% of the patients who did not have a clear state in term of HIV infection. Despite differences in the location of clusters and PAR% attributed to them, the second primary cluster of pulmonary tuberculosis cases (consisting of the cities of Razan, Famenain and Kabudrahang) had the highest amount of PAR% that needs more attention. Conclusion: The presence of significance spatiotemporal clusters in Hamadan highlights the necessity of the use of PAR% to distinguish cluster areas and to implement prevention and control policy. However, more analytical studies are needed to detect the on the determinants of the occurrence of pulmonary TB. Keywords: Spatial analysis, Population attributable risk, Pulmonary tuberculosis, Clustering