Mapping tuberculosis prevalence in Ethiopia: protocol for a geospatial meta-analysis

Alene, Kefyalew Addis; Wagaw, Zeleke Alebachew; Clements, Archie C. A.

doi:10.1136/bmjopen-2019-034704

Cited by 11 publications

(16 citation statements)

References 28 publications

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“…The main result of the study indicates geographical clustering of TB in Hunan Province, which was significantly associated with climatic and health care access factors. Similar spatial clustering of TB was reported in previous studies conducted in China [ 14 , 18 , 19 ] and other high-TB burden countries such as Peru [ 20 ], Ethiopia [ 21 , 22 ], and India [ 23 ]. There could be several reasons for the observed spatial clustering of TB.…”

Section: Discussionsupporting

confidence: 85%

Spatiotemporal Patterns of Tuberculosis in Hunan Province, China

Alene

Bai

et al. 2021

IJERPH

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Tuberculosis (TB) is the leading cause of death from a bacterial pathogen worldwide. China has the third highest TB burden in the world, with a high reported burden in Hunan Province (amongst others). This study aimed to investigate the spatial distribution of TB and identify socioeconomic, demographic, and environmental drivers in Hunan Province, China. Numbers of reported cases of TB were obtained from the Tuberculosis Control Institute of Hunan Province, China. A wide range of covariates were collected from different sources, including from the Worldclim database, and the Hunan Bureau of Statistics. These variables were summarized at the county level and linked with TB notification data. Spatial clustering of TB was explored using Moran’s I statistic and the Getis–Ord statistic. Poisson regression models were developed with a conditional autoregressive (CAR) prior structure, and with posterior parameters estimated using a Bayesian approach with Markov chain Monte Carlo (MCMC) simulation. A total of 323,340 TB cases were reported to the Hunan TB Control Institute from 2013 to 2018. The mean age of patients was 51.7 years (SD + 17.6 years). The majority of the patients were male (72.6%, n = 234,682) and had pulmonary TB (97.5%, n = 315,350). Of 319,825 TB patients with registered treatment outcomes, 306,107 (95.7%) patients had a successful treatment outcome. The annual incidence of TB decreased over time from 85.5 per 100,000 population in 2013 to 76.9 per 100,000 population in 2018. TB case numbers have shown seasonal variation, with the highest number of cases reported during the end of spring and the beginning of summer. Spatial clustering of TB incidence was observed at the county level, with hotspot areas detected in the west part of Hunan Province. The spatial clustering of TB incidence was significantly associated with low sunshine exposure (RR: 0.86; 95% CrI: 0.74, 0.96) and a low prevalence of contraceptive use (RR: 0.88; 95% CrI: 0.79, 0.98). Substantial spatial clustering and seasonality of TB incidence were observed in Hunan Province, with spatial patterns associated with environmental and health care factors. This research suggests that interventions could be more efficiently targeted at locations and times of the year with the highest transmission risk.

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Section: Discussionsupporting

confidence: 85%

Spatiotemporal Patterns of Tuberculosis in Hunan Province, China

Alene

Bai

et al. 2021

IJERPH

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“…In another study we have investigated supplementing the national survey on TB with data from other studies, using a geospatial meta-analytic approach. 22 …”

Section: Discussionmentioning

confidence: 99%

“…A detailed description of the survey is provided elsewhere. 22 Briefly, it was the first nationally representative TB survey conducted in Ethiopia. The survey was conducted between 2010 and 2011, with 85 clusters included in the survey, including 14 clusters in urban areas, 63 clusters in rural areas and 8 clusters in pastoralist areas.…”

Section: Methodsmentioning

confidence: 99%

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Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia

et al. 2022

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BackgroundHIV, tuberculosis (TB) and malaria are the three most important infectious diseases in Ethiopia, and sub-Saharan Africa. Understanding the spatial codistribution of these diseases is critical for designing geographically targeted and integrated disease control programmes. This study investigated the spatial overlap and drivers of HIV, TB and malaria prevalence in Ethiopia.MethodsHIV, TB and malaria data were obtained from different nationwide prevalence surveys, and geospatial covariates were obtained from publicly available sources. A Bayesian model-based geostatistical framework was applied to each survey leveraging the strength of high-resolution spatial covariates to predict continuous disease-specific prevalence surfaces and their codistribution.ResultsThe national prevalence was 1.54% (95% CI 1.40 to 1.70) for HIV, 0.39% (95% CI 0.34 to 0.45) for TB and 1.1% (95%CI 0.95 to 1.32) for malaria. Substantial subnational variation was predicted with the highest HIV prevalence estimated in Gambela (4.52%), Addis Ababa (3.52%) and Dire Dawa (2.67%) regions. TB prevalence was highest in Dire Dawa (0.96%) and Gambela (0.88%), while malaria was highest in Gambela (6.1%) and Benishangul-Gumuz (3.8%). Spatial overlap of their prevalence was observed in some parts of the country, mainly Gambela region. Spatial distribution of the diseases was significantly associated with healthcare access, demographic, and climatic factors.ConclusionsThe national distribution of HIV, TB and malaria was highly focal in Ethiopia, with substantial variation at subnational and local levels. Spatial distribution of the diseases was significantly associated with healthcare access, demographic and climatic factors. Spatial overlap of HIV, TB and malaria prevalence was observed in some parts of the country. Integrated control programmes for these diseases should be targeted to these areas with high levels of co-endemicity.

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“…Despite the several efforts and achievements in the control of TB, the disease is among the major public health problems in the country with an estimated mortality of 24 cases/10,000 population. One of the major reasons for the unabated TB challenge is the uneven distribution of the disease across the country [ 2 ]. Particularly, the heterogeneous prevalence of smear-positive TB in small geographic areas such as districts substantially affects the transmission dynamics and control efforts.…”

Section: Introductionmentioning

confidence: 99%

Spatial clustering and genetic diversity of Mycobacterium tuberculosis isolate among pulmonary tuberculosis suspected patients, Arsi Zone, Ethiopia

Tafess

Beyen²,

Girma

et al. 2021

BMC Pulm Med

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Background Tuberculosis remains a serious public health concern globally. The enormous social, economic, and health impacts of the diseases are attributed to the lack of updated data on the prevalence, geospatial distribution, population structures, and genotypic variants of the circulating M. tuberculosis. Methods Structured questionnaire, mycobacterial culture, and standard 24-Mycobacterial Interspersed Repeated Units-Variable Number Tandem Repeats (MIRU-VNTR) were employed to collect sociodemographic characters, residence linked information, and genotype the isolates. The retrospective discrete Bernoulli model was used to identify the hot spot districts of sputum smear positivity, and Web-based Miru-VNTRPlus were used for the identification of lineages and sublineages. Results Out of 832 presumptive pulmonary tuberculosis (PTB) suspects, 119 (14.3%) were smear-positive. In the multivariate binary logistic model, PTB suspected patients in the age groups of 7–25 and 25–34 and those from rural residents were 4.53 (AOR = 4.53; 95% CI 2.25–9.13), 3.00 (AOR = 3.00; 95% CI 1.41–6.35) and 1.65 (AOR = 1.65; 95% CI 1.01–2.70) times at higher risk of turning smear-positive. Eleven (47.8%) districts of Arsi Zone were shown to have a high rate of clustering (RR = 2.27; 95% CI 1.62–3.2) of smear-positive PTB. Of 72 isolates queried for the lineage assignment, 59 (81.9%) were classified into the previously known lineages and 13 (18.1%) were not assigned to any known lineages. Overall, 42 (58.3%) belong to M. tuberculosis lineage 4 (Euro-American), 16 (22.2%) M. tuberculosis lineage 3 (Delhi/CAS), and 1 (1.4%) M. tuberculosis Lineage 1 (Indo-Oceanic/ East Africa Indian). Further classification to the sublineage indicates that the predominant lineage was Delhi/CAS comprising 16 (22.2%) isolates followed by 15 (20.8%) isolates belonging to Haarlem. The remaining isolates were distributed as 13 (18.1%) TUR, 6 (8.3%) LAM, 4 (5.5%) URAL, 4 (4.5%) NEW-1 and 1 (1.4%) EAI. Conclusion Our study showed higher smear-positive results among PTB suspected patients and remarkable spatial variation across districts of Arsi Zone in smear-positive PTB. This information together with the genotypic features could be used as input for the efforts of designing control strategies.

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Mapping tuberculosis prevalence in Ethiopia: protocol for a geospatial meta-analysis

Cited by 11 publications

References 28 publications

Spatiotemporal Patterns of Tuberculosis in Hunan Province, China

Spatiotemporal Patterns of Tuberculosis in Hunan Province, China

Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia

Spatial clustering and genetic diversity of Mycobacterium tuberculosis isolate among pulmonary tuberculosis suspected patients, Arsi Zone, Ethiopia

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