The identification and spatial distribution of hotspots of tuberculosis occurrence in South Africa

Objective: Prior research has shown strong evidence of spatial clustering of tuberculosis across a range of contexts. Identifying the spatial patterning of infectious diseases such as tuberculosis is crucial as it allows for targeted intervention strategies, directing healthcare resources efficiently to areas where tuberculosis incidence is concentrated. This is especially true for low- and middle-income countries that typically experience greater resource constraints relative to their Global North counterparts. In this study, we extend existing literature by investigating the spatial patterning of tuberculosis among vulnerable communities in South Africa, notably in the relatively under-researched provinces of the North-West and Gauteng.

Results: Data for this study were collected from several locations implementing community-oriented primary care in the country. Community health workers used AitaHealth™, a custom-built mobile information management application, to obtain data on tuberculosis status and environmental conditions of households. We find notable clusters of tuberculosis in these provinces which we speculate could be associated with urban formal and informal settlement densification and overcrowding, the incidence of mining activities prevalent in sampled locations and poor access to healthcare.