Spatiotemporal Distribution of Tuberculosis in the Oromia Region of Ethiopia: A Hotspot Analysis

Dereje Bekele; Solomon Aragie; Kefyalew Addis Alene; Tariku Dejene; Samson Warkaye; Melat Mezemir; Dereje Abdena; Tesfaye Kebebew; Abera Botore; Geremew Mekonen; Gadissa Gutema; Boja Dufera; Kolato Gemede; Birhanu Kenate; Dabesa Gobena; Bizuneh Alemu; Dagnachew Hailemariam; Daba Muleta; Gilman Kit Hang Siu; Ketema Tafess

doi:10.3390/tropicalmed8090437

Spatiotemporal Distribution of Tuberculosis in the Oromia Region of Ethiopia: A Hotspot Analysis

Trop Med Infect Dis. 2023 Sep 7;8(9):437. doi: 10.3390/tropicalmed8090437.

Authors

Dereje Bekele^{1

2}, Solomon Aragie², Kefyalew Addis Alene^{3

4}, Tariku Dejene⁵, Samson Warkaye⁶, Melat Mezemir⁷, Dereje Abdena¹, Tesfaye Kebebew⁸, Abera Botore⁸, Geremew Mekonen¹, Gadissa Gutema^{2

9}, Boja Dufera^{2

10}, Kolato Gemede¹, Birhanu Kenate⁸, Dabesa Gobena⁸, Bizuneh Alemu¹, Dagnachew Hailemariam¹, Daba Muleta⁸, Gilman Kit Hang Siu¹¹, Ketema Tafess^{12

13}

Affiliations

¹ Communicable and Non-Communicable Diseases Prevention and Control Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia.
² Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia.
³ Geospatial and Tuberculosis Team, Telethon Kids Institute, Perth, WA 6009, Australia.
⁴ School of Public Health, Faculty of Public Health Sciences, Curtin University, Perth, WA 6102, Australia.
⁵ Center for Population Studies, College of Development Studies, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia.
⁶ Ethiopian Public Health Institute, National Data Management Center for Health, Addis Ababa P.O. Box 1242, Ethiopia.
⁷ Health Promotion and Diseases Prevention Directorate, Addis Ababa City Administration Health Bureau, Addis Ababa P.O. Box 30738, Ethiopia.
⁸ Public Health Emergency Management, Research, and Blood Bank Service Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia.
⁹ National HIV/AIDS and TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia.
¹⁰ Bacterial, Parasitic, and Zoonotic Research Directorate, Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia.
¹¹ Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
¹² Department of Applied Biology, School of Applied Natural Science, Adama Science and Technology University, Adama P.O. Box 1888, Ethiopia.
¹³ Institute of Pharmaceutical Science, Adama Science and Technology University, Adama P.O. Box 1888, Ethiopia.

Abstract

Tuberculosis (TB) is a major public health concern in low- and middle-income countries including Ethiopia. This study aimed to assess the spatiotemporal distribution of TB and identify TB risk factors in Ethiopia's Oromia region. Descriptive and spatiotemporal analyses were conducted. Bayesian spatiotemporal modeling was used to identify covariates that accounted for variability in TB and its spatiotemporal distribution. A total of 206,278 new pulmonary TB cases were reported in the Oromia region between 2018 and 2022, with the lowest annual TB case notification (96.93 per 100,000 population) reported in 2020 (i.e., during the COVID-19 pandemic) and the highest TB case notification (106.19 per 100,000 population) reported in 2019. Substantial spatiotemporal variations in the distribution of notified TB case notifications were observed at zonal and district levels with most of the hotspot areas detected in the northern and southern parts of the region. The spatiotemporal distribution of notified TB incidence was positively associated with different ecological variables including temperature (β = 0.142; 95% credible interval (CrI): 0.070, 0.215), wind speed (β = -0.140; 95% CrI: -0.212, -0.068), health service coverage (β = 0.426; 95% CrI: 0.347, 0.505), and population density (β = 0.491; 95% CrI: 0.390, 0.594). The findings of this study indicated that preventive measures considering socio-demographic and health system factors can be targeted to high-risk areas for effective control of TB in the Oromia region. Further studies are needed to develop effective strategies for reducing the burden of TB in hotspot areas.

Keywords: Ethiopia; Oromia; TB case notification; spatiotemporal; tuberculosis.

Grants and funding

This research received no external funding.