Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level

• Published in: AIDS research and treatment Vol. 2023; pp. 5191252 - 14
• Main Authors: Gemechu, Leta Lencha, Debusho, Legesse Kassa
• Format: Journal Article
• Language: English
• Published: United States Hindawi 13-01-2023; John Wiley & Sons, Inc; Hindawi Limited
• Subjects: Analysis; Collaboration; Comorbidity; Epidemics; Epidemiology; Ethiopia; HIV; HIV (Viruses); HIV infection; HIV patients; Human immunodeficiency virus; Somalia; Tuberculosis; Somalia; Ethiopia; Sub-Saharan Africa
• ISSN: 2090-1240; 2090-1259
• DOI: 10.1155/2023/5191252

Background. Tuberculosis (TB) is a preventable and treatable disease but it is the leading cause of death among people living with HIV (PLHIV). In addition, the emergence of the HIV pandemic has also had a major impact on TB incidence rates. There are studies in spatial patterns of TB and HIV separately in Ethiopia; there is, however, no information on spatial patterns of TB-HIV coinfection in the country at the districts level at least using yearly data. This paper, therefore, aimed at determining the spatial clustering of TB-HIV coinfection prevalence rates in the country at the districts level on an annual basis over a four-year period, 2015–2018. Methods. District-level aggregated data on the number of TB-HIV infections were obtained from the Ethiopian Federal Ministry of Health for 2015 to 2018. The univariate and bivariate global Moran’s index, Getis-Ord Gi∗ local statistic, a chi-square test, and a modified t-test statistic for Spearman’s correlation coefficient were used to evaluate the spatial clustering and spatial heterogeneity of TB among PLHIV and HIV among TB patients prevalence rates. Results. The district-level prevalence rate of HIV among TB patients was positively and significantly spatially autocorrelated with global Moran’s I values range between 0.021 and 0.134 (p value <0.001); however, the prevalence of TB among PLHIV was significant only for 2015 and 2017 (p value <0.001). Spearman’s correlation also shows there was a strong positive association between the two prevalence rates over the study period. The local indicators of spatial analysis using the Getis–Ord statistic revealed that hot-spots for TB among PLHIV and HIV among TB patients have appeared in districts of various regions and the two city administrations in the country over the study period; however, the geographical distribution of hotspots varies over the study period. Similar trends were also observed for the cold-spots except for 2017 and 2018 where there were no cold-spots for TB among PLHIV. Conclusions. The study presents detailed knowledge about the spatial clustering of TB-HIV coinfection in Ethiopia at the districts level, and the results could provide information for planning coordinated district-specific interventions to jointly control both diseases in Ethiopia.