Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level
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 separa...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Hindawi Limited
2023-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2023/5191252 |
| _version_ | 1797945527249141760 |
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| author | Leta Lencha Gemechu Legesse Kassa Debusho |
| author_facet | Leta Lencha Gemechu Legesse Kassa Debusho |
| author_sort | Leta Lencha Gemechu |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T20:57:33Z |
| format | Article |
| id | doaj.art-3c7548d3bbc94669903eea415869ec67 |
| institution | Directory Open Access Journal |
| issn | 2090-1259 |
| language | English |
| last_indexed | 2024-04-10T20:57:33Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | AIDS Research and Treatment |
| spelling | doaj.art-3c7548d3bbc94669903eea415869ec672023-01-23T00:56:09ZengHindawi LimitedAIDS Research and Treatment2090-12592023-01-01202310.1155/2023/5191252Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts LevelLeta Lencha Gemechu0Legesse Kassa Debusho1Department of StatisticsDepartment of StatisticsBackground. 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.http://dx.doi.org/10.1155/2023/5191252 |
| spellingShingle | Leta Lencha Gemechu Legesse Kassa Debusho Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level AIDS Research and Treatment |
| title | Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level |
| title_full | Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level |
| title_fullStr | Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level |
| title_full_unstemmed | Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level |
| title_short | Spatial Clustering of Tuberculosis-HIV Coinfection in Ethiopia at Districts Level |
| title_sort | spatial clustering of tuberculosis hiv coinfection in ethiopia at districts level |
| url | http://dx.doi.org/10.1155/2023/5191252 |
| work_keys_str_mv | AT letalenchagemechu spatialclusteringoftuberculosishivcoinfectioninethiopiaatdistrictslevel AT legessekassadebusho spatialclusteringoftuberculosishivcoinfectioninethiopiaatdistrictslevel |