Spatial analysis of tuberculosis and risk factors at the lowest administrative level in Nigeria

Abstract

BACKGROUND
Few studies have utilized modern techniques of spatial data analysis to understand the distribution of tuberculosis (TB) and its possible predictors. In 2013, an estimated 9 million new TB cases and 1.5 million deaths occurred worldwide, out of which 360,000 deaths were HIV related.

AIM
To assist in planning key interventions for the control of TB at a sub-national level, the studysought to explore the spatial distribution of TB and associated risk factors at the lowest administrative level in Nigeria.

METHODOLOGY
This was an ecological study carried out using number of notified TB cases for the 774 Local Government Areas (LGAs) in 2013. Bayesian spatial regression analysis was conducted to identify high-risk clusters of the disease and to assess associated factors .

RESULTS
Analysis revealed that TB was significantly clustered in 138 (17%) LGAs. Significant associations were found with household size, urban residence, access to transportation, population density, number of TB diagnostic services. Other predictors, including a composite index of socioeconomic status, living in a single room, number of TB treatment centres, and total health facilities in the LGA were not significantly associated with TB incidence.

CONCLUSION
The study identified LGAs with elevated risk as well as significant factors associated with TB. This information can assist policymakers in rationally planning targeted specific interventions with the potential to effectively control TB in the country.