Spatial patterns of tuberculosis in Aceh Province during the COVID-19 pandemic: a geospatial autocorrelation assessment

Abstract

Abstract Tuberculosis remains a significant global health challenge, especially during the COVID-19 pandemic. In Aceh Province, where tuberculosis incidence has reached alarming levels, understanding the spatial distribution of cases is crucial for effective interventions. This study aimed to assess the spatial autocorrelation of tuberculosis incidence during the COVID-19 pandemic in 23 districts of Aceh Province, Indonesia. Using an ecological study, we analysed secondary data of the reported tuberculosis cases in Aceh Province covering 2020 to 2022. We use the Shapiro-Wilk test to evaluate the normality and the Kruskal-Wallis test to compare the differences between study periods. Spatial autocorrelation was evaluated at both global and local levels using Moran’s I and Getis-Ord statistics, respectively. The study included 24,715 tuberculosis cases, revealing that the district with the highest incidence differed in each year. The study showed that TB case in Aceh Province was not normally distributed yet different for each study period. Surprisingly, the global spatial autocorrelation was detected only in 2022 (p-value = 0.013). However, local spatial autocorrelation identified Pidie Jaya, Lhokseumawe, Aceh Utara and Bener Meriah as statistically significant hot-spots for 3 consecutive years. It suggests that the tuberculosis incidence in most districts did not significantly influence the incidence of tuberculosis in its neighbours. These findings contribute to our understanding of tuberculosis distribution and offer valuable insights for public health planning and resource allocation.