Spatio-temporal characteristics of Tuberculosis in Ghana

Abstract

Background Tuberculosis (TB) remains a key contributor to global mortality; ranks second as the most fatal infectious disease and seventh among the top ten causes of death in Ghana. There is insufficient literature regarding the utilization of Bayesian hierarchical models for examining the spatial and spatio-temporal dynamics of tuberculosis risk in Ghana. Aim This study addresses this gap by determining TB hotspots regions in Ghana using the Bayesian modeling framework. Methods TB data were obtained from the Ghana Health Service and National Tuberculosis Programme for the 10 administrative regions of Ghana, from 2008 to 2017. Spatial and spatio-temporal TB relative risk for each region were estimated under the Bayesian modeling frameworks. Maps for TB risks were created to visualized regions with TB hotspots. Model fitting and parameter estimation were conducted using integrated nested Laplace approximation via R version 4.3.2. Results Among the baseline predictors, TB cure rate, TB success rate, knowledge about TB, human immunodeficiency virus (HIV) prevalence, percentage of literacy, and high income were found to be most significant predictors of TB risk in Ghana. We noted an increased risk of TB infection in the Northern zone and the Eastern and Greater Accra regions in the Southern zone. Spatio-temporal distribution of TB infection risk was predominantly concentrated in the Southern zone. Clustering of TB risk was observed among neighboring regions. Conclusion Factors influencing tuberculosis (TB) risk in Ghana are TB cure rate, TB success rate, knowledge about TB, HIV prevalence, literacy rate, and income level. The risk distribution was mainly concentrated in the Southern zone, with clusters of TB risk observed among neighboring regions. To achieve a significant reduction in TB cases, it is essential to allocate resources to TB hotspots regions and also implement measures to control significant predictors of TB infection risk.