A Spatial Analysis of Tuberculosis Related Mortality in South Africa

<i>Background:</i> South Africa, with an estimated annual tuberculosis (TB) incidence of 360,000 cases in 2019, remains one of the countries with the largest burden of TB in the world. The identification of highly burdened TB areas could support public health policy planners to optimally...

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Autores principales:	Dan Kibuuka, Charles Mpofu, Penny Neave, Samuel Manda
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	tuberculosis mortality age-sex-standardised autocorrelation spatial analysis hot spot analysis Medicine R
Acceso en línea:	https://doaj.org/article/21e0b63ff7dd4f3e8aee8c0f8cda2f5a
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spelling	oai:doaj.org-article:21e0b63ff7dd4f3e8aee8c0f8cda2f5a2021-11-25T17:49:02ZA Spatial Analysis of Tuberculosis Related Mortality in South Africa10.3390/ijerph1822118651660-46011661-7827https://doaj.org/article/21e0b63ff7dd4f3e8aee8c0f8cda2f5a2021-11-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/22/11865https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601<i>Background:</i> South Africa, with an estimated annual tuberculosis (TB) incidence of 360,000 cases in 2019, remains one of the countries with the largest burden of TB in the world. The identification of highly burdened TB areas could support public health policy planners to optimally target resources and TB control and prevention interventions. <i>Objective:</i> To investigate the spatial epidemiology and distribution of TB mortality in South Africa in 2010 and its association with area-level poverty and HIV burden. <i>Methods:</i> The study analysed a total of 776,176 TB deaths for the period 2005–2015. Local and global and spatial clustering of TB death rates were investigated by Global and Local Moran’s Indices methods (Moran’s I). The spatial regression analysis was employed to assess the effect of poverty and HIV on TB mortality rates. <i>Results:</i> There was a significant decrease in TB mortality rate, from 179 per 100,000 population in 2005 to 60 per 100,000 population in 2015. The annual TB mortality rate was higher among males (161.5 per 100,000 male population; (95% confidence interval (CI) 132.9, 190.0) than among females (123.2 per 100,000 female population; (95% CI 95.6, 150.8)). The 35–44 age group experienced higher TB mortality rates, regardless of gender and time. Hot spot clusters of TB mortality were found in the South-Eastern parts of the country, whereas cold spot clusters were largely in the north-eastern parts. Tuberculosis death rates were positively associated with poverty, as measured by the South African Multidimension Poverty Index (SAMPI) as well TB death rates in the neighbouring districts. <i>Conclusion:</i> The findings of this study revealed a statistically significant decrease in TB deaths and a disproportionate distribution of TB deaths among certain areas and population groups in South Africa. The existence of the identified inequalities in the burden of TB deaths calls for targeted public health interventions, policies, and resources to be directed towards the most vulnerable populations in South Africa.Dan KibuukaCharles MpofuPenny NeaveSamuel MandaMDPI AGarticletuberculosismortalityage-sex-standardisedautocorrelationspatial analysishot spot analysisMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11865, p 11865 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tuberculosis mortality age-sex-standardised autocorrelation spatial analysis hot spot analysis Medicine R
spellingShingle	tuberculosis mortality age-sex-standardised autocorrelation spatial analysis hot spot analysis Medicine R Dan Kibuuka Charles Mpofu Penny Neave Samuel Manda A Spatial Analysis of Tuberculosis Related Mortality in South Africa
description	<i>Background:</i> South Africa, with an estimated annual tuberculosis (TB) incidence of 360,000 cases in 2019, remains one of the countries with the largest burden of TB in the world. The identification of highly burdened TB areas could support public health policy planners to optimally target resources and TB control and prevention interventions. <i>Objective:</i> To investigate the spatial epidemiology and distribution of TB mortality in South Africa in 2010 and its association with area-level poverty and HIV burden. <i>Methods:</i> The study analysed a total of 776,176 TB deaths for the period 2005–2015. Local and global and spatial clustering of TB death rates were investigated by Global and Local Moran’s Indices methods (Moran’s I). The spatial regression analysis was employed to assess the effect of poverty and HIV on TB mortality rates. <i>Results:</i> There was a significant decrease in TB mortality rate, from 179 per 100,000 population in 2005 to 60 per 100,000 population in 2015. The annual TB mortality rate was higher among males (161.5 per 100,000 male population; (95% confidence interval (CI) 132.9, 190.0) than among females (123.2 per 100,000 female population; (95% CI 95.6, 150.8)). The 35–44 age group experienced higher TB mortality rates, regardless of gender and time. Hot spot clusters of TB mortality were found in the South-Eastern parts of the country, whereas cold spot clusters were largely in the north-eastern parts. Tuberculosis death rates were positively associated with poverty, as measured by the South African Multidimension Poverty Index (SAMPI) as well TB death rates in the neighbouring districts. <i>Conclusion:</i> The findings of this study revealed a statistically significant decrease in TB deaths and a disproportionate distribution of TB deaths among certain areas and population groups in South Africa. The existence of the identified inequalities in the burden of TB deaths calls for targeted public health interventions, policies, and resources to be directed towards the most vulnerable populations in South Africa.
format	article
author	Dan Kibuuka Charles Mpofu Penny Neave Samuel Manda
author_facet	Dan Kibuuka Charles Mpofu Penny Neave Samuel Manda
author_sort	Dan Kibuuka
title	A Spatial Analysis of Tuberculosis Related Mortality in South Africa
title_short	A Spatial Analysis of Tuberculosis Related Mortality in South Africa
title_full	A Spatial Analysis of Tuberculosis Related Mortality in South Africa
title_fullStr	A Spatial Analysis of Tuberculosis Related Mortality in South Africa
title_full_unstemmed	A Spatial Analysis of Tuberculosis Related Mortality in South Africa
title_sort	spatial analysis of tuberculosis related mortality in south africa
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/21e0b63ff7dd4f3e8aee8c0f8cda2f5a
work_keys_str_mv	AT dankibuuka aspatialanalysisoftuberculosisrelatedmortalityinsouthafrica AT charlesmpofu aspatialanalysisoftuberculosisrelatedmortalityinsouthafrica AT pennyneave aspatialanalysisoftuberculosisrelatedmortalityinsouthafrica AT samuelmanda aspatialanalysisoftuberculosisrelatedmortalityinsouthafrica AT dankibuuka spatialanalysisoftuberculosisrelatedmortalityinsouthafrica AT charlesmpofu spatialanalysisoftuberculosisrelatedmortalityinsouthafrica AT pennyneave spatialanalysisoftuberculosisrelatedmortalityinsouthafrica AT samuelmanda spatialanalysisoftuberculosisrelatedmortalityinsouthafrica
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A Spatial Analysis of Tuberculosis Related Mortality in South Africa

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