Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia

Kefyalew Addis Alene; Ahmed Elagali; Dylan D. Barth; Susan F. Rumisha; Punam Amratia; Daniel J. Weiss; Kendalem Asmare Atalell; Andargachew Kumsa Erena; Peter W. Gething; Archie C.A. Clements

doi:10.1136/bmjgh-2021-007599

Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia

Kefyalew Addis Alene^*, Ahmed Elagali, Dylan D. Barth, Susan F. Rumisha, Punam Amratia, Daniel J. Weiss, Kendalem Asmare Atalell, Andargachew Kumsa Erena, Peter W. Gething, Archie C.A. Clements

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

22 Citations (Scopus)

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Abstract

Background: HIV, tuberculosis (TB) and malaria are the three most important infectious diseases in Ethiopia, and sub-Saharan Africa. Understanding the spatial codistribution of these diseases is critical for designing geographically targeted and integrated disease control programmes. This study investigated the spatial overlap and drivers of HIV, TB and malaria prevalence in Ethiopia.

Methods: HIV, TB and malaria data were obtained from different nationwide prevalence surveys, and geospatial covariates were obtained from publicly available sources. A Bayesian model-based geostatistical framework was applied to each survey leveraging the strength of high-resolution spatial covariates to predict continuous disease-specific prevalence surfaces and their codistribution.

Results: The national prevalence was 1.54% (95% CI 1.40 to 1.70) for HIV, 0.39% (95% CI 0.34 to 0.45) for TB and 1.1% (95%CI 0.95 to 1.32) for malaria. Substantial subnational variation was predicted with the highest HIV prevalence estimated in Gambela (4.52%), Addis Ababa (3.52%) and Dire Dawa (2.67%) regions. TB prevalence was highest in Dire Dawa (0.96%) and Gambela (0.88%), while malaria was highest in Gambela (6.1%) and Benishangul-Gumuz (3.8%). Spatial overlap of their prevalence was observed in some parts of the country, mainly Gambela region. Spatial distribution of the diseases was significantly associated with healthcare access, demographic, and climatic factors.

Conclusions: The national distribution of HIV, TB and malaria was highly focal in Ethiopia, with substantial variation at subnational and local levels. Spatial distribution of the diseases was significantly associated with healthcare access, demographic and climatic factors. Spatial overlap of HIV, TB and malaria prevalence was observed in some parts of the country. Integrated control programmes for these diseases should be targeted to these areas with high levels of co-endemicity.

Original language	English
Article number	e007599
Number of pages	17
Journal	BMJ Global Health
Volume	7
Issue number	2
DOIs	https://doi.org/10.1136/bmjgh-2021-007599
Publication status	Published - 25 Feb 2022
Externally published	Yes

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2022.

Keywords

HIV
malaria
tuberculosis

ASJC Scopus subject areas

Health Policy
Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia
Copyright 2022 the authors. This is an open access article published under a Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium, provided the author and source are cited.
Final published version, 1.62 MBLicence: CC BY

Cite this

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title = "Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia",

abstract = "Background: HIV, tuberculosis (TB) and malaria are the three most important infectious diseases in Ethiopia, and sub-Saharan Africa. Understanding the spatial codistribution of these diseases is critical for designing geographically targeted and integrated disease control programmes. This study investigated the spatial overlap and drivers of HIV, TB and malaria prevalence in Ethiopia. Methods: HIV, TB and malaria data were obtained from different nationwide prevalence surveys, and geospatial covariates were obtained from publicly available sources. A Bayesian model-based geostatistical framework was applied to each survey leveraging the strength of high-resolution spatial covariates to predict continuous disease-specific prevalence surfaces and their codistribution. Results: The national prevalence was 1.54% (95% CI 1.40 to 1.70) for HIV, 0.39% (95% CI 0.34 to 0.45) for TB and 1.1% (95%CI 0.95 to 1.32) for malaria. Substantial subnational variation was predicted with the highest HIV prevalence estimated in Gambela (4.52%), Addis Ababa (3.52%) and Dire Dawa (2.67%) regions. TB prevalence was highest in Dire Dawa (0.96%) and Gambela (0.88%), while malaria was highest in Gambela (6.1%) and Benishangul-Gumuz (3.8%). Spatial overlap of their prevalence was observed in some parts of the country, mainly Gambela region. Spatial distribution of the diseases was significantly associated with healthcare access, demographic, and climatic factors. Conclusions: The national distribution of HIV, TB and malaria was highly focal in Ethiopia, with substantial variation at subnational and local levels. Spatial distribution of the diseases was significantly associated with healthcare access, demographic and climatic factors. Spatial overlap of HIV, TB and malaria prevalence was observed in some parts of the country. Integrated control programmes for these diseases should be targeted to these areas with high levels of co-endemicity.",

keywords = "HIV, malaria, tuberculosis",

author = "Alene, {Kefyalew Addis} and Ahmed Elagali and Barth, {Dylan D.} and Rumisha, {Susan F.} and Punam Amratia and Weiss, {Daniel J.} and Atalell, {Kendalem Asmare} and Erena, {Andargachew Kumsa} and Gething, {Peter W.} and Clements, {Archie C.A.}",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2022.",

year = "2022",

month = feb,

day = "25",

doi = "10.1136/bmjgh-2021-007599",

language = "English",

volume = "7",

journal = "BMJ Global Health",

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TY - JOUR

T1 - Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia

AU - Alene, Kefyalew Addis

AU - Elagali, Ahmed

AU - Barth, Dylan D.

AU - Rumisha, Susan F.

AU - Amratia, Punam

AU - Weiss, Daniel J.

AU - Atalell, Kendalem Asmare

AU - Erena, Andargachew Kumsa

AU - Gething, Peter W.

AU - Clements, Archie C.A.

PY - 2022/2/25

Y1 - 2022/2/25

N2 - Background: HIV, tuberculosis (TB) and malaria are the three most important infectious diseases in Ethiopia, and sub-Saharan Africa. Understanding the spatial codistribution of these diseases is critical for designing geographically targeted and integrated disease control programmes. This study investigated the spatial overlap and drivers of HIV, TB and malaria prevalence in Ethiopia. Methods: HIV, TB and malaria data were obtained from different nationwide prevalence surveys, and geospatial covariates were obtained from publicly available sources. A Bayesian model-based geostatistical framework was applied to each survey leveraging the strength of high-resolution spatial covariates to predict continuous disease-specific prevalence surfaces and their codistribution. Results: The national prevalence was 1.54% (95% CI 1.40 to 1.70) for HIV, 0.39% (95% CI 0.34 to 0.45) for TB and 1.1% (95%CI 0.95 to 1.32) for malaria. Substantial subnational variation was predicted with the highest HIV prevalence estimated in Gambela (4.52%), Addis Ababa (3.52%) and Dire Dawa (2.67%) regions. TB prevalence was highest in Dire Dawa (0.96%) and Gambela (0.88%), while malaria was highest in Gambela (6.1%) and Benishangul-Gumuz (3.8%). Spatial overlap of their prevalence was observed in some parts of the country, mainly Gambela region. Spatial distribution of the diseases was significantly associated with healthcare access, demographic, and climatic factors. Conclusions: The national distribution of HIV, TB and malaria was highly focal in Ethiopia, with substantial variation at subnational and local levels. Spatial distribution of the diseases was significantly associated with healthcare access, demographic and climatic factors. Spatial overlap of HIV, TB and malaria prevalence was observed in some parts of the country. Integrated control programmes for these diseases should be targeted to these areas with high levels of co-endemicity.

AB - Background: HIV, tuberculosis (TB) and malaria are the three most important infectious diseases in Ethiopia, and sub-Saharan Africa. Understanding the spatial codistribution of these diseases is critical for designing geographically targeted and integrated disease control programmes. This study investigated the spatial overlap and drivers of HIV, TB and malaria prevalence in Ethiopia. Methods: HIV, TB and malaria data were obtained from different nationwide prevalence surveys, and geospatial covariates were obtained from publicly available sources. A Bayesian model-based geostatistical framework was applied to each survey leveraging the strength of high-resolution spatial covariates to predict continuous disease-specific prevalence surfaces and their codistribution. Results: The national prevalence was 1.54% (95% CI 1.40 to 1.70) for HIV, 0.39% (95% CI 0.34 to 0.45) for TB and 1.1% (95%CI 0.95 to 1.32) for malaria. Substantial subnational variation was predicted with the highest HIV prevalence estimated in Gambela (4.52%), Addis Ababa (3.52%) and Dire Dawa (2.67%) regions. TB prevalence was highest in Dire Dawa (0.96%) and Gambela (0.88%), while malaria was highest in Gambela (6.1%) and Benishangul-Gumuz (3.8%). Spatial overlap of their prevalence was observed in some parts of the country, mainly Gambela region. Spatial distribution of the diseases was significantly associated with healthcare access, demographic, and climatic factors. Conclusions: The national distribution of HIV, TB and malaria was highly focal in Ethiopia, with substantial variation at subnational and local levels. Spatial distribution of the diseases was significantly associated with healthcare access, demographic and climatic factors. Spatial overlap of HIV, TB and malaria prevalence was observed in some parts of the country. Integrated control programmes for these diseases should be targeted to these areas with high levels of co-endemicity.

KW - HIV

KW - malaria

KW - tuberculosis

U2 - 10.1136/bmjgh-2021-007599

DO - 10.1136/bmjgh-2021-007599

M3 - Article

AN - SCOPUS:85125860167

SN - 2059-7908

VL - 7

JO - BMJ Global Health

JF - BMJ Global Health

IS - 2

M1 - e007599

ER -

Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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