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 journalArticlepeer-review

16 Citations (Scopus)
1 Downloads (Pure)

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 languageEnglish
Article numbere007599
Number of pages17
JournalBMJ Global Health
Volume7
Issue number2
DOIs
Publication statusPublished - 25 Feb 2022
Externally publishedYes

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

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