Mapping tuberculosis prevalence in Africa using a Bayesian geospatial analysis

Abstract Background Worldwide, tuberculosis (TB) remains the leading cause of death from infectious diseases. Africa is the second most-affected region, accounting for a quarter of the global TB burden, but there is limited evidence whether there is subnational variation of TB prevalence across the...

Full description

Saved in:
Bibliographic Details
Main Authors: Alemneh Mekuriaw Liyew, Eyob Alemayehu Gebreyohannes, Andre Python, Archie C. A. Clements, Beth Gilmour, Peter W. Gething, Punam Amratia, Kefyalew Addis Alene
Format: Article
Language:English
Published: Nature Portfolio 2025-05-01
Series:Communications Medicine
Online Access:https://doi.org/10.1038/s43856-025-00831-9
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Background Worldwide, tuberculosis (TB) remains the leading cause of death from infectious diseases. Africa is the second most-affected region, accounting for a quarter of the global TB burden, but there is limited evidence whether there is subnational variation of TB prevalence across the continent. Therefore, this study aimed to estimate sub-national and local TB prevalence across Africa. Methods We compiled geolocated data from 50 population-based surveys across 14 African countries. A total of 212 data points were identified and linked to covariates assembled from publicly available sources. Bayesian geostatistical modelling was used to predict TB prevalence across Africa, and results were aggregated to estimate number of TB cases at national and subnational levels. Results Here we estimate 1.28 million TB cases (95% uncertainty interval [UI] 0.14–4.87) across 14 countries, with marked spatial variations. The highest cases are estimated in Nigeria (460,247 95% UI 7954–1,783,106), and Mozambique (120,622 95%UI 20,027–321,177) while the lowest in Guinea-Bissau (1952 95%UI 154-7365) and Rwanda (2207 95% UI 1050–9225). National TB prevalence range from 0.25 to 7.32 per 1000 with significant variation at higher spatial resolution. Temperature (°C) (OR = 1.27; 95% CrI: 1.20–1.35), precipitation (mm) (OR = 1.34; 95% CrI: 1.26–1.40), and access to city (minute) (OR = 1.21; 95% CrI: 1.14–1.25) are positively associated with TB prevalence, while altitude (m) (OR = 0.83; 95% CrI: 0.78–0.87) is negatively associated. Conclusions We find substantial variations in TB prevalence at national, sub-national, and local levels in Africa. These considerable spatial variations suggest the need for geographically targeted interventions to control TB in Africa.
ISSN:2730-664X