Spatio-temporal Characteristics of Tuberculosis in Ghana

Abstract

Background: Recent global reports show that the number of Tuberculosis (TB) cases or deaths is declining, however, the rate of decline is not adequate to meet the World Health Organization's (WHO's) mitigation. TB remains a public health problem in Ghana with a significant economic and health burden on citizens and health infrastructure. Aims: Consequently, there is a need for further studies about the disease aimed at accelerating the rate of decline in cases. Methods: In this article, we study the spatio-temporal characteristics of TB in Ghana, using data obtained from Ghana National Tuberculosis Programme (NTP) for the 10 regions of Ghana, collected over a six-year period. Bayesian spatial and space-time regression models are used to map the risk of TB infections across the nation, in time and space. The study also examines some baseline predictors of TB infections to ascertain their effects on the TB risk. Results: Our study results showed that hot-spots of TB cases are observed in the Upper East, Upper West, Volta, Western, and Central regions and low risk in the Northern, Ashanti, Greater Accra, Brong Ahafo, Eastern and Western regions. We observed clustering of risk between neighboring regions. TB cure rate, TB success rate, knowledge about TB, awareness that TB is airborne, HIV prevalence, percentage of literacy, high income are important predictors of TB detection across the 10 regions of Ghana. Conclusions: Most regions in Ghana have similar TB risk. Efforts for more TB cases detection should be encouraged to increase TB success and cure rate which will lead to substantial decrease in TB spread. There is the need for provision of adequate health facilities with easy access to these facilities irrespective of your income status to bridge the gap between TB cases among the poor and the rich. TB cases are expected to grow exponentially in countries with low success and cure rate. Finally, for a substantial TB cases reduction, there is the need to adopt measures that will increase TB cases detection, TB success and cure rates, TB awareness, knowledge about how TB spread as well adequate health facilities with easy access.