ArticlePloS one2017
Spatial patterns of multidrug resistant tuberculosis and relationships to socio-economic, demographic and household factors in northwest Ethiopia.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
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Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Molecular epidemiology of drug resistant Mycobacterium tuberculosis in Africa: a systematic review.BMC infectious diseases · 2020Pooled it
- Spatially targeted screening to reduce tuberculosis transmission in high-incidence settings.The Lancet. Infectious diseases · 2019Pooled it
- Methods used in the spatial analysis of tuberculosis epidemiology: a systematic review.BMC medicine · 2018Pooled it
- Article
- Mapping facility-based tuberculosis preventive treatment provision in Ethiopia: a geospatial analysis.BMC health services research · 2026Article
- Rifampicin-resistant tuberculosis in Nangarhar, Afghanistan: prevalence and risk factors.BMC infectious diseases · 2026Observational
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- Trends and Characteristics of Drug-Resistant Tuberculosis: A Five-Year Study at a Major Specialized Hospital in Guizhou, China (2018-2023).Infection and drug resistance · 2026Article
- Local progress towards achieving the End TB targets in Ethiopia: a geospatial analysis.International journal of epidemiology · 2025Article
- Article
- Global trajectory and spatiotemporal epidemiological landscape of multidrug-resistant tuberculosis of spanning 46 years (1990-2035): implications for achieving global end TB goals.Frontiers in public health · 2025Article
- Spatial co-distribution of tuberculosis prevalence and low BCG vaccination coverage in Ethiopia.Scientific reports · 2024Article
- Identifying risk factors for recurrent multidrug resistant tuberculosis based on patient's record data from 2016 to 2021: retrospective study.Scientific reports · 2024Article
- Drug-resistant tuberculosis: a persistent global health concern.Nature reviews. Microbiology · 2024Review
- Spatial analysis of cholangiocarcinoma in relation to diabetes mellitus and Opisthorchis viverrini infection in Northeast Thailand.Scientific reports · 2024Article
- Spatial Analysis of Drug-Susceptible and Multidrug-Resistant Cases of Tuberculosis, Ho Chi Minh City, Vietnam, 2020-2023.Emerging infectious diseases · 2024Article
- Unsuccessful tuberculosis treatment outcomes across Brazil's geographical landscape before and during the COVID-19 pandemic: are we truly advancing toward the sustainable development/end TB goal?Infectious diseases of poverty · 2024Article
- Spatio-Temporal Pattern of Tuberculosis Distribution in Romania and Particulate Matter Pollution Associated With Risk of Infection.GeoHealth · 2024Article
- Ecological-level factors associated with tuberculosis incidence and mortality: A systematic review and meta-analysis.PLOS global public health · 2024Article
- Integrating Molecular Diagnostics and GIS Mapping: A Multidisciplinary Approach to Understanding Tuberculosis Disease Dynamics in South Africa Using Xpert MTB/RIF.Diagnostics (Basel, Switzerland) · 2023Article
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnderstanding the geographical distribution of multidrug-resistant tuberculosis (MDR-TB) in high TB burden countries such as Ethiopia is crucial for effective control of TB epidemics in these countries, and thus globally. We present the first spatial analysis of multidrug resistant tuberculosis, and its relationship to socio-economic, demographic and household factors in northwest Ethiopia.
methodsAn ecological study was conducted using data on patients diagnosed with MDR-TB at the University of Gondar Hospital MDR-TB treatment centre, for the period 2010 to 2015. District level population data were extracted from the Ethiopia National and Regional Census Report. Spatial autocorrelation was explored using Moran's I statistic, Local Indicators of Spatial Association (LISA), and the Getis-Ord statistics. A multivariate Poisson regression model was developed with a conditional autoregressive (CAR) prior structure, and with posterior parameters estimated using a Bayesian Markov chain Monte Carlo (MCMC) simulation approach with Gibbs sampling, in WinBUGS.
resultsA total of 264 MDR-TB patients were included in the analysis. The overall crude incidence rate of MDR-TB for the six-year period was 3.0 cases per 100,000 population. The highest incidence rate was observed in Metema (21 cases per 100,000 population) and Humera (18 cases per 100,000 population) districts; whereas nine districts had zero cases. Spatial clustering of MDR-TB was observed in districts located in the Ethiopia-Sudan and Ethiopia-Eritrea border regions, where large numbers of seasonal migrants live. Spatial clustering of MDR-TB was positively associated with urbanization (RR: 1.02; 95%CI: 1.01, 1.04) and the percentage of men (RR: 1.58; 95% CI: 1.26, 1.99) in the districts; after accounting for these factors there was no residual spatial clustering.
conclusionSpatial clustering of MDR-TB, fully explained by demographic factors (urbanization and percent male), was detected in the border regions of northwest Ethiopia, in locations where seasonal migrants live and work. Cross-border initiatives including options for mobile TB treatment and follow up are important for the effective control of MDR-TB in the region.
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