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Joyce B Der

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Open access Aug 2026

Spatial and Temporal Variations in Newly Notified Pulmonary Tuberculosis Cases in the Volta Region, Ghana (2019–2023)

Background: Tuberculosis (TB) is a major global health challenge and remains a leading infectious cause of morbidity and mortality worldwide. It disproportionately affects low- and middle-income countries, where socioeconomic disparities, limited access to healthcare, and environmental factors contribute to its burden. In Ghana, the Volta Region has experienced variability in TB prevalence, driven by factors such as poverty, urbanisation, and healthcare inequities. However, evidence on the spatial and temporal patterns of drug-susceptible TB cases in the region remains limited. Understanding these variations is essential for designing effective interventions, prioritising resource allocation, and achieving the goals of the World Health Organization’s (WHO) End TB Strategy. Aim: This study aimed to investigate spatial and temporal variations in drug-susceptible TB cases in the Volta Region, Ghana, from 2019 to 2023. Methods: A retrospective study design was employed using secondary data from the District Health Information Management System 2 (DHIMS2). Temporal trends were analysed using a line graph, while spatial patterns were examined using QGIS. Measures of spatial autocorrelation, including Global Moran’s I and Local Indicators of Spatial Association (LISA), were used to identify districts with high or low TB prevalence. Results: The analysis revealed fluctuating TB prevalence in the Volta Region from 2019 to 2023. TB prevalence decreased from 50.2 per 100,000 population in 2019 to 43.6 in 2020, followed by a steady increase to 62.1 per 100,000 in 2023. Males consistently exhibited a higher TB prevalence than females, with an overall male-to-female ratio of 1.92. By 2023, TB prevalence was 84.9 per 100,000 among males and 40.5 per 100,000 among females. Spatial analysis identified Keta and Kpando as high-prevalence districts for drug-susceptible TB. Emerging hotspots included Hohoe, Akatsi South, and Ketu North, which experienced increasing prevalence over time. Cold spots with consistently low TB prevalence were observed in districts such as Adaklu, Agortime-Ziope, and Ho West. High-prevalence districts demonstrated concentrated clustering, whereas overall spatial autocorrelation was random across the region. Conclusion: The study identified an increasing trend in TB prevalence over the five-year period, with males consistently exhibiting higher rates than females. High-prevalence districts, such as Keta and Kpando, and emerging hotspots, including Akatsi South and Ketu North, highlight areas requiring targeted interventions. Low-prevalence districts, including Adaklu, Agortime-Ziope, and Ho West, may provide insights into effective TB-control strategies. Tailored public health measures are essential to address the identified spatial and temporal disparities in TB prevalence.

W. Klenyuie, W. Takramah, Agbesi Williams et al. · Asian Journal of Research in... · 0 citations

Open access Jul 2026

Predictors of tuberculosis preventive therapy initiation among people living with HIV in the Volta region, Ghana

Tuberculosis (TB) remains a leading cause of morbidity and mortality among people living with HIV (PLHIV) despite the availability of effective preventive interventions. Tuberculosis Preventive Therapy (TPT), strongly recommended by the World Health Organization, substantially reduces the risk of active TB among PLHIV, however, uptake of TPT remains suboptimal in many settings. This study, therefore, assessed the predictors of TPT initiation, beginning the course of anti-TB medications among PLHIV. This was a health facility-based analytical cross-sectional study among 806 PLHIV aged ≥ 18 years attending antiretroviral therapy (ART) clinics in the Volta Region of Ghana. A systematic sampling technique was employed to recruit respondents, and data were collected using structured questionnaires mounted in the Kobo Toolbox. Data was exported to Stata version 17.0 for analysis. Descriptive and logistic regression analyses were performed, with statistical significance set at a p < 0.05 at 95% confidence interval. Our study found that out of the 806 PLHIV recruited, with a mean age of 44.7 years (SD ± 13), the majority, 481 (59.70%), were found to have poor knowledge of TPT. We found that 620/806 (88.6%) PLHIV were eligible for TPT, and among those eligible, only 236 (38.1%) were initiated on TPT. Respondents who had good knowledge of TPT were about 7 times more likely to be initiated compared with those who had poor knowledge (aOR = 6.79, 95% CI 4.69–9.83, p < 0.001). Those who had been diagnosed with HIV for one year or more were 4 times as likely to be initiated as those diagnosed for less than a year (aOR = 4.18, 95% CI 1.74–10.04, p = 0.001). Respondents in HIV clinical stage 2 were 66% less likely to be initiated than those in stage 1 (aOR = 0.34, 95% CI 0.20–0.58, p < 0.001). With respect to marital status, married respondents were 40% less likely to be initiated on TPT compared with single respondents (aOR = 0.60, 95% CI 0.37–0.97, p = 0.038). Barriers perceived by PLHIV to TPT initiation were distance to facility, poor health education, and limited drug availability. TPT initiation among PLHIV in the Volta Region was suboptimal, and key predictors of initiation were TPT knowledge, duration since HIV diagnosis, HIV clinical stage, and marital status. Strengthening patient education, ensuring consistent drug and logistics availability, and addressing implementation barriers are critical to improving uptake and advancing progress toward Sustainable Development Goal 3.3 targets.

Felix Mbiba, Raham Agbenorku Yaw Tawiah, Joyce B Der · BMC Public Health · 0 citations