Spatial pattern of tuberculosis cases in Jos Metropolis, Nigeria in the period 2019-2022

Plateau State is one of Nigeria's 14 states with a high Tuberculosis (TB) burden. In this state and its capital city, Jos Metropolis, TB cases have been on the increase. There are no reported studies on the spatial mapping of TB cases from Jos Metropolis. Thus, it is not known how TB hotspots and clusters may contribute to the propagation of area-wide TB transmission in this area and the implications for prevention and control. The objective of this study was to determine the spatial pattern of TB cases in Jos Metropolis from 2019-2022 based on existing TB data in the treatment registers and their residential addresses. We geolocated the cases to the nearest Polling Unit (PU) in their Electoral Ward (EW) using the Global Positioning System (GPS) coordinates obtained from the Polling Unit Locator (PUL) on the website of the Independent National Electoral Commission (INEC). In ArcGIS Pro (version 3.5.3) environment, TB hotspots were determined. Using the SaTScan software (version 10.3.2), a retrospective purely spatial analysis was carried out to identify purely spatial TB clusters based on the discrete Poisson model. A total of 4,897 TB cases were mapped. Significant TB hotspots (Z-score >1.96 and p-value <0.05) and primary TB clusters were found for each of the study years. The hotspots and clusters were located in the northern part of the Jos Metropolis, particularly the more centrally located areas. We found both a potential for future increase in TB cases and a spread to other areas of the Jos Metropolis from these TB hotspots and clusters in the northern part of the metropolis. Hence, there is an urgent need for a targeted TB screening and treatment, resource allocation and health education campaigns in the identified EWs.