BAJOPAS Volume 12 Number 1, June , 2019 http://dx.doi.org/10.4314/bajopas.v12i1.24 Bayero Journal of Pure and Applied Sciences, 12(1): 166 - 175 Received: April, 2019 Accepted: June, 2019 ISSN 2006 – 6996 SPATIO-TEMPORAL TRENDS OF TUBERCULOSIS IN MADOBI LOCAL GOVERNMENT AREA, KANO STATE Adam, A. I. and Yakudima, I. I. Department Of Geography, Kano University Of Science And Technology, Wudil, Kano State P.M.B. 3244, Kano State Email: ( [email protected] ) GSM: 07032343232 ABSTRACT This study analyzed the spatial and temporal trends of tuberculosis in Madobi local government area. Tuberculosis cases reported to Akilu Memorial Hospital and Burji Hospital between 2012 – 2015 were used. The data was analyzed using maps, tables, and graphs.Raw data was subjected to Two – way Analysis of Variance (2- Way ANOVA) to determine the significance difference over time and space. Result shows that cases are not equally distributed spatially and temporally. Highest reported incidences were observed in Madobi and Kwankwaso wards with 31 % and 18.3% of the total reported cases. Lowest cases were recorded in Galinja and KaKauuranran Mata wards with 0.7% and 2.1% respec tively. The results further show an increasing trend of the reported TB cases from 2012 – 2015. Results of Analysis of Variance (Two – way ANOVA) showed strong statistical main effect for the wards (F=3.21, P=0.001), strong statistical main effect for the years under study (F=1.17, P=0.001) and strong statistical interaction effect for the two variables (F=4.77, P=0.001). In addition, post hoc multiple comparison test using Tukey HSD was performed to further investigate which groups of variables differ sign ificantly. Results showed that only two pairs of wards were found not todiffer significantly. The study recommends that further study should be conducted to explore socio-economic and environmental factors that stimulate the spread of tuberculosis in Madobi local government area. Key words: Anova, DOT centers, Madobi, Spatial, Temporal, Tuberculosis INTRODUCTION facultative intracellular (phagocytes) pathogens Tuberculosis is still considered among the major which may be related to their long period of public health concern world-wide for its high persistence in individuals with latent tuberculosis case fatality rate. Although tremendous efforts (Boulahbal and Heifets, 2006). M. tuberculosis is were exerted to fight the disease in many part a slow replicating bacterium, resistant to most of the world, yet it presents a serious health orthodox anti-microbial drugs mainly due to its problem in developing countries (Dye et al . impermeable cell wall. It may persist in a 2005). W orld Health Organization estimated dormant (latent) condition (Murray, 2000). TB is that between 8 -10 million people are annually spread from person to person via the air when contracted with the disease all over the world, infected person cough, sneeze, or release and the disease is responsible for the death of 3 respiratory fluids into the air. million people annually (WHO, 2008) . The above It was estimated that about one -third of the source further predict that if left uncontrolled world’s population is thought to have been tuberculosis will kill up to 35 million people in infected with TB bacteria – Tubercle Bacilli the world by 2025. (Hudson et al. , 2003; WHO, 2014), with new Tuberculosis is an infectious disease principally infections forming about 1% of the population caused by the infection with tubercle bacilli - a yearly (WHO, 2010). In 2007, there were an generic name that incorporates an exp anding list estimat ed 13.7 million chronic cases worldwide of Mycobacterium species collectively called (WHO, 2009), while in 2013, an estimated 9 Mycobacterium tuberculosis Complex . Members million new cases had claimed the lives of 1.5 of this group are; Mycobacterium tuberculosis , million people majority of them in developing M. bovis, M.africanum, M. microti, M. canetti, M. countries (WHO, 2014). The severity of TB caprae, and M. pinnipedi (Grange, 2008 ; epidemics differs widely among countries. Boulahbal and Heifets, 2006). They are generally 166 BAJOPAS Volume 12 Number 1, June, 2019 In 2017, there were an estimated 10 million TB LGAby the North-east (Figure 1). The climate of cases, two-third of the cases occurred in eight the area is tropical wet and dry type coded as countries: India (27%), China (9%), Indonesia Aw in Koppens climatic classification. The mean (8%), the Philippines (6%), Pakistan (5%), annual temperature is about 26 oc, but means Nigeria (4%), Bangladesh (4%) and South Africa monthly values range between 21 oc in the (3%) (WHO, 2018). coolest months December/January and 31 oc in Nigeriais one of the countries that have high the hottest months April/May. (Olofin, 2008). burden of TB cases. According to Federal The annual mean rainfall in the area is between Ministry of Health (2014) an estimated 460,000 800 mm and 900 mm, which concentrate new cases of TB are occurring every year, and between 4-5 months (May to September). The the country is classified among the five leading area experience four distinct seasons: the dry countries of TB cases. The World Health and cool, dry and hot, wet and warm and dry Organization in its 2010 report gave an estimate and warm seasons (Olofin, 2008).The 2006 incidence of 210,000 new cases for all forms of population census puts the population of the TB in Nigeria, equivalent to 133 per 100,000 area at 136,623 with an estimated land mass of populations, and an estimated 320,000 prevalent 273km 2 giving an average population density of cases, equals to 133 per 100,000 populations 500 persons/km 2. (WHO, 2010). Data Sources Kano state is the most populated state in Nigeria Data used for the study were obtained from two where TB is increasingly becoming trouble to the DOT centers purposively selected for the study. healthcare communityover the last two decades The centers are the Akilu Memorial Hospital, and (Imam and Oyeyi, 2008). This is mainly due to Birji Hospital all in Madobi local Figure 1: Madobi the increasing incidence following the advent of Local Government Area HIV infection and the emergence of resistant Government area. These healthcare facilities are strains besides unusual presentation of the the only ones handling and keeping records of disease in other system such as kidney, heart, tuberculosis in the area. Records of TB cases etc. Kano state was at the end of last century from 2012 – 2015 were retrieved and used for included among the vulnerable HIV/TB regions the study. Case file of TB patients were in Africa (Raviglion et al. 1997), and in the reviewed and vital information such as age of beginning of this century registered 12.4% TB- patients, sex of patients, location of the patients, positive cases (Ekanem et al . 2004). Several and year of diagnosis and status of the patient studies (Imam and Oyeyi, 2008; Abubakar, on discharge were recorded. 2015; Nasir, 2015) have been conducted in the Data Analysis state to examine the distributional patterns of Mapping of the case events for the period under TB cases. However, these studies concentrate investigation was done using Arc GIS. Political on cases reported to Infectious Disease Hospital map of the local government was scanned, geo- (IDH) Kano, a comprehensive analysis of TB referenced and digitized using Arc GIS 10.3 cases reported to other DOT centers in the state vision. The annual incidence of the disease from is therefore required. 2012 to 2015 as well as the total incidence was This study therefore, aims at geographical added to the attribute table on the GIS analyses of TB reported cases in Madobi local environment and a chloropleth map was government area, Kano state. The specific produced to display the spatial distribution of objectives were to: develop distributional map of the disease over the study. reported cases and statistically analyze spatio- Descriptive statistics was used to analyze temporal variations of the reported cases. demographic characteristics of the patients including sex structure and age structure. METHODS OF THE STUDY Disease type, treatment type and treatment Study area outcome of the disease were also analyzed The study was carried out in Madobi local descriptively. Two-way analysis of variance government, Kano state. The area is located (Two-way ANOVA) on the other hand was between latitudes 11 0 42’N to11 0 54’N and applied on the raw data to reveal the statistical longitudes 8 015’E to 80 33’ E. It is bounded on difference between wards, months and years in the North by TofaL GA, North-west by Rimin the reported incidences of the disease. Multiple Gado LGA, Kabo LGA by the west, Kiru LGA by comparison tests using Tukey HSD was also the South-west. Bebeji and Garun Malam LGAs applied to further investigate which groups of bordered the area by the South; to the East are variables differ significantly. Kura and Dawakin Kudu LGAs, and Kumbotso 167 BAJOPAS Volume 12 Number 1, June, 2019 Source: GIS Lab KUST Wudil RESULTS AND DISCUSSION this community male interact more frequently Demographic characteristics of TB patients with different people for example, in the market The distribution of gender and age group of TB place, social events, religious gatherings among patients is presented in table 1. The table others. As such this group is expected to be reveals that male gender has higher incidence exposed to TB infection than females who most rate (53%) compared to their counterpart of the time are at home. Effiong and Nwakaego female (47%). This analysis shows that case (2015) relate higher case notification rates notification rate is slightly higher among male among males due to the stigma attached to the than female.