Withdrawn: A Geospatial Analysis of TPT Treatment Outcomes among PLHIV in Ethiopia, South Africa, and Zimbabwe

Résumé fourni par la source

Background: Tuberculosis (TB) preventive treatment (TPT) is crucial in reducing the TB burden among people living with HIV (PLHIV), particularly in high TB/HIV burden countries like Ethiopia, South Africa, and Zimbabwe. Despite the availability of shorter TPT regimens, suboptimal treatment completion persists, and subnational variations remain poorly understood. Methods: This study utilized geospatial analyses of treatment completion data from the Opt4TPT study, a prospective cohort conducted in Ethiopia, South Africa, and Zimbabwe (2021–2023). Participants’ demographic and clinical data were included, and geospatial patterns were assessed using QGIS and local indicators of spatial autocorrelation (LISA) to identify clusters of treatment outcomes. Results: Of the 1,320 participants enrolled, 1,076 (81.5%) had geolocated data, and 90.1% reported completing TPT. Treatment non-completion clustered near clinics in all three countries. LISA analysis identified spatial cold spots for low treatment completion near clinics in South Africa and Zimbabwe, but not in Ethiopia. Distribution of demographic and clinical factors did not align with treatment outcomes. Conclusions: Geospatial analyses revealed clustering of non-completion near clinics, warranting further research on contextual factors, including stigma and facility-switching behavior. These findings emphasize the potential of geospatial tools in optimizing TPT programs through locally tailored interventions.

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