Incidence and Spatial Mapping of Tuberculosis and Multidrug-Resistant Tuberculosis in Libreville, Republic of Gabon, in 2022: A Region-Wide Hotspots Analysis

Background. Tuberculosis (TB) remains a major global health problem, and WHO central Africa region continues to bear the heaviest disease burden. Identifying and mapping high TB and MDRTB burden areas for targeted public health interventions was our objective. Methods. A region-wide eco-epidemiological study and a desk-review carried out with the use of medical records from TB diagnosis and care units in 12 health facilities located across the capital Libreville, Republic of Gabon, from January 1st through December 2022. Libreville is the region that bears the heaviest TB burden in Gabon. With the collaboration of the Agency for Space Studies and Observations (AGEOS, Gabon), collected data were transferred to and analyzed using Q.GIS software in order to develop satellite images. Results. In Libreville health region, there were 4,560 cases diagnosed in 2022, representing 77.9% of all cases in the country, with an annual incidence of 509 per 100,000. Spatial mapping of incident cases by county of residence showed that a large majority of the TB cases diagnosed at CHUL care center in 2022 were from Nzeng-Ayong (range: 36 -50 cases) and Owendo (26-35 cases), whereas higher TB incidence at Nkembo care center was at Nzeng-Ayong (range: 356-455 cases), Owendo (256-355 cases), followed by Nkembo, Akebe ville, Akebe Baraka, Akebe Plaine/plateau, Angondje, Angondje village, Charbonnages, Bikele, Pk11, Pk12, Pk9, Mindoube I, Mindoube II (66-255 cases), Sotega and Nkok (46-65 cases). Other counties accounted for less than 45 TB cases. Considering MDRTB cases, higher incidence was observed at Pk9 county, which accounted for 6 cases (14.6%), followed by Owendo, 4 (9.7%). Discussion. Findings suggest that Nzeng-Ayong and Owendo were high TB burden counties in Libreville in 2022, whereas Pk9 and Owendo counties were counties categorized as hotspots for MDR-TB. They should be subject to targeted to public health interventions in order to enhance TB control in Libreville.