{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T23:05:04Z","timestamp":1762643104470,"version":"3.40.5"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,25]],"date-time":"2024-11-25T00:00:00Z","timestamp":1732492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Mozambique is among the highest\u2010burden countries for drug\u2010resistant tuberculosis in the world. However, the spatial distribution of drug\u2010resistant tuberculosis, in the country is unknown. Therefore, we aimed to analyse the spatial distribution, predictors, and hotspot districts for drug\u2010resistant tuberculosis incidence in Mozambique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We carried out an ecological study using the district as the unit of analysis where we included all cases of drug\u2010resistant tuberculosis diagnosed in Mozambique from 2016 to 2020. We obtained the data from the Minister of Health and other open sources. Parameters of interest were estimated through a spatial Bayesian Poisson regression model using Markov Chain Monte Carlo simulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 5092 people with drug\u2010resistant tuberculosis in Mozambique were diagnosed during our study period. We found heterogeneity in the spatial distribution of drug\u2010resistant tuberculosis incidence across the country. Higher incidence rates were mainly observed in the south and central regions, and 26 (16.9%) districts out of 154 were identified as hotspot areas. The incidence of drug\u2010resistant tuberculosis increased with an increase in the HIV prevalence (Relative risk [RR]: 1.53; 95% Credibility Interval [CrI]: 1.32 to 1.76), electricity coverage rate (RR: 1.59; 95% CrI: 1.19 to 2.09), and population density (RR: 1.36; 95% CrI: 1.08 to 1.69) and decreased with an increase in the proportion of people with a bank account per district (RR: 0.71; 95% Crl: 0.51 to 0.96).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The incidence of drug\u2010resistant tuberculosis was not homogeneous, and it was associated with social determinants of health. Targeting interventions in hotspot districts and addressing social determinants is crucial for tuberculosis elimination in Mozambique.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.14060","type":"journal-article","created":{"date-parts":[[2024,11,26]],"date-time":"2024-11-26T04:20:37Z","timestamp":1732594837000},"page":"1051-1061","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Spatial distribution and predictors of drug\u2010resistant tuberculosis incidence in Mozambique: A nationwide Bayesian disease mapping study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6903-9750","authenticated-orcid":false,"given":"Nelson","family":"Cuboia","sequence":"first","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine University of Porto  Porto Portugal"},{"name":"CINTESIS@RISE \u2013 Center for Health Technology and Services Research (CINTESIS) &amp; Health Research Network Associated Laboratory (RISE) University of Porto  Porto Portugal"},{"name":"Hospital Rural de Chicumbane  Chicumbane Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3030-3769","authenticated-orcid":false,"given":"Cl\u00e1udia","family":"Mutaquiha","sequence":"additional","affiliation":[{"name":"National Tuberculosis Control Program Ministry of Health  Maputo Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Manhi\u00e7a","sequence":"additional","affiliation":[{"name":"Ministry of Health  Maputo Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedita","family":"Jos\u00e9","sequence":"additional","affiliation":[{"name":"National Tuberculosis Control Program Ministry of Health  Maputo Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0062-5936","authenticated-orcid":false,"given":"Marla","family":"Amaro","sequence":"additional","affiliation":[{"name":"National Nutritional Program Ministry of Health  Maputo Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6987-8001","authenticated-orcid":false,"given":"Isabel","family":"Pfumo\u2010Cuboia","sequence":"additional","affiliation":[{"name":"Hospital Rural de Chicumbane  Chicumbane Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1363-8273","authenticated-orcid":false,"given":"Lu\u00eds","family":"Nitrog\u00e9nio","sequence":"additional","affiliation":[{"name":"Tuberculosis Program Gaza Provincial Health Directorate  Xai\u2013Xai Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-8233","authenticated-orcid":false,"given":"Joana","family":"Reis\u2010Pardal","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine University of Porto  Porto Portugal"},{"name":"CINTESIS@RISE \u2013 Center for Health Technology and Services Research (CINTESIS) &amp; Health Research Network Associated Laboratory (RISE) University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0348-574X","authenticated-orcid":false,"given":"Pereira","family":"Zindoga","sequence":"additional","affiliation":[{"name":"USAID  Maputo Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2109-198X","authenticated-orcid":false,"given":"Aleny","family":"Couto","sequence":"additional","affiliation":[{"name":"National Sexually Transmitted Infection (STI) and HIV\/AIDS Control Program, Ministry of Health  Maputo Mozambique"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8421-2937","authenticated-orcid":false,"given":"Lu\u00eds","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine University of Porto  Porto Portugal"},{"name":"CINTESIS@RISE \u2013 Center for Health Technology and Services Research (CINTESIS) &amp; Health Research Network Associated Laboratory (RISE) University of Porto  Porto Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,25]]},"reference":[{"volume-title":"Global tuberculosis report 2021","year":"2021","author":"Organization WH","key":"e_1_2_10_2_1"},{"key":"e_1_2_10_3_1","unstructured":"Organization WH.Tuberculosis overview: World Health Organization.2022Available from:https:\/\/www.who.int\/health-topics\/tuberculosis#tab=tab_1"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.17.0835"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00079413"},{"volume-title":"Global Tuberculosis Report 2023","year":"2023","author":"Organization WH","key":"e_1_2_10_6_1"},{"key":"e_1_2_10_7_1","unstructured":"Organization WH.Global Tuberculosis Report 2023 [Mobile Appliaction Software]2023."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0171800"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00111812"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijtb.2020.09.016"},{"key":"e_1_2_10_11_1","unstructured":"Electr\u00f3nico INdG.Geografia de Mo\u00e7ambique Maputo 2015. [updated 2015. Geografia de Mo\u00e7ambique] Available from:https:\/\/www.portaldogoverno.gov.mz\/por\/Mocambique\/Geografia\u2010de\u2010Mocambique"},{"key":"e_1_2_10_12_1","unstructured":"Mo\u00e7ambique INdEd.Popula\u00e7\u00e3o Mo\u00e7ambicana para o ano 2021: Instituto Nacional de Estatistica Mo\u00e7ambique.2021Available from:http:\/\/www.ine.gov.mz\/noticias\/populacao-mocambicana-para-2021"},{"key":"e_1_2_10_13_1","unstructured":"Sa\u00fade Md.Plano estrat\u00e9gico e operacional da tuberculose 2014\u20132019 em mo\u00e7ambique. Dire\u00e7\u00e3o Nacional de Sa\u00fade Publica PNdCdT editor: MISAU2013Available from:http:\/\/gard\u2010cplp.ihmt.unl.pt\/Documentos\/Paises\/Mocambique\/Plano_Estrategico_Operacional_Tuberculose_Mocambhttp:\/\/gard\u2010cplp.ihmt.unl.pt\/Documentos\/Paises\/Mocambique\/Plano_Estrategico_Operacional_Tuberculose_Mocamb"},{"volume-title":"SARA 2018, Invent\u00e1rio Nacional","year":"2018","author":"Mo\u00e7ambique MdSd","key":"e_1_2_10_14_1"},{"volume-title":"PNdCd. Manual de Manejo Cl\u00ednico e Program\u00e1tico da Tuberculose Multiresitante","year":"2019","author":"Minist\u00e9rio da Sa\u00fade, Tuberculose","key":"e_1_2_10_15_1"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40475-018-0167-1"},{"volume-title":"Avalia\u00e7\u00e3o e Manejo dos Pacientes com Tuberculose, Protocolos Nacionais","year":"2019","author":"Mo\u00e7ambique MdSd","key":"e_1_2_10_17_1"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sste.2023.100632"},{"volume-title":"Dados Definitivos do IV Recenseamento Geral da Popula\u00e7\u00e3o e Habita\u00e7\u00e3o, 2017","year":"2022","author":"Estat\u00edstica INd","key":"e_1_2_10_19_1"},{"key":"e_1_2_10_20_1","unstructured":"(ITOS) ITOS.Mozambique \u2010 Subnational Administrative Boundaries 2021. Available from:https:\/\/data.humdata.org\/dataset\/mozambique-administrative-levels-0-3"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2008.07.021"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3680"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00116466"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1201\/9781351271769"},{"key":"e_1_2_10_25_1","first-page":"65","article-title":"Variable selection for regression models","author":"Kuo L","year":"1998","journal-title":"Sankhy\u0101: Ind J Stat, Ser B"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1214\/009053604000000238"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9868.00353"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/rssb.12062"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1574-6941.2001.tb00841.x"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/0013164418817803"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0221027"},{"volume-title":"R: a language and environment for statistical computing","year":"2022","author":"Team RC","key":"e_1_2_10_32_1"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss"},{"key":"e_1_2_10_34_1","unstructured":"Team QD.QGIS geographic information system. Open Source Geospatial Foundation Project2023Available from:http:\/\/qgis.osgeo.org"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1201\/9780429088933"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235009"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1080\/2330443X.2014.970247"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-73759-w"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.13708"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.18.0575"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234034"},{"key":"e_1_2_10_42_1","unstructured":"Castel\u2010BrancoCN.Economic Linkages between South Africa and Mozambique. Paper de investiga\u00e7\u00e3o e discuss\u00e3o preparado para o DfID (Dept para o Desenvolvimento Internacional do Governo Brit\u00e2nico): Pretoria.2002www.iese.ac.mz\/lib\/cncb\/AI-2002a-SA-Mozambique-linkages.pdf"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/1744-8603-5-11"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.15.0361"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.2190\/HS.43.4.c"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.17.0457"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1128\/cmr.00042-10"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.3390\/app10144842"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.14060","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T12:06:12Z","timestamp":1733227572000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.14060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,25]]},"references-count":47,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/tmi.14060"],"URL":"https:\/\/doi.org\/10.1111\/tmi.14060","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"type":"print","value":"1360-2276"},{"type":"electronic","value":"1365-3156"}],"subject":[],"published":{"date-parts":[[2024,11,25]]},"assertion":[{"value":"2024-11-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}