Spatiotemporal distribution and predictors of tuberculosis incidence in Morocco

Background Tuberculosis (TB) is a major health problem in Morocco. This study aims at examining trends in TB in Morocco and identifying TB spatial clusters and TB-associated predictors. Method Country-level surveillance data was exploited. Kendall's correlation test was used to examine trends and an exploratory spatial data analysis was conducted to assess the global and local patterns of spatial autocorrelation in TB rates (Moran's I and local indicator of spatial association [LISA]) at the prefecture/province level. Covariates including living in a prefecture versus living in a province, annual rainfall, annual mean temperature, population density, and AIDS incidence were controlled. An ordinary least squares regression was thus performed and both spatial dependence and heteroscedasticity were assessed. Results A decrease in TB incidence rate was seen between 1995 and 2014 (Kendall's tau b = - 0.72; P Conclusions New information on TB incidence and TB-related predictors was provided to decision-making and to further pertinent research. Association between annual rainfall and TB may be of interest to be explored elsewhere.