CLIMATIC AND DEMOGRAPHIC DETERMINANTS OF TUBERCULOSIS IN DISTRICT DIR UPPER, PAKISTAN

Abstract

Background: Tuberculosis (TB) remains one of the leading infectious causes of death globally. Climatic variability may influence TB transmission dynamics, particularly in mountainous regions.

Objective: To determine the prevalence of TB and evaluate its association with demographic and climatic factors in District Dir Upper, Pakistan. Methods: A cross-sectional analytical study was conducted among 215 suspected TB patients registered between April and December 2024. TB status was confirmed through microbiological and clinical assessment. Demographic variables (age, gender, tehsil) and climatic factors (temperature, rainfall, month) were analyzed. Pearson's Chi-square tests, prevalence estimates, crude odds ratios (OR), and multivariable logistic regression were performed using SPSS v26.

 Results: Overall TB prevalence was 43.7% (94/215). Females showed significantly higher prevalence (56.4%) compared to males (33.9%) (χ²=10.88, p=0.001; OR=2.52, 95% CI: 1.39–4.56). The highest age-specific prevalence was observed among 51–60 years (66.7%) and 41–50 years (60.0%). Seasonal variation was significant (χ²=82.05, p<0.001), with peak prevalence in November and December (100%). TB prevalence was highest at 1–10°C (100%) and 11–20°C (62.2%) (χ²=42.36, p<0.001). Rainfall extremes (10–100 mm: 63.3%; 201–350 mm: 54.8%) were strongly associated (χ²=29.44, p<0.001). Logistic regression identified female gender, moderate temperature (11–20°C), and low rainfall (10–100 mm) as independent predictors.

Conclusion: TB prevalence in District Dir Upper is significantly influenced by demographic and climatic factors. Integration of meteorological surveillance into TB control strategies is recommended.