Background: The Human Immunodeficiency Virus(HIV) infection prevalence in Cameroon has consecutively decreased from 5.28% in 2004 to 2.8% in 2018. However, this total decrease in prevalence may hide some disparities especially in terms of spatial or geographical pattern. Efficient control and fighting against HIV infection requires to target hotspot areas. This study was aimed to investigate whether there is a spatial pattern of HIV in Cameroon and to determine the hot-spots clusters.
Methods: HIV biomarkers data with Global Positioning System (GPS) location data were leveraged from the Cameroon 2004, 2011, and 2018 Demographic and Health Survey (DHS) after an approved request from the MEASURES Demographic and Health Survey Program. The spatial autocorrelation test was performed with the Moran I test through the R package ”DCluster”. The discrete Poisson model was fitted to scan and detect hot-spots clusters based on the Kulldorff test with the SaTScan software version 9.4, with purely spatial and space-time analysis respectively. Finally, the data and detected clusters were imported to QGIS software version 3.20.2 for maps manipulations.
Results: For the three considered periods of 2004, 2011, and 2018 respectively, there was a spatial autocorrelation of HIV infection in Cameroon. A total of 3, 5, and 2 significant hot-spots clusters were detected for the periods of 2004, 2011, and 2018 respectively. In the prospective space-time analysis, 2 significant clusters have been detected from 2004 to 2018. The relative-risk in the significant detected clusters were 2.72(p-value= 0.001) and 3.37(p-value=0.026) respectively. Cluster 1 included the following subdivisions : Mefou et Afamba, Nyong et So’o, Nyong et Mfoumou, Haute Sanaga, Mvila, Dja et lobo, Haut-Nyong, Boumba et Ngoko; Kadey, Lom et Djerem, and Mbere. The other cluster included : Nkam, Sanaga-Maritime, and Nyong-Ekele.
Conclusion: Despite the decrease of HIV epidemiology in Cameroon, the study revealed that there is a spatial pattern of HIV in Cameroon and the hot-spots clusters were detected. In its effort to eliminate HIV infection by 2030 in Cameroon, the public health policies should target more of the detected HIV hot-spots clusters in this study while maintaining effective control in other parts of the country which are cold-spots.