Regional variations in Antibiotic Consumption in Tanzania: A Geospatial Analysis of eLMIS Data for Targeted Stewardship

Abstract

Abstract Background Understanding regional variations in antibiotic consumption is critical for guiding antimicrobial stewardship (AMS) in low- and middle-income countries. Although national antibiotic use data exist for Tanzania, spatial disparities across regions remain poorly characterized. Methods This retrospective analysis utilized facility-level antibiotic supply data from the electronic Logistics Management Information System (eLMIS), using data from July 2020 to June 2024. Antibiotic consumption was expressed as defined daily doses per 1,000 inhabitants per day (DID) following the WHO ATC and AWaRe classifications. Regional- and facility-level variations were analyzed and visualized using descriptive and geospatial mapping approaches. Temporal trends and national forecasts were modeled using ARIMA and polynomial regression. Results A total of 1.63 million facility-level records were analyzed. National antibiotic consumption increased from 142.4 to 182.8 DID between 2020–2021 and 2023–2024 (a 28% rise). Dispensaries accounted for 71% of the total DID, highlighting the dominant role of primary care in antibiotic distribution. Dar es Salaam (37.9 DID), Ruvuma (34.5 DID), and Lindi (34.0 DID) showed the highest cumulative consumption, whereas Katavi (13.7 DID) and Geita (15.4 DID) recorded the lowest. The access category antibiotics comprised ≥ 60% of the total consumption, Watch category antibiotics comprised 35–40%, and Reserve category antibiotics comprised ≤ 0.1%. The forecasting models project continued growth, reaching approximately 215 DID by 2027. Conclusions Antibiotic consumption in Tanzania exhibits a rising trend characterized by pronounced regional disparities, particularly in the coastal and southern regions. The analysis emphasizes the importance of tailoring AMS programs to local contexts and illustrates how digital supply chain platforms can inform geographically targeted interventions in resource-constrained settings. Strengthening AMS at the primary care level and prioritizing high-consumption regions are essential steps.