Geographical variation in community-acquired pneumonia prevalence during the COVID-19 pandemic in northern Sumatra, Indonesia

Community-acquired pneumonia (CAP) remains a significant focus within public health discourse, denoting the inflammation of lung tissue due to infection acquired in non-hospital environments. This study aimed to investigate the trend and spatial distribution of CAP prevalence and hotspots in the province of North Sumatera, Indonesia, during the study period from 2019 to 2022. This study used routine CAP data from the Early Warning and Alert System, National Health Surveillance, and the Provincial Health Office of North Sumatera from the 1st week of 2019 to the 52nd week of 2022. An annual prevalence map for CAP was developed using spatial interpolation via inverse distance weighting to estimate the continuous geographic distribution. In this process, the centroid of each district served as a point layer, indicating that the interpolation surface is predominantly influenced by proximate points, with the impact of more distant points diminishing. During the study period, a total of 23,147 cases of CAP were reported, with 94.6% (21,887 cases) occurring in rural districts. A decline in cases was noted in 2020 compared to 2019, followed by a tenfold increase in 2021. The cumulative CAP prevalence was significantly higher in rural areas (194.89 cases per 100,000 population) than in urban areas (32.43 cases per 100,000 population). The number of high-spots detected in 2019, 2020, 2021, and 2022 was 3, 2, 4, and 3 locations. The high-spots detected were classified in both town administrations (north) and rural districts (south). Low-spot areas in the center of the study area were consistently observed. Strengthening an-depth understanding of CAP high-spots will provide valuable insights for improving public health measures.