Geospatial analysis of regional variations in antibiotic consumption in Tanzania from 2020 to 2024 using the electronic logistics management information system

Objective: To quantify and map regional variations in antibiotic consumption across Tanzania using national supply-chain data to guide antimicrobial stewardship (AMS) priorities. Design: A retrospective facility-level analysis was conducted using antibiotic distribution data from the electronic Logistics Management Information System (eLMIS), covering the period from July 2020 to June 2024. Setting: Public healthcare facilities across Tanzania's 26 administrative regions. Methods: Antibiotic consumption was standardized using the WHO Anatomical Therapeutic Chemical (ATC) classification and expressed as defined daily doses per 1,000 inhabitants per day (DID). Variations by region, facility level, and antibiotic class were analyzed descriptively and visualized through geospatial mapping. National trends and forecasts for 2025-2027 were modeled using autoregressive integrated moving average (ARIMA) and polynomial regression models. Results: A total of 1.63 million facility-level records were analyzed. National antibiotic consumption rose from 142.4 to 182.8 DID between 2020-2021 and 2023-2024 (a 28% increase). Dispensaries accounted for 71% of the total DID, underscoring the dominant role of primary-care facilities in antibiotic distribution. Dar es Salaam (37.9 DID), Ruvuma (34.5 DID), and Lindi (34.0 DID) recorded the highest cumulative consumption, whereas Katavi (13.7 DID) and Geita (15.4 DID) had the lowest. Access-category antibiotics comprised ≥60% of all consumption, Watch agents 35-40%, and Reserve agents ≤0.1%. Forecasting predicts continued national growth, reaching ≈ 215 DID by 2027 if current trends persist. Conclusions: Antibiotic consumption in Tanzania is concentrated in the coastal and southern regions. Geospatial analytics and digital supply chain enable targeted, data-driven stewardship interventions in resource-limited settings.