<![CDATA[Introduction: Tuberculosis (TB) remains a critical public health issue, particularly in high-incidence regions like Aceh Province, Indonesia. This study aimed to estimate the Relative Risk (RR) and analyze significant differences in the temporal distribution of TB cases across Aceh Province. Methods: A time-series ecological study was conducted using TB case and population data from 23 districts/cities in Aceh Province between 2016 and 2022. Data were analyzed using R software, applying descriptive and inferential statistics. The Standardized Morbidity Ratio (SMR) method estimates RR and is categorized into five risk levels. The Kolmogorov-Smirnov test assessed data normality, guiding the selection of statistical tests. The Friedman and Wilcoxon Signed-Rank tests examined differences in TB case distribution trends. Results: Significant spatial and temporal variations in TB risk were identified. Districts such as Banda Aceh (RR = 2.29–2.13) and Lhokseumawe (RR = 1.89–2.21) consistently demonstrated high RR from 2016 to 2022, reflecting persistent TB transmission. A general upward trend in TB cases was observed across districts, with significant spatial variation (p < 0.001), highlighting a worsening TB burden. Conclusions: The study emphasizes the urgent need for targeted public health interventions tailored to TB's unique spatial and temporal dynamics in Aceh Province, Indonesia. Applying SMR and robust statistical analyses provides valuable insights to inform localized TB control policies and strengthen management strategies in high-burden areas.]]>
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