Spatiotemporal epidemiology of, and factors associated with, the tuberculosis prevalence in northern China, 2010-2014

• Published in: BMC infectious diseases Vol. 19; no. 1; pp. 365 - 8
• Main Authors: Wang, Xuemei, Yin, Shaohua, Li, Yunpeng, Wang, Wenrui, Du, Maolin, Guo, Weidong, Xue, Mingming, Wu, Jing, Liang, Danyan, Wang, Ruiqi, Liu, Dan, Chu, Di
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.04.2019; BioMed Central; BMC
• Subjects: Analysis; Associated factors; Bayes Theorem; Bayesian analysis; Care and treatment; China - epidemiology; Clustering; Correlation analysis; Data models; Disease control; Environmental factors; Environmental impact; Epidemics; Epidemiology; Farmers; Female; Geographical variations; Health aspects; Health care; Humans; Infectious diseases; Inner Mongolia; Male; Males; Meningitis; Meteorological factors; Middle Aged; Mortality; Mycobacterium tuberculosis; Occupations; Population Density; Precipitation (Meteorology); Prevalence; Public health; Reliability analysis; Residential density; Retrospective Studies; Risk factors; Spatial Analysis; Spatial data; Spatial distribution; Spatial-temporal; Studies; Temporal distribution; Trends; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - epidemiology; Weather; China; Inner Mongolia China; Associated factors; Meteorological factors; Tuberculosis; Inner Mongolia; Spatial-temporal
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-019-3910-x

Tuberculosis (TB) is an important public health issue worldwide. However, evidence concerning the impact of environmental factors on TB is sparse. We performed a retrospective analysis to determine the spatiotemporal trends and geographic variations of, and the factors associated with, the TB prevalence in Inner Mongolia. We performed a retrospective analysis of the epidemiology of TB. A Bayesian spatiotemporal model was used to investigate the spatiotemporal distribution and trends of the TB prevalence. A spatial panel data model was used to identify factors associated with the TB prevalence in the 101 counties of Inner Mongolia, using county-level aggregated data collected by the Inner Mongolia Center for Disease Control and Prevention. From January 2010 to December 2014, 79,466 (6.36‱) incident TB cases were recorded. The TB prevalence ranged from 4.97‱ (12,515/25,167,547) in 2014 to 7.49‱ (18,406/ 24,578,678) in 2010; the majority of TB cases were in males, and in those aged 46-60 years; by occupation, farmers and herdsmen were the most frequently affected. The Bayesian spatiotemporal model showed that the overall TB prevalence decreased linearly from 2010 to 2014 and occupation-stratified analyses yielded similar results, corroborating the reliability of the findings. The decrease of TB prevalence in the central-western and eastern regions was more rapid than that in the overall TB prevalence. A spatial correlation analysis showed spatial clustering of the TB prevalence from 2011 to 2014 (Moran's index > 0, P < 0.05); in the spatial panel data model, rural residence, birth rate, number of beds, population density, precipitation, air pressure, and sunshine duration were associated with the TB prevalence. The overall TB prevalence in Inner Mongolia decreased from 2010 to 2014; however, the incidence of TB was high throughout this period. The TB prevalence was influenced by a spatiotemporal interaction effect and was associated with epidemiological, healthcare, and environmental factors.