Spatio-temporal variation in tuberculosis incidence and risk factors for the disease in a region of unbalanced socio-economic development

Wang, Li; Xu, Chengdong; Hu, Maogui; Jia-jun, Qiao; Wei, Chen; Li, Tao; Qian, Songbo; Yan, Mingtao

doi:10.1186/s12889-021-11833-2

Cited by 23 publications

(13 citation statements)

References 38 publications

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“…A subsequent prospective cohort study reported high TB incidence rates, [ 21 ] highlighting the need to prioritise older adults in the TB response. TB-related mortality was also more prevalent among older adults [ 19 ] concentrated in China’s Central and South-Eastern regions, [ 22 ] among lower-income residents from rural areas and in those with comorbidities [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis in older adults: case studies from four countries with rapidly ageing populations in the western pacific region

et al. 2023

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Background The Western Pacific Region has one of the fastest-growing populations of older adults (≥ 65 years) globally, among whom tuberculosis (TB) poses a particular concern. This study reports country case studies from China, Japan, the Republic of Korea, and Singapore reflecting on their experiences in managing TB among older adults. Findings Across all four countries, TB case notification and incidence rates were highest among older adults, but clinical and public health guidance focused on this population was limited. Individual country reports illustrated a range of practices and challenges. Passive case finding remains the norm, with limited active case finding (ACF) programs implemented in China, Japan, and the Republic of Korea. Different approaches have been trialled to assist older adults in securing an early diagnosis, as well as adhering to their TB treatment. All countries emphasised the need for person-centred approaches that include the creative application of new technology and tailored incentive programs, as well as reconceptualisation of how we provide treatment support. The use of traditional medicines was found to be culturally entrenched among older adults, with a need for careful consideration of their complementary use. TB infection testing and the provision of TB preventive treatment (TPT) were underutilised with highly variable practice. Conclusion Older adults require specific consideration in TB response policies, given the burgeoning aging population and their high TB risk. Policymakers, TB programs and funders must invest in and develop locally contextualised practice guidelines to inform evidence-based TB prevention and care practices for older adults.

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Section: Introductionmentioning

confidence: 99%

Tuberculosis in older adults: case studies from four countries with rapidly ageing populations in the western pacific region

et al. 2023

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“…Conversely, economically undeveloped regions have a lower population density but relatively abundant per capita medical resources. However, the uneven development of regional economy contributes to spatial differences in TB incidence in the study area [ 37 – 39 ], due to limitations imposed by the natural environment, educational level, and customs, TB prevention and control efforts may not yield immediate results in these regions [ 26 ]. Previous studies have revealed associations between TB and per capita GDP, poverty, living standards, and malnutrition [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Toward tuberculosis elimination by understanding epidemiologic characteristics and risk factors in Hainan Province, China

Zhou,

Li,

et al. 2024

Infect Dis Poverty

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Background The disease burden of tuberculosis (TB) was heavy in Hainan Province, China, and the information on transmission patterns was limited with few studies. This atudy aims to further explore the epidemiological characteristics and influencing factors of TB in Hainan Province, and thereby contribute valuable scientific evidences for TB elimination in Hainan Province. Methods The TB notification data in Hainan Province from 2013 to 2022 were collected from the Chinese National Disease Control Information System Tuberculosis Surveillance System, along with socio-economic data. The spatial–temporal and population distributions were analyzed, and spatial autocorrelation analysis was conducted to explore TB notification rate clustering. In addition, the epidemiological characteristics of the cases among in-country migrants were described, and the delay pattern in seeking medical care was investigated. Finally, a geographically and temporally weighted regression (GTWR) model was adopted to analyze the relationship between TB notification rate and socio-economic indicators. The tailored control suggestions in different regions for TB elimination was provided by understanding epidemiological characteristics and risk factors obtained by GTWR. Results From 2013 to 2022, 64,042 cases of TB were notified in Hainan Province. The estimated annual percentage change of TB notification rate in Hainan Province from 2013 to 2020 was − 6.88% [95% confidence interval (CI): − 5.30%, − 3.69%], with higher rates in central and southern regions. The majority of patients were males (76.33%) and farmers (67.80%). Cases among in-country migrants primarily originated from Sichuan (369 cases), Heilongjiang (267 cases), Hunan (236 cases), Guangdong (174 cases), and Guangxi (139 cases), accounting for 53%. The majority (98.83%) of TB cases were notified through passive case finding approaches, with delay in seeking care. The GTWR analysis showed that gross domestic product per capita, the number of medical institutions and health personnel per 10,000 people were main factors affecting the high TB notification rates in some regions in Hainan Province. Different regional tailored measures such as more TB specialized hospitals were proposed based on the characteristics of each region. Conclusions The notification rate of TB in Hainan Province has been declining overall but still remained high in central and southern regions. Particular attention should be paid to the prevalence of TB among males, farmers, and out-of-province migrant populations. The notification rate was also influenced by economic development and medical conditions, indicating the need of more TB specialized hospitals, active surveillance and other tailored prevention and control measures to promote the progress of TB elimination in Hainan Province.

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“…The resident population data of each district and county were from the Statistical Yearbook published by the Chongqing Municipal Bureau of statistics. The four variables of social economy and environment were considered as followings: (1) Environment: including PM 10 (μg/m 3 ), SO 2 (μg/m 3 ), and NO 2 (μg/m 3 ) [ 11 , 17 , 18 ]; (2) Population characteristics: including population density (PD)(people/km 2 ), urbanization rate (UR)(%) and proportion of people engaged in agriculture(%)(PEIA); (3) Economic level: including per capita GDP (1000 yuan)(PGDP), disposable income of urban residents (1000 yuan)(DIUR), disposable income of rural residents (1000 yuan)(DIRR) and the number of low-income group per 1000 non-agricultural households (LINA per 1000 persons) [ 19 ]. The above data were obtained from the Statistical Yearbook published by the Chongqing Municipal Bureau of statistics and the environmental statistical bulletin issued by the Chongqing Municipal Bureau of ecological environment.…”

Section: Methodsmentioning

confidence: 99%

A Spatio-temporal Bayesian model to estimate risk and influencing factors related to tuberculosis in Chongqing, China, 2014–2020

et al. 2023

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Background Tuberculosis (TB) is a serious infectious disease that is one of the leading causes of death worldwide. This study aimed to investigate the spatial and temporal distribution patterns and potential influencing factors of TB incidence risk, and to provide a scientific basis for the prevention and control of TB. Methods We collected reported cases of TB in 38 districts and counties in Chongqing from 2014 to 2020 and data on environment, population characteristics and economic factors during the same period. By constructing a Bayesian spatio-temporal model, we explored the spatio-temporal distribution pattern of TB incidence risk and potential influencing factors, identified key areas and key populations affected by TB, compared the spatio-temporal distribution characteristics of TB in populations with different characteristics, and explored the differences in the influence of various social and environmental factors. Results The high-risk areas for TB incidence in Chongqing from 2014 to 2020 were mainly concentrated in southeastern and northeastern regions of Chongqing, and the overall relative risk (RR) of TB showed a decreasing trend during the study period, while RR of TB in main urban area and southeast of Chongqing showed an increasing trend. The RR of TB was relatively high in the main urban area for the female population and the population aged 0–29 years, and the RR of TB for the population aged 30–44 years in the main urban area and the population aged 60 years or older in southeast of Chongqing had an increasing trend, respectively. For each 1 μg/m3 increase in SO2 and 1% increase in the number of low-income per 1000 non-agricultural households (LINA per 1000 persons), the RR of TB increased by 0.35% (95% CI: 0.08–0.61%) and 0.07% (95% CI: 0.05–0.10%), respectively. And LINA per 1000 persons had the greatest impact on the female population and the over 60 years old age group. Although each 1% increase in urbanization rate (UR) was associated with 0.15% (95% CI: 0.11–0.17%) reduction in the RR of TB in the whole population, the RR increased by 0.18% (95% CI: 0.16–0.21%) in the female population and 0.37% (95% CI: 0.34–0.45%) in the 0–29 age group. Conclusion This study showed that high-risk areas for TB were concentrated in the southeastern and northeastern regions of Chongqing, and that the elderly population was a key population for TB incidence. There were spatial and temporal differences in the incidence of TB in populations with different characteristics, and various socio-environmental factors had different effects on different populations. Local governments should focus on areas and populations at high risk of TB and develop targeted prevention interventions based on the characteristics of different populations.

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Spatio-temporal variation in tuberculosis incidence and risk factors for the disease in a region of unbalanced socio-economic development

Cited by 23 publications

References 38 publications

Tuberculosis in older adults: case studies from four countries with rapidly ageing populations in the western pacific region

Tuberculosis in older adults: case studies from four countries with rapidly ageing populations in the western pacific region

Toward tuberculosis elimination by understanding epidemiologic characteristics and risk factors in Hainan Province, China

A Spatio-temporal Bayesian model to estimate risk and influencing factors related to tuberculosis in Chongqing, China, 2014–2020

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