Intervention Effect of New Tuberculosis Control Model on Tuberculosis Incidence in Xinjiang

Yan Zhang; Xinqi Wang; Nianqiang Liu; Senlu Wang; Xiaomin Wang; Mingqin Cao

doi:10.2147/IDR.S441899

Intervention Effect of New Tuberculosis Control Model on Tuberculosis Incidence in Xinjiang

Infect Drug Resist. 2023 Dec 6:16:7485-7496. doi: 10.2147/IDR.S441899. eCollection 2023.

Authors

Yan Zhang¹, Xinqi Wang², Nianqiang Liu², Senlu Wang², Xiaomin Wang¹, Mingqin Cao¹

Affiliations

¹ Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, 830011, People's Republic of China.
² The Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830002, People's Republic of China.

Abstract

Objective: To quantitatively evaluate the intervention effect of the "Xinjiang model" policy on pulmonary tuberculosis (PTB) incidence in Xinjiang, and to compare the difference of policy effect between areas with different tuberculosis burdens.

Methods: We retrospectively collected data on the registered incidence of PTB patients in 14 prefectures of Xinjiang from January 2012 to December 2021 and used Joinpoint model to describe the time trend of registered incidence, single-group interrupted time series (ITS) model to analyze the dynamics of registered incidence before and after the policy intervention, and controlled interrupted time series (CITS) model to compare the differences in the effects of the policy in different tuberculosis burdened areas.

Results: The areas with high registered incidence of PTB in Xinjiang were mainly located in the four prefectures of southern Xinjiang. The time trend of registered incidence of PTB in Xinjiang from 2012 to 2021 showed a general downward trend (AAPC=-3.4%), an upward trend from 2012 to 2018 (APC=12.1%), and a rapid downward trend from 2018 to 2021 (APC=-28.3%). Single-group ITS results showed that registered incidence in Xinjiang increased by 13.806/100,000 one month after policy was implemented (P<0.001); the long-term effect of policy was a downward trend in registered incidence (β₃<0, P<0.001), decreasing by 0.690/100,000 per month. In high-, medium-, and low-burden areas of PTB, the long-term effect of policy was a monthly decrease in registered incidence of 1.460/100,000, 0.227/100,000, and 0.064/100,000, respectively. The long-term effects of policy interventions in high- and medium-burden areas showed a faster decline in registered incidence than in low-burden areas (β₇ was -1.548 and -0.194, respectively, P<0.001).

Conclusion: A dynamic causal relationship exists between "Xinjiang model" policy and registered incidence, and its continued implementation is effective in controlling the spread of tuberculosis.

Keywords: active case finding; interrupted time series; policy evaluation; pulmonary tuberculosis; treatment.

Grants and funding

This research was supported by the Xinjiang Uygur Autonomous Region Postgraduate Scientific Research Innovation Project (grant number XJ2023G188), and the National Natural Science Foundation of China (grant number 82060622).