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

Xuemei Wang; Shaohua Yin; Yunpeng Li; Wenrui Wang; Maolin Du; Weidong Guo; Mingming Xue; Jing Wu; Danyan Liang; Ruiqi Wang; Dan Liu; Di Chu

doi:10.1186/s12879-019-3910-x

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

BMC Infect Dis. 2019 Apr 30;19(1):365. doi: 10.1186/s12879-019-3910-x.

Authors

Xuemei Wang^{1

2}, Shaohua Yin^{1

2}, Yunpeng Li³, Wenrui Wang⁴, Maolin Du⁵, Weidong Guo⁶, Mingming Xue⁷, Jing Wu⁸, Danyan Liang¹, Ruiqi Wang¹, Dan Liu¹, Di Chu⁶

Affiliations

¹ School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, China.
² School of Public Health, Peking University, Beijing, 100191, China.
³ Inner Mongolia Ecology and Agrometeorology Center, Hohhot, 010110, China.
⁴ Inner Mongolia Center for Disease Control and Prevention, Hohhot, 010031, China. wangwrcdc@126.com.
⁵ School of Public Health, Inner Mongolia Medical University, Hohhot, 010110, China. dumaolin2016@163.com.
⁶ Inner Mongolia Center for Disease Control and Prevention, Hohhot, 010031, China.
⁷ School of Basic Medicine, Inner Mongolia Medical University, Hohhot, 010110, China.
⁸ National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Associated factors; Inner Mongolia; Meteorological factors; Spatial-temporal; Tuberculosis.

MeSH terms

Bayes Theorem
China / epidemiology
Female
Humans
Male
Middle Aged
Population Density
Prevalence
Retrospective Studies
Spatial Analysis
Tuberculosis / diagnosis*
Tuberculosis / epidemiology
Weather

Grants and funding

none/Inner Mongolia Science and Technology Major Projects