Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014-2021.

IF 8.1 1区 医学 Infectious Diseases of Poverty Pub Date : 2024-05-21 DOI:10.1186/s40249-024-01203-6
Le-le Deng, Fei Zhao, Zhuo-Wei Li, Wei-Wei Zhang, Guang-Xue He, Xiang Ren
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Abstract

Background: Tuberculosis (TB) remains a pressing public health issue, posing a significant threat to individuals' well-being and lives. This study delves into the TB incidence in Chinese mainland during 2014-2021, aiming to gain deeper insights into their epidemiological characteristics and explore macro-level factors to enhance control and prevention.

Methods: TB incidence data in Chinese mainland from 2014 to 2021 were sourced from the National Notifiable Disease Reporting System (NNDRS). A two-stage distributed lag nonlinear model (DLNM) was constructed to evaluate the lag and non-linearity of daily average temperature (℃, Atemp), average relative humidity (%, ARH), average wind speed (m/s, AWS), sunshine duration (h, SD) and precipitation (mm, PRE) on the TB incidence. A spatial panel data model was used to assess the impact of demographic, medical and health resource, and economic factors on TB incidence.

Results: A total of 6,587,439 TB cases were reported in Chinese mainland during 2014-2021, with an average annual incidence rate of 59.17/100,000. The TB incidence decreased from 67.05/100,000 in 2014 to 46.40/100,000 in 2021, notably declining from 2018 to 2021 (APC = -8.87%, 95% CI: -11.97, -6.85%). TB incidence rates were higher among males, farmers, and individuals aged 65 years and older. Spatiotemporal analysis revealed a significant cluster in Xinjiang, Qinghai, and Xizang from March 2017 to June 2019 (RR = 3.94, P < 0.001). From 2014 to 2021, the proportion of etiologically confirmed cases increased from 31.31% to 56.98%, and the time interval from TB onset to diagnosis shortened from 26 days (IQR: 10-56 days) to 19 days (IQR: 7-44 days). Specific meteorological conditions, including low temperature (< 16.69℃), high relative humidity (> 71.73%), low sunshine duration (< 6.18 h) increased the risk of TB incidence, while extreme low wind speed (< 2.79 m/s) decreased the risk. The spatial Durbin model showed positive associations between TB incidence rates and sex ratio (β = 1.98), number of beds in medical and health institutions per 10,000 population (β = 0.90), and total health expenses (β = 0.55). There were negative associations between TB incidence rates and population (β = -1.14), population density (β = -0.19), urbanization rate (β = -0.62), number of medical and health institutions (β = -0.23), and number of health technicians per 10,000 population (β = -0.70).

Conclusions: Significant progress has been made in TB control and prevention in China, but challenges persist among some populations and areas. Varied relationships were observed between TB incidence and factors from meteorological, demographic, medical and health resource, and economic aspects. These findings underscore the importance of ongoing efforts to strengthen TB control and implement digital/intelligent surveillance for early risk detection and comprehensive interventions.

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2014-2021 年中国大陆结核病发病的流行病学特征及其宏观影响因素。
背景:结核病(TB)仍然是一个紧迫的公共卫生问题,对个人的福祉和生命构成重大威胁。本研究对 2014-2021 年中国大陆结核病发病情况进行了深入研究,旨在深入了解其流行病学特征,并探索宏观因素,以加强防控工作:方法:2014 年至 2021 年中国大陆结核病发病率数据来源于国家疫情报告系统(NNDRS)。建立两阶段分布式滞后非线性模型(DLNM),评估日平均气温(℃,Atemp)、平均相对湿度(%,ARH)、平均风速(m/s,AWS)、日照时数(h,SD)和降水量(mm,PRE)对结核病发病率的滞后性和非线性。采用空间面板数据模型评估人口、医疗卫生资源和经济因素对结核病发病率的影响:结果:2014-2021年间,中国大陆共报告肺结核病例6,587,439例,年平均发病率为59.17/100,000。结核病发病率从 2014 年的 67.05/100,000 降至 2021 年的 46.40/100,000,2018 年至 2021 年的发病率明显下降(APC = -8.87%,95% CI:-11.97, -6.85%)。男性、农民和 65 岁及以上人群的结核病发病率较高。时空分析显示,2017 年 3 月至 2019 年 6 月期间,新疆、青海和西藏出现了一个显著的群集(RR = 3.94,P 71.73%),日照时间短(结论:新疆、青海和西藏的结核病发病率较高:中国在结核病防控方面取得了重大进展,但部分人群和地区仍面临挑战。肺结核发病率与气象、人口、医疗卫生资源和经济等因素之间存在不同的关系。这些发现凸显了当前加强结核病控制、实施数字化/智能化监测以实现早期风险检测和综合干预的重要性。
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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty INFECTIOUS DISEASES-
自引率
1.20%
发文量
368
期刊介绍: Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.
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