Wubuli Atikaimu, Li Yuehua, Xue Feng, Yao Xuemei, Upur Halmurat, Wushouer Qimanguli
Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China.
Center for Tuberculosis Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, China.
PLoS One. 2017 Jul 5;12(7):e0180226. doi: 10.1371/journal.pone.0180226. eCollection 2017.
Xinjiang is one of the highest TB-burdened provinces of China. A time-series analysis was conducted to evaluate the trend, seasonality of active TB in Xinjiang, and explore the underlying mechanism of TB seasonality by comparing the seasonal variations of different subgroups.
Monthly active TB cases from 2005 to 2014 in Xinjiang were analyzed by the X-12-ARIMA seasonal adjustment program. Seasonal amplitude (SA) was calculated and compared within the subgroups.
A total of 277,300 confirmed active TB cases were notified from 2005 to 2014 in Xinjiang, China, with a monthly average of 2311±577. The seasonality of active TB notification was peaked in March and troughed in October, with a decreasing SA trend. The annual 77.31% SA indicated an annual mean of additional TB cases diagnosed in March as compared to October. The 0-14-year-old group had significantly higher SA than 15-44-year-old group (P<0.05). Students had the highest SA, followed by herder and migrant workers (P<0.05). The pleural TB cases had significantly higher SA than the pulmonary cases (P <0.05). Significant associations were not observed between SA and sex, ethnic group, regions, the result of sputum smear microcopy, and treatment history (P>0.05).
TB notification in Xinjiang shows an apparent seasonal variation with a peak in March and trough in October. For the underlying mechanism of TB seasonality, our results hypothesize that winter indoor crowding increases the risk of TB transmission, and seasonality was mainly influenced by the recent exogenous infection rather than the endogenous reactivation.
新疆是中国结核病负担最重的省份之一。本研究进行了一项时间序列分析，以评估新疆活动性结核病的趋势、季节性，并通过比较不同亚组的季节性变化来探索结核病季节性的潜在机制。
采用X-12-ARIMA季节调整程序对2005年至2014年新疆每月的活动性结核病病例进行分析。计算并比较亚组内的季节性幅度（SA）。
2005年至2014年，中国新疆共报告277,300例确诊活动性结核病病例，月平均为2311±577例。活动性结核病报告的季节性在3月达到峰值，10月降至谷底，且季节性幅度呈下降趋势。年度季节性幅度为77.31%，表明3月诊断的结核病病例年平均比10月多。0-14岁组的季节性幅度显著高于15-44岁组（P<0.05）。学生的季节性幅度最高，其次是牧民和农民工（P<0.05）。胸膜结核病例的季节性幅度显著高于肺结核病例（P<0.05）。未观察到季节性幅度与性别、民族、地区、痰涂片显微镜检查结果及治疗史之间存在显著关联（P>0.05）。
新疆的结核病报告显示出明显的季节性变化，3月达到峰值，10月降至谷底。对于结核病季节性的潜在机制，我们的研究结果推测冬季室内人群聚集增加了结核病传播风险，且季节性主要受近期外源性感染而非内源性再激活的影响。
