Lin Yangming, Liang Dabin, Liang Xiaoyan, Huang Minying, Lin Mei, Cui Zhezhe
School of Public Health, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
Guangxi Key Laboratory of Major Infectious Disease Prevention and Control and Biosafety Emergency Response, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi Zhuang Autonomous Region, 530028, People's Republic of China.
Infect Drug Resist. 2022 May 20;15:2603-2616. doi: 10.2147/IDR.S356292. eCollection 2022.
Guangxi is a high prevalence area of tuberculosis (TB) in China, urgent needing of further TB reduction. Our purpose is to analyze the epidemiological characteristics of TB in Guangxi and analyze the relationship between socioeconomic factors and TB from the dimensions of time and space to provide evidence to effectively prevent and control TB.
We performed a retrospective analysis of the epidemiology of TB. Moran's index () was used for spatial autocorrelation analysis, and space-time scanning was used to detect temporal, space, and space-time clusters of TB. A Bayesian space-time model was used to analyze related factors of the TB epidemic at the county level in Guangxi.
From 2015 to 2019, a total of 233,623 TB cases were reported in Guangxi. The majority of TB cases were in males; the reported incidence of TB was the highest in people aged ≥65 years. By occupation, farmers were the most frequently affected. The overall reported incidence of TB decreased by 4.95% during this period. Tuberculosis occurs all year round, but the annual reporting peak is usually from March to July. Spatial autocorrelation analysis showed that the reported incidence of TB in 2015-2019 was spatially clustered (Moran's > 0, < 0.05); Kulldorff's scan revealed that the space-time cluster (log-likelihood ratio = 2683.76, relative risk = 1.60, < 0.001) was mainly concentrated in northern Guangxi. Using Bayesian space-time modeling, socioeconomic and healthcare factors are related to the high prevalence of TB.
The prevalence of TB is influenced by a space-time interaction effect and is associated with socioeconomic and healthcare status. It is necessary to improve the economic development and health service in areas with a high TB prevalence.
广西是中国结核病(TB)高流行区,迫切需要进一步降低结核病负担。本研究旨在分析广西结核病的流行病学特征,并从时间和空间维度分析社会经济因素与结核病之间的关系,为有效防控结核病提供依据。
对结核病流行病学进行回顾性分析。采用莫兰指数()进行空间自相关分析,运用时空扫描检测结核病的时间、空间和时空聚集性。采用贝叶斯时空模型分析广西县级结核病流行的相关因素。
2015年至2019年,广西共报告233,623例结核病病例。结核病病例以男性居多;报告发病率在≥65岁人群中最高。按职业划分,农民受影响最为频繁。在此期间,结核病总体报告发病率下降了4.95%。结核病全年均有发生,但年度报告高峰通常在3月至7月。空间自相关分析显示,2015 - 至2019年结核病报告发病率存在空间聚集性(莫兰指数>0,<0.05);Kulldorff扫描显示,时空聚集区(对数似然比=2683.76,相对风险=1.60,<0.001)主要集中在广西北部。使用贝叶斯时空模型分析发现,社会经济和医疗因素与结核病高流行有关。
结核病流行受时空交互作用影响,且与社会经济和卫生服务状况相关。有必要改善结核病高流行地区的经济发展和卫生服务水平。