School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.
Department of Prevention and Health Care, The Sixth People's Hospital of Dongguan City, Dongguan, China.
BMJ Open. 2024 Sep 10;14(9):e085733. doi: 10.1136/bmjopen-2024-085733.
Pulmonary tuberculosis (PTB) is a critical challenge worldwide, particularly in China. This study aimed to explore the spatiotemporal transmission patterns and socioeconomic factors of PTB in Dongguan city, China.
METHODS/DESIGN: An ecological study based on the reported new PTB cases between 2011 and 2020 was conducted in Dongguan city, China. The spatiotemporal analysis methods were used to explore the long-term trend, spatiotemporal transmission pattern and socioeconomic factors of PTB.
The number of new PTB cases.
We collected 35 756 new PTB cases, including 23 572 males and 12 184 females.
The seasonal-trend decomposition indicated a significant downward trend for PTB with a significant peak in 2017 and 2018, and local spatial autocorrelation showed more and more high-high clusters in the central and north-central towns with high incidence. The multivariate spatial time series analysis revealed that the endemic component had a leading role in driving PTB transmission, with a high total effect value being 189.40 (95% CI: 171.65-207.15). A Bayesian spatiotemporal model revealed that PTB incidence is positively associated with the agricultural population ratio (relative risk (RR) =1.074), gender ratio (RR=1.104) and the number of beds in medical institutions (RR=1.028).
These findings revealed potential spatiotemporal variability and spatial aggregation of PTB, so targeted preventive strategies should be made in different towns based on spatiotemporal transmission patterns and risk factors.
肺结核（PTB）是全球面临的重大挑战，尤其在中国。本研究旨在探索中国东莞市肺结核的时空传播模式和社会经济因素。
方法/设计：本研究采用基于 2011 年至 2020 年报告的新肺结核病例的生态学研究，利用时空分析方法探讨肺结核的长期趋势、时空传播模式和社会经济因素。
新肺结核病例数。
共收集到 35756 例新肺结核病例，其中男性 23572 例，女性 12184 例。
季节性趋势分解表明肺结核呈显著下降趋势，2017 年和 2018 年达到高峰，局部空间自相关显示发病率较高的中部和中北部城镇的高-高聚集区越来越多。多变量时空时间序列分析表明，地方性成分在驱动肺结核传播方面发挥主导作用，总效应值较高，为 189.40（95%置信区间：171.65-207.15）。贝叶斯时空模型显示，肺结核发病率与农业人口比例（相对风险（RR）=1.074）、性别比例（RR=1.104）和医疗机构床位数量（RR=1.028）呈正相关。
这些发现揭示了肺结核潜在的时空变异性和空间聚集性，因此应根据时空传播模式和危险因素在不同城镇制定有针对性的预防策略。
