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Pan S, Chen L, Xin X, Li S, Zhang Y, Chen Y, Xiao S. Spatiotemporal analysis and seasonality of tuberculosis in Pudong New Area of Shanghai, China, 2014-2023. BMC Infect Dis 2024; 24:761. [PMID: 39085765 PMCID: PMC11293123 DOI: 10.1186/s12879-024-09645-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Spatiotemporal analysis is a vital method that plays an indispensable role in monitoring epidemiological changes in diseases and identifying high-risk clusters. However, there is still a blank space in the spatial and temporal distribution of tuberculosis (TB) incidence rate in Pudong New Area, Shanghai. Consequently, it is crucial to comprehend the spatiotemporal distribution of TB in this district, this will guide the prevention and control of TB in the district. METHODS Our research used Geographic Information System (GIS) visualization, spatial autocorrelation analysis, and space-time scan analysis to analyze the TB incidence reported in the Pudong New Area of Shanghai from 2014 to 2023, and described the spatiotemporal clustering and seasonal hot spot distribution of TB incidence. RESULTS From 2014 to 2023, the incidence of TB in the Pudong New Area decreased, and the mortality was at a low level. The incidence of TB in different towns/streets has declined. The spatial autocorrelation analysis revealed that the incidence of TB was spatially clustered in 2014, 2016-2018, and 2022, with the highest clusters in 2014 and 2022. The high clustering area was mainly concentrated in the northeast. The space-time scan analysis indicated that the most likely cluster was located in 12 towns/streets, with a period of 2014-2018 and a radiation radius of 15.74 km. The heat map showed that there was a correlation between TB incidence and seasonal variations. CONCLUSIONS From 2014 to 2023, the incidence of TB in the Pudong New Area of Shanghai declined, but there were spatiotemporal clusters and seasonal correlations in the incidence area. Local departments should formulate corresponding intervention measures, especially in high-clustering areas, to achieve accurate prevention and control of TB within the most effective time and scope.
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Affiliation(s)
- Shuishui Pan
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Lili Chen
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Xin Xin
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Shihong Li
- Third Branch Center, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yixing Zhang
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yichen Chen
- General Management Office , Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Shaotan Xiao
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
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Nie Y, Yang Z, Lu Y, Bahani M, Zheng Y, Tian M, Zhang L. Interaction between air pollutants and meteorological factors on pulmonary tuberculosis in northwest China: A case study of eight districts in Urumqi. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:691-700. [PMID: 38182774 DOI: 10.1007/s00484-023-02615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
Meteorological factors and air pollutants are associated with the spread of pulmonary tuberculosis (PTB), but few studies have examined the effects of their interactions on PTB. Therefore, this study investigated the impact of meteorological factors and air pollutants and their interactions on the risk of PTB in Urumqi, a city with a high prevalence of PTB and a high level of air pollution. The number of new PTB cases in eight districts of Urumqi from 2014 to 2019 was collected, along with data on meteorological factors and air pollutants for the same period. A generalized additive model was applied to explore the effects of meteorological factors and air pollutants and their interactions on the risk of PTB incidence. Segmented linear regression was used to estimate the nonlinear characteristics of the impact of meteorological factors on PTB. During 2014-2019, a total of 14,402 new cases of PTB were reported in eight districts, with March to May being the months of high PTB incidence. The exposure-response curves for temperature (Temp), relative humidity (RH), wind speed (WS), air pressure (AP), and diurnal temperature difference (DTR) were generally inverted "U" shaped, with the corresponding threshold values of - 5.411 °C, 52.118%, 3.513 m/s, 1021.625 hPa, and 8.161 °C, respectively. The effects of air pollutants on PTB were linear and lagged. All air pollutants were positively associated with PTB, except for O3, which was not associated with PTB, and the ER values for the effects on PTB were as follows: 0.931 (0.255, 1.612) for PM2.5, 1.028 (0.301, 1.760) for PM10, 5.061 (0.387, 9.952) for SO2, 2.830 (0.512, 5.200) for NO2, and 5.789 (1.508, 10.251) for CO. Meteorological factors and air pollutants have an interactive effect on PTB. The risk of PTB incidence was higher when in high Temp-high air pollutant, high RH-high air pollutant, high WS-high air pollutant, lowAP-high air pollutant, and high DTR-high air pollutant. In conclusion, both meteorological and pollutant factors had an influence on PTB, and the influence on PTB may have an interaction.
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Affiliation(s)
- Yanwu Nie
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Zhen Yang
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yaoqin Lu
- Urumqi Center for Disease Control and Prevention, Urumqi, China
| | - Mailiman Bahani
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yanling Zheng
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Maozai Tian
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Liping Zhang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China.
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Yadav BK, Srivastava SK, Arasu PT, Singh P. Time Series Modeling of Tuberculosis Cases in India from 2017 to 2022 Based on the SARIMA-NNAR Hybrid Model. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:5934552. [PMID: 38144388 PMCID: PMC10748728 DOI: 10.1155/2023/5934552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/01/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023]
Abstract
Tuberculosis (TB) is still one of the severe progressive threats in developing countries. There are some limitations to social and economic development among developing nations. The present study forecasts the notified prevalence of TB based on seasonality and trend by applying the SARIMA-NNAR hybrid model. The NIKSHAY database repository provides monthly informed TB cases (2017 to 2022) in India. A time series model was constructed based on the seasonal autoregressive integrated moving averages (SARIMA), neural network autoregressive (NNAR), and, SARIM-NNAR hybrid models. These models were estimated with the help of the Bayesian information criterion (BIC) and Akaike information criterion (AIC). These models were established to compare the estimation. A total of 12,576,746 notified TB cases were reported over the years whereas the average case was observed as 174,677.02. The evaluating parameters values of RMSE, MAE, and MAPE for the hybrid model were found to be (13738.97), (10369.48), and (06.68). SARIMA model was (19104.38), (14304.15), and (09.45) and the NNAR were (11566.83), (9049.27), and (05.37), respectively. Therefore, the NNAR model performs better with time series data for fitting and forecasting compared to other models such as SARIMA as well as the hybrid model. The NNAR model indicated a suitable model for notified TB incidence forecasting. This model can be a good tool for future prediction. This will assist in devising a policy and strategizing for better prevention and control.
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Affiliation(s)
- Baikunth Kumar Yadav
- Department of Zoology, Mahatma Gandhi Central University, Motihari 845401, Bihar, India
| | | | - Ponnusamy Thillai Arasu
- Department of Chemistry, College of Natural and Computational Sciences, Wollega University, Post Box No. 395, Nekemte, Ethiopia
| | - Pranveer Singh
- Department of Zoology, Mahatma Gandhi Central University, Motihari 845401, Bihar, India
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Ab Rashid MA, Ahmad Zaki R, Wan Mahiyuddin WR, Yahya A. Forecasting New Tuberculosis Cases in Malaysia: A Time-Series Study Using the Autoregressive Integrated Moving Average (ARIMA) Model. Cureus 2023; 15:e44676. [PMID: 37809275 PMCID: PMC10552684 DOI: 10.7759/cureus.44676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Background The application of the Box-Jenkins autoregressive integrated moving average (ARIMA) model has been widely employed in predicting cases of infectious diseases. It has shown a positive impact on public health early warning surveillance due to its capability in producing reliable forecasting values. This study aimed to develop a prediction model for new tuberculosis (TB) cases using time-series data from January 2013 to December 2018 in Malaysia and to forecast monthly new TB cases for 2019. Materials and methods The ARIMA model was executed using data gathered between January 2013 and December 2018 in Malaysia. Subsequently, the well-fitted model was employed to make projections for new TB cases in the year 2019. To assess the efficacy of the model, two key metrics were utilized: the mean absolute percentage error (MAPE) and stationary R-squared. Furthermore, the sufficiency of the model was validated via the Ljung-Box test. Results The results of this study revealed that the ARIMA (2,1,1)(0,1,0)12 model proved to be the most suitable choice, exhibiting the lowest MAPE value of 6.762. The new TB cases showed a clear seasonality with two peaks occurring in March and December. The proportion of variance explained by the model was 55.8% with a p-value (Ljung-Box test) of 0.356. Conclusions The application of the ARIMA model has developed a simple, precise, and low-cost forecasting model that provides a warning six months in advance for monitoring the TB epidemic in Malaysia, which exhibits a seasonal pattern.
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Affiliation(s)
- Mohd Ariff Ab Rashid
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | - Rafdzah Ahmad Zaki
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | | | - Abqariyah Yahya
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
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Zhang Y, Zhan B, Hao X, Wang W, Zhang X, Fang C, Wang M. Factors associated with diagnostic delay of pulmonary tuberculosis among children and adolescents in Quzhou, China: results from the surveillance data 2011-2021. BMC Infect Dis 2023; 23:541. [PMID: 37596514 PMCID: PMC10439644 DOI: 10.1186/s12879-023-08516-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/05/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE Tuberculosis is a high-burden disease and a major health concern in China, especially among children and adolescents. The purpose of this study was to assess risk factors for diagnostic delay in students with pulmonary tuberculosis in Quzhou City in eastern China. PATIENTS AND METHODS Cases of PTB in students and relevant information in Quzhou from 2011 to 2021 were collected using the TB Management Information System. The outcome of interest was diagnostic delay (i.e. ≥ 28 days between symptom onset and treatment initiation). Risk factors for diagnostic delay were identified using multivariable logistic regression. RESULTS A total of 629 students in Quzhou were diagnosed with PTB during the study period, of whom 55.5% were male. The median diagnostic delay was 18 days (Inter Quartile Range, [IQR]: 8-38) and 38.0% of the students had a diagnostic delay. Living in a rural area (adjusted odds ratio, [AOR]: 1.56, 95% confidence interval [CI:] 1.11-2.19), developing PTB symptoms in the first quarter of the year (AOR: 2.18, 95% CI: 1.40-3.40), and no sputum smear result (AOR: 8.73, 95% CI: 1.68-45.30) were significantly associated with a diagnostic delay. Discovery through health examinations (AOR: 0.33, 95% CI: 0.17-0.63) was associated with reduced risk of diagnostic delay. CONCLUSION Schools in rural areas should pay special attention to increasing student awareness of the symptoms of tuberculosis and provide health education on tuberculosis prevention and control to students and staff.
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Affiliation(s)
- Yating Zhang
- School of Public Health, Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
| | - Bingdong Zhan
- Department of Tuberculosis Control and Prevention, Quzhou Center for Disease Control and Prevention, No.154, Xi'an Road, Ke Cheng District, Quzhou, Zhejiang, 324000, China
| | - Xiaogang Hao
- Department of Tuberculosis Control and Prevention, Quzhou Center for Disease Control and Prevention, No.154, Xi'an Road, Ke Cheng District, Quzhou, Zhejiang, 324000, China
| | - Wei Wang
- Department of Tuberculosis Control and Prevention, Quzhou Center for Disease Control and Prevention, No.154, Xi'an Road, Ke Cheng District, Quzhou, Zhejiang, 324000, China
| | - Xing Zhang
- Department of Tuberculosis Control and Prevention, Quzhou Center for Disease Control and Prevention, No.154, Xi'an Road, Ke Cheng District, Quzhou, Zhejiang, 324000, China
| | - Chunfu Fang
- Department of Tuberculosis Control and Prevention, Quzhou Center for Disease Control and Prevention, No.154, Xi'an Road, Ke Cheng District, Quzhou, Zhejiang, 324000, China
| | - Min Wang
- Department of Tuberculosis Control and Prevention, Quzhou Center for Disease Control and Prevention, No.154, Xi'an Road, Ke Cheng District, Quzhou, Zhejiang, 324000, China.
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Taylan M, Dogru S, Sezgi C, Yilmaz S. Epidemiological trends and seasonal dynamics of tuberculosis in Southeastern Turkey. Niger J Clin Pract 2023; 26:928-933. [PMID: 37635576 DOI: 10.4103/njcp.njcp_629_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Abstract
Background Tuberculosis (TB) is an important public health issue. Determining TB trend and seasonal variability provides useful information for designing treatment strategies and control programs. Aim The present study attempts to investigate the epidemiological trend and the seasonal variations. Materials and Methods TB data containing 2450 cases were collected over a period of seven years in the province of Diyarbakir in southeast Turkey. Trend function and seasonal variability were investigated by statistical curve fitting, surface fitting, and autoregressive time series analysis. Results The study revealed a gradually decreasing trend in the number of TB cases over a period of seven years. Total TB incidence had seasonal variations (P = 0.04); there was a greater number of TB cases between April and July, with a peak in June. There were significant monthly seasonal variations with June peaks among females (P < 0.001), in patients in the age groups of 0-15 (P < 0.001) and 36-45 years (P < 0.001), in new cases (P < 0.001) and in the patients with pulmonary TB (P = 0.01). The extra-pulmonary TB cases peak in May (P = 0.01). Pulmonary TB and TB patients in the 36-45 age group had summer peak, while the other groups peaked at spring. Conclusions Spring and summer peaks detected in total TB cases and in many subgroups indicate that multicenter and comprehensive clinical studies are needed to explain these variations.
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Affiliation(s)
- M Taylan
- Department of Chest Disease, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - S Dogru
- Department of Chest Disease, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - C Sezgi
- Department of Chest Disease, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - S Yilmaz
- Department of Chest Disease, Dicle University Faculty of Medicine, Diyarbakir, Turkey
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Paz LC, Saavedra CAPB, Braga JU, Kimura H, Evangelista MDSN. [Analysis of the seasonality of tuberculosis in Brazilian capitals and the Federal District from 2001 to 2019]. CAD SAUDE PUBLICA 2022; 38:e00291321. [PMID: 35894370 DOI: 10.1590/0102-311xpt291321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/29/2022] [Indexed: 11/21/2022] Open
Abstract
The literature has few studies on the seasonality of tuberculosis (TB) in the southern hemisphere, entailing the fill of this knowledge gap. This study aims to analyze whether TB incidence in Brazilian capitals and the Federal District is seasonal. This is an ecological study of a time series (2001-2019) of TB cases, conducted with 26 capitals and the Federal District. The Ministry of Health database, with 516,524 TB cases, was used. Capitals and the Federal District were divided into five groups based on social indicators, disease burden, and the Koppen climate classification. The seasonal variation of TB notifications and group amplitude were evaluated. We found TB seasonality in Brazil with a 1% significance in all capital groups (Stability assumption and Krusall-Wallis tests, p < 0.01). In the combined seasonality test, capital groups A, D, and E showed seasonality, whereas groups B and C, its probability. Our findings showed that health service supply and/or demand - rather than climate - may be the most relevant underlying factor in TB seasonality. It is challenging to raise the other seasonal factors underlying TB seasonality in tropical regions in the Southern Hemisphere.
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Affiliation(s)
- Leidijany Costa Paz
- Centro Especializado em Doenças Infecciosas, Secretaria de Estado da Saúde do Distrito Federal, Brasília, Brasil.,Faculdade de Ciências da Saúde, Universidade de Brasília, Brasília, Brasil
| | | | - José Ueleres Braga
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.,Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Herbert Kimura
- Faculdade de Economia, Administração, Contabilidade e Gestão de Políticas Públicas, Universidade de Brasília, Brasília, Brasil
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Nie Y, Lu Y, Wang C, Yang Z, Sun Y, Zhang Y, Tian M, Rifhat R, Zhang L. Effects and Interaction of Meteorological Factors on Pulmonary Tuberculosis in Urumqi, China, 2013–2019. Front Public Health 2022; 10:951578. [PMID: 35910866 PMCID: PMC9330012 DOI: 10.3389/fpubh.2022.951578] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Most existing studies have only investigated the delayed effect of meteorological factors on pulmonary tuberculosis (PTB). However, the effect of extreme climate and the interaction between meteorological factors on PTB has been rarely investigated. Methods Newly diagonsed PTB cases and meteorological factors in Urumqi in each week between 2013 and 2019 were collected. The lag-exposure-response relationship between meteorological factors and PTB was analyzed using the distributed lag non-linear model (DLNM). The generalized additive model (GAM) was used to visualize the interaction between meteorological factors. Stratified analysis was used to explore the impact of meteorological factors on PTB in different stratification and RERI, AP and SI were used to quantitatively evaluate the interaction between meteorological factors. Results A total of 16,793 newly diagnosed PTB cases were documented in Urumqi, China from 2013 to 2019. The median (interquartile range) temperature, relative humidity, wind speed, and PTB cases were measured as 11.3°C (−5.0–20.5), 57.7% (50.7–64.2), 4.1m/s (3.4–4.7), and 47 (37–56), respectively. The effects of temperature, relative humidity and wind speed on PTB were non-linear, which were found with the “N”-shaped, “L”-shaped, “N”-shaped distribution, respectively. With the median meteorological factor as a reference, extreme low temperature was found to have a protective effect on PTB. However, extreme high temperature, extreme high relative humidity, and extreme high wind speed were found to increase the risk of PTB and peaked at 31.8°C, 83.2%, and 7.6 m/s respectively. According to the existing monitoring data, no obvious interaction between meteorological factors was found, but low temperature and low humidity (RR = 1.149, 95%CI: 1.003–1.315), low temperature and low wind speed (RR = 1.273, 95%CI: 1.146–1.415) were more likely to cause the high incidence of PTB. Conclusion Temperature, relative humidity and wind speed were found to play vital roles in PTB incidence with delayed and non-linear effects. Extreme high temperature, extreme high relative humidity, and extreme high wind speed could increase the risk of PTB. Moreover, low temperature and low humidity, low temperature and low wind speed may increase the incidence of PTB.
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Affiliation(s)
- Yanwu Nie
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yaoqin Lu
- Urumqi Center for Disease Control and Prevention, Urumqi, China
| | - Chenchen Wang
- Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Zhen Yang
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yahong Sun
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yuxia Zhang
- Department of Clinical Nutrition, Urumqi Maternal and Child Health Institute, Urumqi, China
| | - Maozai Tian
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Ramziya Rifhat
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Liping Zhang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
- *Correspondence: Liping Zhang
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Walker TM, Choisy M, Dedicoat M, Drennan PG, Wyllie D, Yang-Turner F, Crook DW, Robinson ER, Walker AS, Smith EG, Peto TE. Mycobacterium tuberculosis transmission in Birmingham, UK, 2009-19: An observational study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 17:100361. [PMID: 35345560 PMCID: PMC8956939 DOI: 10.1016/j.lanepe.2022.100361] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background Over 10-years of whole-genome sequencing (WGS) of Mycobacterium tuberculosis in Birmingham presents an opportunity to explore epidemiological trends and risk factors for transmission in new detail. Methods Between 1st January 2009 and 15th June 2019, we obtained the first WGS isolate from every patient resident in a postcode district covered by Birmingham's centralised tuberculosis service. Data on patients' sex, country of birth, social risk-factors, anatomical locus of disease, and strain lineage were collected. Poisson harmonic regression was used to assess seasonal variation in case load and a mixed-effects multivariable Cox proportionate hazards model was used to assess risk factors for a future case arising in clusters defined by a 5 single nucleotide polymorphism (SNP) threshold, and by 12 SNPs in a sensitivity analysis. Findings 511/1653 (31%) patients were genomically clustered with another. A seasonal variation in diagnoses was observed, peaking in spring, but only among clustered cases. Risk-factors for a future clustered case included UK-birth (aHR=2·03 (95%CI 1·35-3·04), p < 0·001), infectious (pulmonary/laryngeal/miliary) tuberculosis (aHR=3·08 (95%CI 1·98-4·78), p < 0·001), and M. tuberculosis lineage 3 (aHR=1·91 (95%CI 1·03-3·56), p = 0·041) and 4 (aHR=2·27 (95%CI 1·21-4·26), p = 0·011), vs. lineage 1. Similar results pertained to 12 SNP clusters, for which social risk-factors were also significant (aHR 1·72 (95%CI 1·02-2·93), p = 0·044). There was marked heterogeneity in transmission patterns between postcode districts. Interpretation There is seasonal variation in the diagnosis of genomically clustered, but not non-clustered, cases. Risk factors for clustering include UK-birth, infectious forms of tuberculosis, and infection with lineage 3 or 4. Funding Wellcome Trust, MRC, UKHSA.
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Affiliation(s)
- Timothy M. Walker
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Marc Choisy
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Martin Dedicoat
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Philip G. Drennan
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, UK
- Oxford University Hospitals NHS Foundation Trust, UK
| | - David Wyllie
- TB Unit and National Mycobacterial Reference Service, UK Health Security Agency, UK
| | - Fan Yang-Turner
- NIHR Oxford Biomedical Research Centre, University of Oxford, UK
| | - Derrick W. Crook
- Oxford University Hospitals NHS Foundation Trust, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, UK
| | - Esther R. Robinson
- TB Unit and National Mycobacterial Reference Service, UK Health Security Agency, UK
| | - A. Sarah Walker
- NIHR Oxford Biomedical Research Centre, University of Oxford, UK
| | - E. Grace Smith
- TB Unit and National Mycobacterial Reference Service, UK Health Security Agency, UK
| | - Timothy E.A. Peto
- Oxford University Hospitals NHS Foundation Trust, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, UK
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Jiang H, Sun X, Hua Z, Liu H, Cao Y, Ren D, Qi X, Zhang T, Zhang S. Distribution of bacteriologically positive and bacteriologically negative pulmonary tuberculosis in Northwest China: spatiotemporal analysis. Sci Rep 2022; 12:6895. [PMID: 35477716 PMCID: PMC9046232 DOI: 10.1038/s41598-022-10675-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/04/2022] [Indexed: 11/09/2022] Open
Abstract
Pulmonary tuberculosis (PTB) is a major health issue in Northwest China. Most previous studies on the spatiotemporal patterns of PTB considered all PTB cases as a whole; they did not distinguish notified bacteriologically positive PTB (BP-PTB) and notified bacteriologically negative PTB (BN-PTB). Thus, the spatiotemporal characteristics of notified BP-PTB and BN-PTB are still unclear. A retrospective county-level spatial epidemiological study (2011-2018) was conducted in Shaanxi, Northwest China. In total, 44,894 BP-PTB cases were notified, with an average annual incidence rate of 14.80 per 100,000 persons between 2011 and 2018. Global Moran's I values for notified BP-PTB ranged from 0.19 to 0.49 (P < 0.001). Anselin's local Moran's I analysis showed that the high-high (HH) cluster for notified BP-PTB incidence was mainly located in the southernmost region. The primary spatiotemporal cluster for notified BP-PTB (LLR = 612.52, RR = 1.77, P < 0.001) occurred in the central region of the Guanzhong Plain in 2011. In total, 116,447 BN-PTB cases were notified, with an average annual incidence rate of 38.38 per 100,000 persons between 2011 and 2018. Global Moran's I values for notified BN-PTB ranged from 0.39 to 0.69 (P < 0.001). The HH clusters of notified BN-PTB were mainly located in the north between 2011 and 2014 and in the south after 2015. The primary spatiotemporal cluster for notified BN-PTB (LLR = 1084.59, RR = 1.85, P < 0.001) occurred in the mountainous areas of the southernmost region from 2014 to 2017. Spatiotemporal clustering of BP-PTB and BN-PTB was detected in the poverty-stricken mountainous areas of Shaanxi, Northwest China. Our study provides evidence for intensifying PTB control activities in these geographical clusters.
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Affiliation(s)
- Hualin Jiang
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xiaolu Sun
- Shaanxi Provincial Institute for Tuberculosis Control and Prevention, Xi'an, 710048, China
| | - Zhongqiu Hua
- Wuxi Early Intervention Centre for Children With Special Needs, Wuxi, 214000, China
| | - Haini Liu
- Shangluo University, Shangluo, 726000, China
| | - Yi Cao
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Dan Ren
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China
| | - Xin Qi
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China.
| | - Tianhua Zhang
- Shaanxi Provincial Institute for Tuberculosis Control and Prevention, Xi'an, 710048, China.
| | - Shaoru Zhang
- Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, China.
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Aljanaby AAJ, Al-Faham QMH, Aljanaby IAJ, Hasan TH. Epidemiological study of Mycobacterium Tuberculosis in Baghdad Governorate, Iraq. GENE REPORTS 2022. [DOI: 10.1016/j.genrep.2021.101467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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12
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Shiau R, Holmen J, Chitnis AS. Public Health Expenditures and Clinical and Social Complexity of Tuberculosis Cases-Alameda County, California, July-December 2017. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2022; 28:188-198. [PMID: 33938488 DOI: 10.1097/phh.0000000000001356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
CONTEXT Alameda County, California, is a high tuberculosis (TB) burden county that reported a TB incidence rate of 8.1 per 100 000 during 2017. It is the only high TB burden California county that does not have a public health-funded TB clinic. OBJECTIVE To describe TB public health expenditures and clinical and social complexities of TB case-patients. DESIGN, SETTING, AND PARTICIPANTS Public health surveillance of confirmed and possible TB case-patients reported to Alameda County Public Health Department during July 1, 2017, to December 31, 2017. Social complexity status was categorized for all case-patients using surveillance data; clinical complexity status, either by surveillance definition or by the Charlson Comorbidity Index (CCI), was categorized only for confirmed TB case-patients. MAIN OUTCOME MEASURES Total public health and per patient expenditures were stratified by insurance status. Cohen's kappa assessed concordance between clinical complexity definitions. All comparisons were conducted using Fisher's exact or Kruskal-Wallis tests. RESULTS Of 81 case-patients reported, 68 (84%) had confirmed TB, 29 (36%) were socially complex, and 15 (19%) were uninsured. Total public health expenditures were $487 194, and 18% of expenditures were in nonlabor domains, 57% of which were for TB treatment, diagnostics, and insurance, with insured patients also incurring such expenditures. Median per patient expenditures were significantly higher for uninsured and government-insured patients than for privately insured patients ($7007 and $5045 vs $3704; P = .03). Among confirmed TB case-patients, 72% were clinically complex by surveillance definition and 53% by the CCI; concordance between definitions was poor (κ = 0.25; 95% confidence interval, 0.03-0.46). CONCLUSIONS Total public health expenditures approached $500 000. Most case-patients were clinically complex, and about 20% were uninsured. While expenditures were higher for uninsured case-patients, insured case-patients still incurred TB treatment, diagnostic, and insurance-related expenditures. State and local health departments may be able to use our expenditure estimates by insurance status and description of clinically complex TB case-patients to inform efforts to allocate and secure adequate funding.
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Affiliation(s)
- Rita Shiau
- Tuberculosis Control Section, Division of Communicable Disease Control and Prevention, Alameda County Public Health Department, San Leandro, California (Ms Shiau and Dr Chitnis); and Division of Pediatric Infectious Diseases, University of California San Francisco Benioff Children's Hospital of Oakland, Oakland, California (Dr Holmen)
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Abdelouahab MS, Arama A, Lozi R. Bifurcation analysis of a model of tuberculosis epidemic with treatment of wider population suggesting a possible role in the seasonality of this disease. CHAOS (WOODBURY, N.Y.) 2021; 31:123125. [PMID: 34972319 DOI: 10.1063/5.0057635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
In this paper, a novel epidemiological model describing the evolution of tuberculosis in a human population is proposed. This model is of the form SEIR, where S stands for Susceptible people, E for Exposed (infected but not yet infectious) people, I for Infectious people, and R for Recovered people. The main characteristic of this model inspired from the disease biology and some realistic hypothesis is that the treatment is administered not only to infectious but also to exposed people. Moreover, this model is characterized by an open structure, as it considers the transfer of infected or infectious people to other regions more conducive to their care and accepts treatment for exposed or infectious patients coming from other regions without care facilities. Stability and bifurcation of the solutions of this model are investigated. It is found that saddle-focus bifurcation occurs when the contact parameter β passes through some critical values. The model undergoes a Hopf bifurcation when the quality of treatment r is considered as a bifurcation parameter. It is shown also that the system exhibits saddle-node bifurcation, which is a transcritical bifurcation between equilibrium points. Numerical simulations are done to illustrate these theoretical results. Amazingly, the Hopf bifurcation suggests an unexpected and never suggested explanation of seasonality of such a disease, linked to the quality of treatment.
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Affiliation(s)
- M-S Abdelouahab
- Laboratory of Mathematics and Their Interactions, Abdelhafid Boussouf University Center, Mila 43000, Algeria
| | - A Arama
- School of Mathematics and Statistics, Central South University, Changsha, Hunan 410083, People's Republic of China
| | - R Lozi
- Université Côte d'Azur, CNRS, LJAD, Nice 06108, France
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Dhamnetiya D, Patel P, Jha RP, Shri N, Singh M, Bhattacharyya K. Trends in incidence and mortality of tuberculosis in India over past three decades: a joinpoint and age-period-cohort analysis. BMC Pulm Med 2021; 21:375. [PMID: 34784911 PMCID: PMC8597252 DOI: 10.1186/s12890-021-01740-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/05/2021] [Indexed: 12/05/2022] Open
Abstract
Background Tuberculosis, as a communicable disease, is an ongoing global epidemic that accounts for high burden of global mortality and morbidity. Globally, with an estimated 10 million new cases and around 1.4 million deaths, TB has emerged as one of the top 10 causes of morbidity and mortality in 2019. Worst hit 8 countries account for two thirds of the new TB cases in 2019, with India leading the count. Despite India's engagement in various TB control activities since its first recognition through the resolution passed in the All-India Sanitary Conference in 1912 and launch of first National Tuberculosis Control Programme in 1962, it has remained a major public health challenge to overcome. To accelerate progress towards the goal of ending TB by 2025, 5 years ahead of the global SDG target, it is imperative to outline the incidence and mortality trends of tuberculosis in India. This study aims to provide deep insights into the recent trends of TB incidence and mortality in India from 1990 to 2019. Methods This is an observational study based on the most recent data from the Global Burden of Disease (GBD) Study 2019. We extracted numbers, age-specific and age-standardized incidence and mortality rates of Tuberculosis for the period 1990–2019 from the Global Health Data Exchange. The average annual percent change (AAPC) along with 95% Confidence Interval (CI) in incidence and mortality were derived by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality rates were estimated by using Age–Period–Cohort model. Results During the study period, age-standardized incidence and mortality rates of TB in India declines from 390.22 to 223.01 and from 121.72 to 36.11 per 100,000 population respectively. The Joinpoint regression analysis showed a significant decreasing pattern in incidence rates in India between 1990 and 2019 for both male and female; but larger decline was observed in case of females (AAPC: − 2.21; 95% CI: − 2.29 to − 2.12; p < 0.001) as compared to males (AAPC: − 1.63; 95% CI: − 1.71 to − 1.54; p < 0.001). Similar pattern was observed for mortality where the declining trend was sharper for females (AAPC: − 4.35; 95% CI: − 5.12 to − 3.57; p < 0.001) as compared to males (AAPC: − 3.88; 95% CI: − 4.63 to − 3.11; p < 0.001). For age-specific rates, incidence and mortality rates of TB decreased for both male and female across all ages during this period. The age effect showed that both incidence and mortality significantly increased with advancing age; period effect showed that both incidence and mortality decreased with advancing time period; cohort effect on TB incidence and mortality also decreased from earlier birth cohorts to more recent birth cohorts. Conclusion Mortality and Incidence of TB decreased across all age groups for both male and female over the period 1990–2019. The incidence as well as mortality was higher among males as compared to females. The net age effect showed an unfavourable trend while the net period effect and cohort effect presented a favourable trend. Aging was likely to drive a continued increase in the mortality of TB. Though the incidence and mortality of tuberculosis significantly decreased from 1990 to 2019, the annual rate of reduction is not sufficient enough to achieve the aim of India’s National Strategic plan 2017–2025. Approximately six decades since the launch of the National Tuberculosis Control Programme, TB still remains a major public health problem in India. Government needs to strengthen four strategic pillars “Detect–Treat–Prevent–Build” (DTPB) in order to achieve TB free India as envisaged in the National Tuberculosis Elimination Programme (2020). Supplementary Information The online version contains supplementary material available at 10.1186/s12890-021-01740-y.
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Affiliation(s)
- Deepak Dhamnetiya
- Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India
| | - Priyanka Patel
- Department of Development Studies, International Institute for Population Sciences (IIPS), Mumbai, 400088, India
| | - Ravi Prakash Jha
- Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College and Hospital, Delhi, 110085, India
| | - Neha Shri
- International Institute for Population Sciences (IIPS), Mumbai, 400088, India
| | - Mayank Singh
- Department of Fertility Studies, International Institute for Population Sciences (IIPS), Mumbai, 400088, India
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Chung S, Seon JY, Lee SH, Kim HY, Lee YW, Bae K, Oh IH. The Relationship Between Socio-Demographic Factors and Tuberculosis Mortality in the Republic of Korea During 2008-2017. Front Public Health 2021; 9:691006. [PMID: 34746074 PMCID: PMC8564039 DOI: 10.3389/fpubh.2021.691006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
The Republic of Korea has a high incidence of tuberculosis (TB) and TB-specific mortality rate. In 2019, it had the second highest TB-specific mortality among Organization for Economic Co-operation and Development countries. Understanding the factors associated with TB-specific deaths may help eradicate the disease. Therefore, we aimed to identify the general characteristics associated with TB-specific mortality among Koreans. Using Causes of Death Statistics data from Statistics Korea, we assessed the year of death, sex, age, occupation, area of residence, marital status, and education level reported between 2008 and 2017. Patient characteristics associated with TB-specific deaths were analyzed using the Chi-squared test, while influencing factors of TB-specific mortality were analyzed using logistic regression analysis to calculate adjusted odds ratios (AOR). Female (AOR: 0.509, 95% CI: 0.493–0.526), those with a graduate degree or higher (AOR: 0.559, 95% CI: 0.474–0.660) had lower TB-specific mortality rates than those of their counterparts. Conversely, those aged ≥70 years (AOR: 1.239, 95% CI: 1.199–1.280), single (AOR: 1.355, 95% CI: 1.315–1.396), and skilled agricultural, forestry, and fishery workers (AOR: 1.441, 95% CI: 1.359–1.529) had higher TB-specific mortality rates than those of their counterparts. In conclusion, TB-specific mortality rates differed according to the characteristics of the deceased patients. In order to establish effective TB control, multisectoral action on broader determinants should be strengthened.
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Affiliation(s)
- SeoYeon Chung
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Jeong-Yeon Seon
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Seung Heon Lee
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine Ansan, Korea University Ansan Hospital, Ansan-Si, South Korea
| | - Hae-Young Kim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Yeo Wool Lee
- Department of Public Health, School of Medicine, Korea University, Seoul, South Korea
| | - Kyoungeun Bae
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
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16
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Benecke J, Benecke C, Ciutan M, Dosius M, Vladescu C, Olsavszky V. Retrospective analysis and time series forecasting with automated machine learning of ascariasis, enterobiasis and cystic echinococcosis in Romania. PLoS Negl Trop Dis 2021; 15:e0009831. [PMID: 34723982 PMCID: PMC8584970 DOI: 10.1371/journal.pntd.0009831] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 11/11/2021] [Accepted: 09/22/2021] [Indexed: 12/04/2022] Open
Abstract
The epidemiology of neglected tropical diseases (NTD) is persistently underprioritized, despite NTD being widespread among the poorest populations and in the least developed countries on earth. This situation necessitates thorough and efficient public health intervention. Romania is at the brink of becoming a developed country. However, this South-Eastern European country appears to be a region that is susceptible to an underestimated burden of parasitic diseases despite recent public health reforms. Moreover, there is an evident lack of new epidemiologic data on NTD after Romania's accession to the European Union (EU) in 2007. Using the national ICD-10 dataset for hospitalized patients in Romania, we generated time series datasets for 2008-2018. The objective was to gain deep understanding of the epidemiological distribution of three selected and highly endemic parasitic diseases, namely, ascariasis, enterobiasis and cystic echinococcosis (CE), during this period and forecast their courses for the ensuing two years. Through descriptive and inferential analysis, we observed a decline in case numbers for all three NTD. Several distributional particularities at regional level emerged. Furthermore, we performed predictions using a novel automated time series (AutoTS) machine learning tool and could interestingly show a stable course for these parasitic NTD. Such predictions can help public health officials and medical organizations to implement targeted disease prevention and control. To our knowledge, this is the first study involving a retrospective analysis of ascariasis, enterobiasis and CE on a nationwide scale in Romania. It is also the first to use AutoTS technology for parasitic NTD.
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Affiliation(s)
- Johannes Benecke
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, and Center of Excellence in Dermatology, Mannheim, Germany
| | - Cornelius Benecke
- Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain
| | - Marius Ciutan
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - Mihnea Dosius
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - Cristian Vladescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
- University Titu Maiorescu, Faculty of Medicine, Bucharest, Romania
| | - Victor Olsavszky
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, and Center of Excellence in Dermatology, Mannheim, Germany
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Lau LHW, Wong NS, Leung CC, Chan CK, Lau AKH, Tian L, Lee SS. Seasonality of tuberculosis in intermediate endemicity setting dominated by reactivation diseases in Hong Kong. Sci Rep 2021; 11:20259. [PMID: 34642391 PMCID: PMC8511215 DOI: 10.1038/s41598-021-99651-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/21/2021] [Indexed: 12/16/2022] Open
Abstract
Summer-spring predominance of tuberculosis (TB) has been widely reported. The relative contributions of exogenous recent infection versus endogenous reactivation to such seasonality remains poorly understood. Monthly TB notifications data between 2005 and 2017 in Hong Kong involving 64,386 cases (41% aged ≥ 65; male-to-female ratio 1.74:1) were examined for the timing, amplitude, and predictability of variation of seasonality. The observed seasonal variabilities were correlated with demographics and clinical presentations, using wavelet analysis coupled with dynamic generalised linear regression models. Overall, TB notifications peaked annually in June and July. No significant annual seasonality was demonstrated for children aged ≤ 14 irrespective of gender. The strongest seasonality was detected in the elderly (≥ 65) among males, while seasonal pattern was more prominent in the middle-aged (45–64) and adults (30–44) among females. The stronger TB seasonality among older adults in Hong Kong suggested that the pattern has been contributed largely by reactivation diseases precipitated by defective immunity whereas seasonal variation of recent infection was uncommon.
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Affiliation(s)
- Leonia Hiu Wan Lau
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong , China
| | - Ngai Sze Wong
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Chiu Leung
- Hong Kong Tuberculosis, Chest and Heart Disease Association, Hong Kong, China
| | - Chi Kuen Chan
- Tuberculosis and Chest Service, Centre for Health Protection, Department of Health, Hong Kong, China
| | - Alexis K H Lau
- Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong, China.,Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shui Shan Lee
- Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.
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Maharjan B, Gopali RS, Zhang Y. A scoping review on climate change and tuberculosis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1579-1595. [PMID: 33728507 DOI: 10.1007/s00484-021-02117-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 03/04/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Climate change is a global public health challenge. The changes in climatic factors affect the pattern and burden of tuberculosis, which is a worldwide public health problem affecting low and middle-income countries. However, the evidence related to the impact of climate change on tuberculosis is few and far between. This study is a scoping review following a five-stage version of Arksey and O'Malley's method. We searched the literature using the keywords and their combination in Google scholar, and PubMed. Climate change affects tuberculosis through diverse pathways: changes in climatic factors like temperature, humidity, and precipitation influence host response through alterations in vitamin D distribution, ultraviolet radiation, malnutrition, and other risk factors. The rise in extreme climatic events induces population displacement resulting in a greater number of vulnerable and risk populations of tuberculosis. It creates a conducive environment of tuberculosis transmission and development of active tuberculosis and disrupts tuberculosis diagnosis and treatment services. Therefore, it stands to reasons that climate change affects tuberculosis, particularly in highly vulnerable countries and areas. However, further studies and novel methodologies are required to address such a complex relationship and better understand the occurrence of tuberculosis attributable to climate change.
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Affiliation(s)
- Bijay Maharjan
- Japan-Nepal Health and Tuberculosis Research Association, Kathmandu, Nepal.
| | - Ram Sharan Gopali
- Japan-Nepal Health and Tuberculosis Research Association, Kathmandu, Nepal
| | - Ying Zhang
- School of Public Health, University of Sydney, Sydney, Australia
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Wu Q, He J, Zhang WY, Zhao KF, Jin J, Yu JL, Chen QQ, Hou S, Zhu M, Xu Z, Pan HF. The contrasting relationships of relative humidity with influenza A and B in a humid subtropical region. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:36828-36836. [PMID: 33710490 DOI: 10.1007/s11356-021-13107-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/18/2021] [Indexed: 05/19/2023]
Abstract
Influenza is an acute respiratory disease that seriously threatens public health. The occurrence of influenza has been proved to be related to a variety of meteorological factors. However, less attention has been paid to the effect of relative humidity (RH) on different types of influenza, especially in subtropical regions. Daily data on laboratory-confirmed influenza cases, weather variables, and air pollutants in Hefei covering the 2014-2019 period were collected. The seasonality and trend of daily influenza cases were explored by the time series seasonal decomposition method. Generalized linear model was fitted in conjunction with distributed lag nonlinear model to quantify the associations of RH with influenza A and influenza B. Subgroup analyses were conducted by sex, age (0-4, 5-17, and ≥18 years), and season (cold and warm seasons). A total of 5238 influenza cases including 2847 influenza A cases and 2391 influenza B cases were recorded. The epidemic of influenza presented a distinct seasonal pattern, and the number of daily influenza cases increased steadily since 2016. High RH was related to an increased risk of influenza A (maximum RR = 1.683, 95%CI: 1.365-2.076), especially among males, females, and school-age children. Low RH was associated with an increased risk of influenza B (maximum RR = 1.252, 95%CI: 1.169-1.340). The contrasting relationships of RH with influenza A and B remained significant in cold seasons. High RH and low RH were significantly associated with the increased risk of influenza A and B, respectively. The findings of our study may provide clues for proposing new effective interventions.
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Affiliation(s)
- Qian Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China
| | - Jun He
- Anhui Provincial Center for Disease Control and Prevention, 12560, Fanhua Avenue, Hefei, China
- Key Laboratory for Medical and Health of the 13th Five-Year Plan, 12560, Fanhua Avenue, Hefei, Anhui, China
| | - Wen-Yan Zhang
- Hefei Center for Disease Control and Prevention, Anhui, China
| | - Ke-Fu Zhao
- Hefei Center for Disease Control and Prevention, Anhui, China
| | - Jing Jin
- Hefei Center for Disease Control and Prevention, Anhui, China
| | - Jun-Ling Yu
- Anhui Provincial Center for Disease Control and Prevention, 12560, Fanhua Avenue, Hefei, China
- Key Laboratory for Medical and Health of the 13th Five-Year Plan, 12560, Fanhua Avenue, Hefei, Anhui, China
| | - Qing-Qing Chen
- Anhui Provincial Center for Disease Control and Prevention, 12560, Fanhua Avenue, Hefei, China
- Key Laboratory for Medical and Health of the 13th Five-Year Plan, 12560, Fanhua Avenue, Hefei, Anhui, China
| | - Sai Hou
- Anhui Provincial Center for Disease Control and Prevention, 12560, Fanhua Avenue, Hefei, China
| | - Meng Zhu
- Anhui Provincial Center for Disease Control and Prevention, 12560, Fanhua Avenue, Hefei, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia.
| | - Hai-Feng Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, 81 Meishan Road, Hefei, Anhui, China.
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Li J, Li Y, Ye M, Yao S, Yu C, Wang L, Wu W, Wang Y. Forecasting the Tuberculosis Incidence Using a Novel Ensemble Empirical Mode Decomposition-Based Data-Driven Hybrid Model in Tibet, China. Infect Drug Resist 2021; 14:1941-1955. [PMID: 34079304 PMCID: PMC8164697 DOI: 10.2147/idr.s299704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/14/2021] [Indexed: 12/13/2022] Open
Abstract
Objective The purpose of this study is to develop a novel data-driven hybrid model by fusing ensemble empirical mode decomposition (EEMD), seasonal autoregressive integrated moving average (SARIMA), with nonlinear autoregressive artificial neural network (NARNN), called EEMD-ARIMA-NARNN model, to assess and forecast the epidemic patterns of TB in Tibet. Methods The TB incidence from January 2006 to December 2017 was obtained, and then the time series was partitioned into training subsamples (from January 2006 to December 2016) and testing subsamples (from January to December 2017). Among them, the training set was used to develop the EEMD-SARIMA-NARNN combined model, whereas the testing set was used to validate the forecasting performance of the model. Whilst the forecasting accuracy level of this novel method was compared with the basic SARIMA model, basic NARNN model, error-trend-seasonal (ETS) model, and traditional SARIMA-NARNN mixture model. Results By comparing the accuracy level of the forecasting measurements including root-mean-square error, mean absolute deviation, mean error rate, mean absolute percentage error, and root-mean-square percentage error, it was shown that the EEMD-SARIMA-NARNN combined method produced lower error rates than the others. The descriptive statistics suggested that TB was a seasonal disease, peaking in late winter and early spring and a trough in autumn and early winter, and the TB epidemic indicated a drastic increase by a factor of 1.7 from 2006 to 2017 in Tibet, with average annual percentage change of 5.8 (95% confidence intervals: 3.5–8.1). Conclusion This novel data-driven hybrid method can better consider both linear and nonlinear components in the TB incidence than the others used in this study, which is of great help to estimate and forecast the future epidemic trends of TB in Tibet. Besides, under present trends, strict precautionary measures are required to reduce the spread of TB in Tibet.
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Affiliation(s)
- Jizhen Li
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, People's Republic of China
| | - Yuhong Li
- National Center for Tuberculosis Control and Prevention, China Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Ming Ye
- Preventive Medicine Clinic, Xinxiang Center for Disease Control and Prevention, Xinxiang, Henan Province, People's Republic of China
| | - Sanqiao Yao
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, People's Republic of China
| | - Chongchong Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, People's Republic of China
| | - Lei Wang
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Weidong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, People's Republic of China
| | - Yongbin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province, People's Republic of China
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Uwamahoro D, Beeman A, Sharma VK, Henry MB, Garbern SC, Becker J, Harfouche FD, Rogers AP, Kendric K, Guptill M. Seasonal influence of tuberculosis diagnosis in Rwanda. Trop Med Health 2021; 49:36. [PMID: 33980306 PMCID: PMC8114710 DOI: 10.1186/s41182-021-00328-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022] Open
Abstract
Background Tuberculosis (TB) remains a major global health concern. Previous research reveals that TB may have a seasonal peak during the spring and summer seasons in temperate climates; however, few studies have been conducted in tropical climates. This study evaluates the influence of seasonality on laboratory-confirmed TB diagnosis in Rwanda, a tropical country with two rainy and two dry seasons. Methods A retrospective chart review was performed at the University Teaching Hospital-Kigali (CHUK). From January 2016 to December 2017, 2717 CHUK patients with TB laboratory data were included. Data abstracted included patient demographics, season, HIV status, and TB laboratory results (microscopy, GeneXpert, culture). Univariate and multivariable logistic regression (adjusted for age, gender, and HIV status) analyses were performed to assess the association between season and laboratory-confirmed TB diagnoses. Results Patients presenting during rainy season periods had a lower odds of laboratory-confirmed TB diagnosis compared to the dry season (aOR=0.78, 95% CI 0.63–0.97, p=0.026) when controlling for age group, gender, and HIV status. Males, adults, and people living with HIV were more likely to have laboratory-confirmed TB diagnosis. On average, more people were tested for TB during the rainy season per month compared to the dry season (120.3 vs. 103.3), although this difference was not statistically significant. Conclusion In Rwanda, laboratory-confirmed TB case detection shows a seasonal variation with patients having higher odds of TB diagnosis occurring in the dry season. Further research is required to further elucidate this relationship and to delineate the mechanism of season influence on TB diagnosis.
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Affiliation(s)
- Doris Uwamahoro
- Department of Anesthesia, Emergency Medicine and Critical Care, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Aly Beeman
- Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - Vinay K Sharma
- Family Medicine Residency Program, Froedtert Hospital Menomonee Falls, Menomonee Falls, WI, USA
| | - Michael B Henry
- Columbia University-Vagelos College of Physicians and Surgeons, New York, NY, 10032, USA.,Department of Emergency Medicine, Maricopa Medical Center-Creighton University Arizona Health Education Alliance, Phoenix, AZ, USA
| | - Stephanie Chow Garbern
- Department of Emergency Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Joseph Becker
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Alexis Perez Rogers
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Kayla Kendric
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Mindi Guptill
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
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22
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Charles T, Eckardt M, Karo B, Haas W, Kröger S. Seasonality in extra-pulmonary tuberculosis notifications in Germany 2004-2014- a time series analysis. BMC Public Health 2021; 21:661. [PMID: 33823839 PMCID: PMC8025493 DOI: 10.1186/s12889-021-10655-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 03/18/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Seasonality in tuberculosis (TB) has been found in different parts of the world, showing a peak in spring/summer and a trough in autumn/winter. The evidence is less clear which factors drive seasonality. It was our aim to identify and evaluate seasonality in the notifications of TB in Germany, additionally investigating the possible variance of seasonality by disease site, sex and age group. METHODS We conducted an integer-valued time series analysis using national surveillance data. We analysed the reported monthly numbers of started treatments between 2004 and 2014 for all notified TB cases and stratified by disease site, sex and age group. RESULTS We detected seasonality in the extra-pulmonary TB cases (N = 11,219), with peaks in late spring/summer and troughs in fall/winter. For all TB notifications together (N = 51,090) and for pulmonary TB only (N = 39,714) we did not find a distinct seasonality. Additional stratified analyses did not reveal any clear differences between age groups, the sexes, or between active and passive case finding. CONCLUSION We found seasonality in extra-pulmonary TB only, indicating that seasonality of disease onset might be specific to the disease site. This could point towards differences in disease progression between the different clinical disease manifestations. Sex appears not to be an important driver of seasonality, whereas the role of age remains unclear as this could not be sufficiently investigated.
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Affiliation(s)
- Tanja Charles
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
- Postgraduate Training for Applied Epidemiology, Robert Koch Institute, Berlin, Germany.
- European Programme for Intervention Epidemiology Training, ECDC, Solna, Sweden.
| | - Matthias Eckardt
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Basel Karo
- Centre for International Health Protection (ZIG), Robert Koch Institute, Berlin, Germany
| | - Walter Haas
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Stefan Kröger
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
- German Center for Infection Research (DZIF), partner site Hanover - Brunswick, Germany
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Kirolos A, Thindwa D, Khundi M, Burke RM, Henrion MYR, Nakamura I, Divala TH, Nliwasa M, Corbett EL, MacPherson P. Tuberculosis case notifications in Malawi have strong seasonal and weather-related trends. Sci Rep 2021; 11:4621. [PMID: 33633272 PMCID: PMC7907065 DOI: 10.1038/s41598-021-84124-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/02/2021] [Indexed: 12/30/2022] Open
Abstract
Seasonal trends in tuberculosis (TB) notifications have been observed in several countries but are poorly understood. Explanatory factors may include weather, indoor crowding, seasonal respiratory infections and migration. Using enhanced citywide TB surveillance data collected over nine years in Blantyre, Malawi, we set out to investigate how weather and seasonality affect temporal trends in TB case notification rates (CNRs) across different demographic groups. We used data from prospective enhanced surveillance between April 2011 and December 2018, which systematically collected age, HIV status, sex and case notification dates for all registering TB cases in Blantyre. We retrieved temperature and rainfall data from the Global Surface Summary of the Day weather station database. We calculated weekly trends in TB CNRs, rainfall and temperature, and calculated 10-week moving averages. To investigate the associations between rainfall, temperature and TB CNRs, we fitted generalized linear models using a distributed lag nonlinear framework. The estimated Blantyre population increased from 1,068,151 in April 2011 to 1,264,304 in December 2018, with 15,908 TB cases recorded. Overall annual TB CNRs declined from 222 to 145 per 100,000 between 2012 and 2018, with the largest declines seen in HIV-positive people and adults aged over 20 years old. TB CNRs peaks occurred with increasing temperature in September and October before the onset of increased rainfall, and later in the rainy season during January-March, after sustained rainfall. When lag between a change in weather and TB case notifications was accounted for, higher average rainfall was associated with an equivalent six weeks of relatively lower TB notification rates, whereas there were no changes in TB CNR associated with change in average temperatures. TB CNRs in Blantyre have a seasonal pattern of two cyclical peaks per year, coinciding with the start and end of the rainy season. These trends may be explained by increased transmission at certain times of the year, by limited healthcare access, by patterns of seasonal respiratory infections precipitating cough and care-seeking, or by migratory patterns related to planting and harvesting during the rainy season.
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Affiliation(s)
- Amir Kirolos
- grid.10025.360000 0004 1936 8470Department of Clinical Infection, Microbiology & Immunology, Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Deus Thindwa
- grid.8991.90000 0004 0425 469XDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - McEwen Khundi
- grid.8991.90000 0004 0425 469XDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK ,grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi
| | - Rachael M. Burke
- grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi ,grid.8991.90000 0004 0425 469XClinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Marc Y. R. Henrion
- grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi ,grid.48004.380000 0004 1936 9764Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Itaru Nakamura
- grid.412781.90000 0004 1775 2495Department of Infectious Diseases, Tokyo Medical University Hospital, Tokyo, Japan
| | - Titus H. Divala
- grid.8991.90000 0004 0425 469XDepartment of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK ,grid.10595.380000 0001 2113 2211Helse Nord TB Initiative, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Marriott Nliwasa
- grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi ,grid.10595.380000 0001 2113 2211Helse Nord TB Initiative, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Elizabeth L. Corbett
- grid.415487.b0000 0004 0598 3456Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi ,grid.8991.90000 0004 0425 469XClinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter MacPherson
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, PO30096, Blantyre, Malawi. .,Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK. .,Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
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24
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Butt MF, Younis S, Wu Z, Hadi SH, Latif A, Martineau AR. The relationship between seasonality, latitude and tuberculosis notifications in Pakistan. BMC Infect Dis 2021; 21:210. [PMID: 33632152 PMCID: PMC7905850 DOI: 10.1186/s12879-021-05899-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 02/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background Pakistan ranks amongst the top 20 highest burden tuberculosis (TB) countries in the world. Approximately 369,548 cases of TB (all forms) were notified in 2018, with an estimated incidence of 265 per 100,000 people per year. In other settings, TB has been shown to demonstrate seasonal variation, with higher incidence in the spring/summer months and lower incidence in the autumn/winter; the amplitude of seasonal variation has also been reported to be higher with increasing distance from the equator. Methods Notifications of newly-diagnosed pulmonary and extrapulmonary TB cases were obtained for 139 districts in Pakistan from 2011 to 2017. Data were provided by the Pakistan National TB Control Programme, Islamabad, Pakistan. Statistical analyses were performed to determine whether there was seasonal variation in TB notifications in Pakistan; whether the amplitude of seasonal variation in TB notifications varied according to latitude; whether the amplitude of seasonal variation of TB in Pakistan differed between extrapulmonary TB vs. pulmonary TB. To assess the quarterly seasonality of TB, we used the X-13-ARIMA-SEATS seasonal adjustment programme from the United States Census Bureau. The mean difference and corresponding 95% confidence intervals of seasonal amplitudes between different latitudes and clinical phenotype of TB were estimated using linear regression. Results TB notifications were highest in quarter 2, and lowest in quarter 4. The mean amplitude of seasonal variation was 25.5% (95% CI 25.0 to 25.9%). The mean seasonal amplitude of TB notifications from latitude 24.5°N- < 26.5°N was 29.5% (95% CI 29.3 to 29.7%) whilst the mean seasonal amplitude of TB notifications from latitude 34.5°N - < 36.5°N was 21.7% (95% CI 19.6 to 23.9%). The mean seasonal amplitude of TB notifications across Pakistan between latitudes 24.5°N to 36.5°N reached statistically significant difference (p < 0.001). The amplitude of seasonal variation was greater for extrapulmonary TB (mean seasonal amplitude: 32.6, 95% CI 21.4 to 21.8%) vs. smear positive pulmonary TB mean seasonal amplitude: 21.6, 95% CI 32.1 to 33.1%), p < 0.001. Conclusion TB notifications in Pakistan exhibit seasonal variation with a peak in quarter 2 (April–June) and trough in quarter 4 (October–December). The amplitude of seasonality decreases with increasing latitude, and is more pronounced for extrapulmonary than for pulmonary TB. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-05899-x.
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Affiliation(s)
- Mohsin F Butt
- The Wingate Institute of Neurogastroenterology, Centre for Neuroscience, Trauma and Surgery, The Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 26 Ashfield Street, Whitechapel, London, E1 2AJ, UK. .,Department of Respiratory Medicine, Royal Free Hospital, Royal Free NHS Foundation Trust, Pond Street, Hampstead, London, NW3 2QG, UK.
| | - Sidra Younis
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Abid Majeed Road, Rawalpindi, Pakistan.,Institute of Population Health Sciences, Yvonne Carter Building, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 58 Turner Street, Whitechapel, London, E1 2AB, UK
| | - Zhenqiang Wu
- Department of Geriatric Medicine, The University of Auckland, Auckland, New Zealand
| | - Syed H Hadi
- National Tuberculosis Control Programme, Islamabad, Pakistan
| | - Abdullah Latif
- National Tuberculosis Control Programme, Islamabad, Pakistan
| | - Adrian R Martineau
- Institute of Population Health Sciences, Yvonne Carter Building, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, 58 Turner Street, Whitechapel, London, E1 2AB, UK
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25
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Huang K, Yang XJ, Hu CY, Ding K, Jiang W, Hua XG, Liu J, Cao JY, Sun CY, Zhang T, Kan XH, Zhang XJ. Short-term effect of ambient temperature change on the risk of tuberculosis admissions: Assessments of two exposure metrics. ENVIRONMENTAL RESEARCH 2020; 189:109900. [PMID: 32980000 DOI: 10.1016/j.envres.2020.109900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/20/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Although the effects of seasonal variations and ambient temperature on the incidence of tuberculosis (TB) have been well documented, it is still unknown whether ambient temperature change is an independent risk factor for TB. The aim of this study was to assess the association between ambient temperature change and the risk of TB admissions. METHOD A distributed lag non-linear model (DLNM) combined with Poisson generalized linear regression model was performed to assess the association between ambient temperature change and the risk of TB admissions from 2014 to 2018 in Hefei, China. Two temperature change metrics including temperature change between neighboring days (TCN) and diurnal temperature range (DTR) were used to assess the effects of temperature change exposure. Subgroup analyses were performed by gender, age and season. Besides, the attributable risk was calculated to evaluated the public health significance. RESULTS The overall exposure-response curves suggested that there were statistically significant associations between two temperature change metrics and the risk of TB admissions. The maximum lag-specific relative risk (RR) of TB admissions was 1.088 (95%CI: 1.012-1.171, lag 4 day) for exposing to large temperature drop (TCN= -4 °C) in winter. Besides, the overall cumulative risk of TB admissions increased continuously and peaked at a lag of 7 days (RR=1.350, 95%CI: 1.120-1.628). Subgroup analysis suggested that exposure to large temperature drop had an adverse effect on TB admissions among males, females and adults. Similarly, large level of DTR exposure (DTR=15 °C) in spring also increased the risk of TB admissions on lag 0 day (RR=1.039, 95%CI: 1.016-1.063), and the cumulative RRs peaked at a lag of 1 days (RR=1.029, 95%CI: 1.012-1.047). We also found that females and elderly people were more vulnerable to the large level of DTR exposure. Additionally, the assessment of attributable risk suggested that taking target measures for the upcoming large temperature drop (b-AF = 4.17%, 95% eCI: 1.24%, 7.22%, b-AN = 1195) may achieve great public health benefits for TB prevention. CONCLUSION This study suggests that ambient temperature change is associated with the risk of TB admissions. Besides, TCN may be a better predictor for the TB prevention and public health.
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Affiliation(s)
- Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Jing Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Cheng-Yang Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Kun Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Wen Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Xiao-Guo Hua
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Jie Liu
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ji-Yu Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Chen-Yu Sun
- AMITA Health Saint Joseph Hospital Chicago, 2900 N. Lake Shore Drive, Chicago, 60657, Illinois, USA
| | - Tao Zhang
- Anhui Chest Hospital, 397 Jixi Road, Hefei, 230022, China
| | - Xiao-Hong Kan
- Anhui Chest Hospital, 397 Jixi Road, Hefei, 230022, China; Anhui Medical University Clinical College of Chest, 397 Jixi Road, Hefei, 230022, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Zhang YQ, Li XX, Li WB, Jiang JG, Zhang GL, Zhuang Y, Xu JY, Shi J, Sun DY. Analysis and predication of tuberculosis registration rates in Henan Province, China: an exponential smoothing model study. Infect Dis Poverty 2020; 9:123. [PMID: 32867846 PMCID: PMC7457775 DOI: 10.1186/s40249-020-00742-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background The World Health Organization End TB Strategy meant that compared with 2015 baseline, the reduction in pulmonary tuberculosis (PTB) incidence should be 20 and 50% in 2020 and 2025, respectively. The case number of PTB in China accounted for 9% of the global total in 2018, which ranked the second high in the world. From 2007 to 2019, 854 672 active PTB cases were registered and treated in Henan Province, China. This study was to assess whether the WHO milestones could be achieved in Henan Province. Methods The active PTB numbers in Henan Province from 2007 to 2019, registered in Chinese Tuberculosis Information Management System were analyzed to predict the active PTB registration rates in 2020 and 2025, which is conductive to early response measures to ensure the achievement of the WHO milestones. The time series model was created by monthly active PTB registration rates from 2007 to 2016, and the optimal model was verified by data from 2017 to 2019. The Ljung-Box Q statistic was used to evaluate the model. The statistically significant level is α = 0.05. Monthly active PTB registration rates and 95% confidence interval (CI) from 2020 to 2025 were predicted. Results High active PTB registration rates in March, April, May and June showed the seasonal variations. The exponential smoothing winter’s multiplication model was selected as the best-fitting model. The predicted values were approximately consistent with the observed ones from 2017 to 2019. The annual active PTB registration rates were predicted as 49.1 (95% CI: 36.2–62.0) per 100 000 population and 34.4 (95% CI: 18.6–50.2) per 100 000 population in 2020 and 2025, respectively. Compared with the active PTB registration rate in 2015, the reduction will reach 23.7% (95% CI, 3.2–44.1%) and 46.8% (95% CI, 21.4–72.1%) in 2020 and 2025, respectively. Conclusions The high active PTB registration rates in spring and early summer indicate that high risk of tuberculosis infection in late autumn and winter in Henan Province. Without regard to the CI, the first milestone of WHO End TB Strategy in 2020 will be achieved. However, the second milestone in 2025 will not be easily achieved unless there are early response measures in Henan Province, China.
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Affiliation(s)
- Yan-Qiu Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou, 450016, P. R. China.
| | - Xin-Xu Li
- Center for Drug Evaluation, National Medical Products Administration, Beijing, 100022, P. R. China
| | - Wei-Bin Li
- Kaifeng Municipal Health Commission, Kaifeng, 475000, P. R. China
| | - Jian-Guo Jiang
- Henan Center for Disease Control and Prevention, Zhengzhou, 450016, P. R. China
| | - Guo-Long Zhang
- Henan Center for Disease Control and Prevention, Zhengzhou, 450016, P. R. China
| | - Yan Zhuang
- Henan Center for Disease Control and Prevention, Zhengzhou, 450016, P. R. China
| | - Ji-Ying Xu
- Henan Center for Disease Control and Prevention, Zhengzhou, 450016, P. R. China
| | - Jie Shi
- Henan Center for Disease Control and Prevention, Zhengzhou, 450016, P. R. China
| | - Ding-Yong Sun
- Henan Center for Disease Control and Prevention, Zhengzhou, 450016, P. R. China
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Li Y, Zhu L, Lu W, Chen C, Yang H. Seasonal variation in notified tuberculosis cases from 2014 to 2018 in eastern China. J Int Med Res 2020; 48:300060520949031. [PMID: 32840170 PMCID: PMC7450459 DOI: 10.1177/0300060520949031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective Tuberculosis (TB) incidence shows a seasonal trend. The purpose of this study
was to explore seasonal trends in TB cases in Jiangsu Province. Methods TB case data were collected from the TB registration system from 2014 to
2018. The X12-ARIMA model was used to adjust the Jiangsu TB time series.
Analysis of variance was used to compare TB seasonal amplitude (SA) between
subgroups and identify factors responsible for seasonal variation. Results The TB incidence in Jiangsu showed a seasonal trend. Confirmed active TB
peaked in March and reached a minimum in February. The amplitude of the
peak-to-bottom difference was 38.15%. The SAs in individuals 7 to 17 years
old (80.00%) and students (71.80%) were significantly different than those
in other subgroups. Among bacterial culture positive individuals, the SAs
among female patients, individuals aged 7 to 17 years and students were
significantly different from those in the reference group. Among
culture-negative patients, the SA among individuals aged 7 to 17 years was
significantly different those in other subgroups. Conclusions The TB incidence in Jiangsu Province displayed a seasonal trend. Factors
related to seasonal variation were age and occupation. Our results highlight
the importance of controlling Mycobacterium tuberculosis
transmission during winter.
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Affiliation(s)
- Yishu Li
- Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu Province, PR China
| | - Limei Zhu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, PR China
| | - Wei Lu
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, PR China
| | - Cheng Chen
- Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, Jiangsu Province, PR China
| | - Haitao Yang
- Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu Province, PR China
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Time Series Analysis and Forecasting with Automated Machine Learning on a National ICD-10 Database. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144979. [PMID: 32664331 PMCID: PMC7400312 DOI: 10.3390/ijerph17144979] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/29/2020] [Accepted: 07/07/2020] [Indexed: 12/22/2022]
Abstract
The application of machine learning (ML) for use in generating insights and making predictions on new records continues to expand within the medical community. Despite this progress to date, the application of time series analysis has remained underexplored due to complexity of the underlying techniques. In this study, we have deployed a novel ML, called automated time series (AutoTS) machine learning, to automate data processing and the application of a multitude of models to assess which best forecasts future values. This rapid experimentation allows for and enables the selection of the most accurate model in order to perform time series predictions. By using the nation-wide ICD-10 (International Classification of Diseases, Tenth Revision) dataset of hospitalized patients of Romania, we have generated time series datasets over the period of 2008–2018 and performed highly accurate AutoTS predictions for the ten deadliest diseases. Forecast results for the years 2019 and 2020 were generated on a NUTS 2 (Nomenclature of Territorial Units for Statistics) regional level. This is the first study to our knowledge to perform time series forecasting of multiple diseases at a regional level using automated time series machine learning on a national ICD-10 dataset. The deployment of AutoTS technology can help decision makers in implementing targeted national health policies more efficiently.
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Zhao F, Zhu JF, Tang WQ, Wang Y, Xu LX, Chen JG. The epidemic trend and characteristics of tuberculosis for local population and migrants from 2010 to 2017 in Jiading, China. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01035-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Estimating seasonal variation in Australian pertussis notifications from 1991 to 2016: evidence of spring to summer peaks. Epidemiol Infect 2020; 147:e155. [PMID: 31063086 PMCID: PMC6518527 DOI: 10.1017/s0950268818003680] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Unlike for many other respiratory infections, the seasonality of pertussis is not well understood. While evidence of seasonal fluctuations in pertussis incidence has been noted in some countries, there have been conflicting findings including in the context of Australia. We investigated this issue by analysing the seasonality of pertussis notifications in Australia using monthly data from January 1991 to December 2016. Data were made available for all states and territories in Australia except for the Australian Capital Territory and were stratified into age groups. Using a time-series decomposition approach, we formulated a generalised additive model where seasonality is expressed using cosinor terms to estimate the amplitude and peak timing of pertussis notifications in Australia. We also compared these characteristics across different jurisdictions and age groups. We found evidence that pertussis notifications exhibit seasonality, with peaks observed during the spring and summer months (November–January) in Australia and across different states and territories. During peak months, notifications are expected to increase by about 15% compared with the yearly average. Peak notifications for children <5 years occurred 1–2 months later than the general population, which provides support to the theory that older household members remain an important source of pertussis infection for younger children. In addition, our results provide a more comprehensive spatial picture of seasonality in Australia, a feature lacking in previous studies. Finally, our findings suggest that seasonal forcing may be useful to consider in future population transmission models of pertussis.
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Bonell A, Contamin L, Thai PQ, Thuy HTT, van Doorn HR, White R, Nadjm B, Choisy M. Does sunlight drive seasonality of TB in Vietnam? A retrospective environmental ecological study of tuberculosis seasonality in Vietnam from 2010 to 2015. BMC Infect Dis 2020; 20:184. [PMID: 32111195 PMCID: PMC7048025 DOI: 10.1186/s12879-020-4908-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 02/19/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) is a major global health burden, with an estimated quarter of the world's population being infected. The World Health Organization (WHO) launched the "End TB Strategy" in 2014 emphasising knowing the epidemic. WHO ranks Vietnam 12th in the world of high burden countries. TB spatial and temporal patterns have been observed globally with evidence of Vitamin D playing a role in seasonality. We explored the presence of temporal and spatial clustering of TB in Vietnam and their determinants to aid public health measures. METHODS Data were collected by the National TB program of Vietnam from 2010 to 2015 and linked to the following datasets: socio-demographic characteristics; climatic variables; influenza-like-illness (ILI) incidence; geospatial data. The TB dataset was aggregated by province and quarter. Descriptive time series analyses using LOESS regression were completed per province to determine seasonality and trend. Harmonic regression was used to determine the amplitude of seasonality by province. A mixed-effect linear model was used with province and year as random effects and all other variables as fixed effects. RESULTS There were 610,676 cases of TB notified between 2010 and 2015 in Vietnam. Heat maps of TB incidence per quarter per province showed substantial temporal and geospatial variation. Time series analysis demonstrated seasonality throughout the country, with peaks in spring/summer and troughs in autumn/winter. Incidence was consistently higher in the south, the three provinces with the highest incidence per 100,000 population were Tay Ninh, An Giang and Ho Chi Minh City. However, relative seasonal amplitude was more pronounced in the north. Mixed-effect linear model confirmed that TB incidence was associated with time and latitude. Of the demographic, socio-economic and health related variables, population density, percentage of those under 15 years of age, and HIV infection prevalence per province were associated with TB incidence. Of the climate variables, absolute humidity, average temperature and sunlight were associated with TB incidence. CONCLUSION Preventative public health measures should be focused in the south of Viet Nam where incidence is highest. Vitamin D is unlikely to be a strong driver of seasonality but supplementation may play a role in a package of interventions.
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Affiliation(s)
- Ana Bonell
- London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK.
- Oxford University Clinical Research Unit - Hanoi, National Hospital of Tropical Diseases, 78 Giai Phong, Hanoi, Vietnam.
| | - Lucie Contamin
- Oxford University Clinical Research Unit - Hanoi, National Hospital of Tropical Diseases, 78 Giai Phong, Hanoi, Vietnam
- Institute of Research for Development, 34394, Montpellier, France
| | - Pham Quang Thai
- National Institute of Hygiene and Epidemiology, 1 Yec Xanh, Pham Dinh Ho, Hai Ba Trung, Hanoi, 100000, Vietnam
| | | | - H Rogier van Doorn
- Oxford University Clinical Research Unit - Hanoi, National Hospital of Tropical Diseases, 78 Giai Phong, Hanoi, Vietnam
| | - Richard White
- TB Modelling Group, Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK
| | - Behzad Nadjm
- London School of Hygiene and Tropical Medicine, WC1E 7HT, London, UK
- Oxford University Clinical Research Unit - Hanoi, National Hospital of Tropical Diseases, 78 Giai Phong, Hanoi, Vietnam
| | - Marc Choisy
- Oxford University Clinical Research Unit - Hanoi, National Hospital of Tropical Diseases, 78 Giai Phong, Hanoi, Vietnam
- Institute of Research for Development, 34394, Montpellier, France
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Chen J, Qiu Y, Yang R, Li L, Hou J, Lu K, Xu L. The characteristics of spatial-temporal distribution and cluster of tuberculosis in Yunnan Province, China, 2005-2018. BMC Public Health 2019; 19:1715. [PMID: 31864329 PMCID: PMC6925503 DOI: 10.1186/s12889-019-7993-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 11/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) makes a big challenge to public health, especially in high TB burden counties of China and Greater Mekong Subregion (GMS). The aim of this study was to identify the spatial-temporal dynamic process and high-risk region of notified pulmonary tuberculosis (PTB), sputum smear-positive tuberculosis (SSP-TB) and sputum smear-negative tuberculosis (SSN-TB) cases in Yunnan, the south-western of China between years of 2005 to 2018. Meanwhile, to evaluate the similarity of prevalence pattern for TB among GMS. METHODS Data for notified PTB were extracted from the China Information System for Disease Control and Prevention (CISDCP) correspond to population information in 129 counties of Yunnan between 2005 to 2018. Seasonally adjusted time series defined the trend cycle and seasonality of PTB prevalence. Kulldorff's space-time scan statistics was applied to identify temporal, spatial and spatial-temporal PTB prevalence clusters at county-level of Yunnan. Pearson correlation coefficient and hierarchical clustering were applied to define the similarity of TB prevalence among borders with GMS. RESULT There were a total of 381,855 notified PTB cases in Yunnan, and the average prevalence was 59.1 per 100,000 population between 2005 to 2018. A declined long-term trend with seasonality of a peak in spring and a trough in winter for PTB was observed. Spatial-temporal scan statistics detected the significant clusters of PTB prevalence, the most likely cluster concentrated in the northeastern angle of Yunnan between 2011 to 2015 (RR = 2.6, P < 0.01), though the most recent cluster for PTB and spatial cluster for SSP-TB was in borders with GMS. There were six potential TB prevalence patterns among GMS. CONCLUSION This study detected aggregated time interval and regions for PTB, SSP-TB, and SSN-TB at county-level of Yunnan province. Similarity prevalence pattern was found in borders and GMS. The localized prevention strategy should focus on cross-boundary transmission and SSN-TB control.
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Affiliation(s)
- Jinou Chen
- Division of tuberculosis control and prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan China
| | - Yubing Qiu
- Division of tuberculosis control and prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan China
| | - Rui Yang
- Division of tuberculosis control and prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan China
| | - Ling Li
- Division of tuberculosis control and prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan China
| | - Jinglong Hou
- Division of tuberculosis control and prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan China
| | - Kunyun Lu
- Division of tuberculosis control and prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan China
| | - Lin Xu
- Division of tuberculosis control and prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan China
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Delay effect and burden of weather-related tuberculosis cases in Rajshahi province, Bangladesh, 2007-2012. Sci Rep 2019; 9:12720. [PMID: 31481739 PMCID: PMC6722246 DOI: 10.1038/s41598-019-49135-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/20/2019] [Indexed: 12/17/2022] Open
Abstract
Tuberculosis (TB) is a potentially fatal infectious disease that continues to be a public health problem in Bangladesh. Each year in Bangladesh an estimated 70,000 people die of TB and 300,000 new cases are projected. It is important to understand the association between TB incidence and weather factors in Bangladesh in order to develop proper intervention programs. In this study, we examine the delayed effect of weather variables on TB occurrence and estimate the burden of the disease that can be attributed to weather factors. We used generalized linear Poisson regression models to investigate the association between weather factors and TB cases reported to the Bangladesh National TB control program between 2007 and 2012 in three known endemic districts of North-East Bangladesh. The associated risk of TB in the three districts increases with prolonged exposure to temperature and rainfall, and persisted at lag periods beyond 6 quarters. The association between humidity and TB is strong and immediate at low humidity, but the risk decreases with increasing lag. Using the optimum weather values corresponding to the lowest risk of infection, the risk of TB is highest at low temperature, low humidity and low rainfall. Measures of the risk attributable to weather variables revealed that weather-TB cases attributed to humidity is higher than that of temperature and rainfall in each of the three districts. Our results highlight the high linearity of temporal lagged effects and magnitudes of the burden attributable to temperature, humidity, and rainfall on TB endemics. The results can hopefully advise the Bangladesh National TB control program and act as a practical reference for the early warning of TB cases.
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Li T, Cheng Q, Li C, Stokes E, Collender P, Ohringer A, Li X, Li J, Zelner JL, Liang S, Yang C, Remais JV, He J. Evidence for heterogeneity in China's progress against pulmonary tuberculosis: uneven reductions in a major center of ongoing transmission, 2005-2017. BMC Infect Dis 2019; 19:615. [PMID: 31299911 PMCID: PMC6626433 DOI: 10.1186/s12879-019-4262-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 07/04/2019] [Indexed: 02/02/2023] Open
Abstract
Background China contributed 8.9% of all incident cases of tuberculosis globally in 2017, and understanding the spatiotemporal distribution of pulmonary tuberculosis (PTB) in major transmission foci in the country is critical to ongoing efforts to improve population health. Methods We estimated annual PTB notification rates and their spatiotemporal distributions in Sichuan province, a major center of ongoing transmission, from 2005 to 2017. Time series decomposition was used to obtain trend components from the monthly incidence rate time series. Spatiotemporal cluster analyses were conducted to detect spatiotemporal clusters of PTB at the county level. Results From 2005 to 2017, 976,873 cases of active PTB and 388,739 cases of smear-positive PTB were reported in Sichuan Province, China. During this period, the overall reported incidence rate of active PTB decreased steadily at a rate of decrease (3.77 cases per 100,000 per year, 95% confidence interval (CI): 3.28–4.31) that was slightly faster than the national average rate of decrease (3.14 cases per 100,000 per year, 95% CI: 2.61–3.67). Although reported PTB incidence decreased significantly in most regions of the province, incidence was observed to be increasing in some counties with high HIV incidence and ethnic minority populations. Active and smear-positive PTB case reports exhibited seasonality, peaking in March and April, with apparent links to social dynamics and climatological factors. Conclusions While PTB incidence rates decreased strikingly in the study area over the past decade, improvements have not been equally distributed. Additional surveillance and control efforts should be guided by the seasonal-trend and spatiotemporal cluster analyses presented here, focusing on areas with increasing incidence rates, and updated to reflect the latest information from real-time reporting. Electronic supplementary material The online version of this article (10.1186/s12879-019-4262-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ting Li
- Institute of Tuberculosis Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China
| | - Qu Cheng
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Charles Li
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Everleigh Stokes
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Philip Collender
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Alison Ohringer
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Xintong Li
- Department of Biostatistics Rollins School of Public Health, Emory University, Atlanta, 30322, USA
| | - Jing Li
- Institute of Tuberculosis Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China
| | - Jonathan L Zelner
- Department of Epidemiology and Center for Social Epidemiology and Population Health School of Public Health, University of Michigan, Ann Arbor, 48109, USA
| | - Song Liang
- Department of Environmental and Global Health College of Public Health and Health Professions, University of Florida, Gainesville, 32611, USA
| | - Changhong Yang
- Institute of Public Health Information, Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China
| | - Justin V Remais
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Jin'ge He
- Institute of Tuberculosis Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China.
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Manabe T, Takasaki J, Kudo K. Seasonality of newly notified pulmonary tuberculosis in Japan, 2007-2015. BMC Infect Dis 2019; 19:497. [PMID: 31170932 PMCID: PMC6555020 DOI: 10.1186/s12879-019-3957-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/08/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The seasonality of pulmonary tuberculosis (TB) incidence may indicate season-specific risk factors that could be controlled if they were better understood. The aims of this study were to elucidate how the incidence of TB changes seasonally and to determine the factors influencing TB incidence, to reduce the TB burden in Japan. METHODS We assessed the seasonality of newly notified TB cases in Japan using national surveillance data collected between 2007 and 2015. To investigate age and sex differences, seasonal variation was analyzed according to sex for all cases and then by stratified age groups (0-4, 5-14, 15-24, 25-44, 45-64, 65-74, and ≥ 75 years). We used Roger's test to analyze the cyclic monthly trends in seasonal variation of TB incidence. RESULTS A total of 199,856 newly notified TB cases (male, 62.2%) were reported over the past 9-year period. Among them, 60.6% involved patients aged ≥65 years. Overall, the peak months of TB incidence occurred from April to October, excluding September. In the analysis stratified by age group, a significant seasonal variation in TB cases was observed for age groups ≥15 years, whereas no seasonal variation was observed for age groups ≤14 years. For female patients aged ≥25 years, the peak TB epidemic period was seen from June to December, excluding November. Male patients in the same age groups exhibited declining TB incidence from September to March. CONCLUSIONS TB incidence exhibits seasonality in Japan for people aged > 15 years and peaks in summer to fall. Monthly trends differ according to age and sex. For age groups ≥25 years, cases in women showed longer peaks from June to December whereas cases in men declined from September to December. These results suggest that the seasonality of TB incidence in Japan might be influenced by health checkups in young adults, reactivation of latent TB infection with aging, and lifestyle habits in older adults. These findings can contribute to establishing the potential determinants of TB seasonality in Japan.
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Affiliation(s)
- Toshie Manabe
- Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, 333-1 Yakushiji, Shimotsuke, Tochigi, Japan. .,Waseda University Organization of Regional and Inter-Regional Studies, Tokyo, Japan. .,Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
| | - Jin Takasaki
- Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koichiro Kudo
- Waseda University Organization of Regional and Inter-Regional Studies, Tokyo, Japan
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Wang H, Tian C, Wang W, Luo X. Temporal Cross-Correlations between Ambient Air Pollutants and Seasonality of Tuberculosis: A Time-Series Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091585. [PMID: 31064146 PMCID: PMC6540206 DOI: 10.3390/ijerph16091585] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/22/2019] [Accepted: 05/02/2019] [Indexed: 11/18/2022]
Abstract
The associations between ambient air pollutants and tuberculosis seasonality are unclear. We assessed the temporal cross-correlations between ambient air pollutants and tuberculosis seasonality. Monthly tuberculosis incidence data and ambient air pollutants (PM2.5, PM10, carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2)) and air quality index (AQI) from 2013 to 2017 in Shanghai were included. A cross-correlogram and generalized additive model were used. A 4-month delayed effect of PM2.5 (0.55), PM10 (0.52), SO2 (0.47), NO2 (0.40), CO (0.39), and AQI (0.45), and a 6-month delayed effect of O3 (−0.38) on the incidence of tuberculosis were found. The number of tuberculosis cases increased by 8%, 4%, 18%, and 14% for a 10 μg/m3 increment in PM2.5, PM10, SO2, and NO2; 4% for a 10 unit increment in AQI; 8% for a 0.1 mg/m3 increment in CO; and decreased by 4% for a 10 μg/m3 increment in O3. PM2.5 concentrations above 50 μg/m3, 70 μg/m3 for PM10, 16 μg/m3 for SO2, 47 μg/m3 for NO2, 0.85 mg/m3 for CO, and 85 for AQI, and O3 concentrations lower than 95 μg/m3 were positively associated with the incidence of tuberculosis. Ambient air pollutants were correlated with tuberculosis seasonality. However, this sort of study cannot prove causality.
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Affiliation(s)
- Hua Wang
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan 215300, China.
| | - Changwei Tian
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan 215300, China.
| | - Wenming Wang
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan 215300, China.
| | - Xiaoming Luo
- Department of Infectious Disease Control, Kunshan Centers for Disease Control and Prevention, Kunshan 215300, China.
- Department of Public Health, Soochow University, Kunshan 215300, China.
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Jaganath D, Wobudeya E, Sekadde MP, Nsangi B, Haq H, Cattamanchi A. Seasonality of childhood tuberculosis cases in Kampala, Uganda, 2010-2015. PLoS One 2019; 14:e0214555. [PMID: 30964908 PMCID: PMC6456174 DOI: 10.1371/journal.pone.0214555] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/14/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Seasonality in tuberculosis (TB) has been described, especially in children. However, few studies have assessed seasonality of TB in the equatorial region, and none in children. OBJECTIVES To assess for seasonality of childhood TB cases in Kampala, Uganda, and determine the role of temperature, rainfall patterns, and influenza cases on TB diagnoses. METHODS We retrospectively analyzed demographic and clinical data of children (under 15 years) diagnosed with TB at a pediatric TB clinic in Kampala, Uganda from 2010 to 2015. We performed decomposition analysis of the monthly case time series to assess seasonality. We compared monthly mean plots and performed Poisson regression to assess any association between TB diagnoses and temperature, rainfall, and influenza. RESULTS Of the 713 childhood TB cases diagnosed at the clinic, 609 (85%) were clinically diagnosed and 492 (69%) were pulmonary cases. There were minimal monthly variations in TB cases, with a trough in December and peaks in July and October, but there was no significant seasonality. Temperature variations did not show a clear pattern with TB diagnoses. Rainfall alternated with TB diagnoses in the first half of the year, but then overlapped in the second half and was significantly associated with TB diagnoses. Influenza cases were significantly related to TB diagnoses with (β = 0.05, 95% CI 0.01 to 0.09, p = 0.01) or without (β = 0.06, 95% CI 0.01 to 0.1, p = 0.01) rainfall, and had particular overlap with pulmonary TB cases. CONCLUSIONS Seasonal variations in childhood TB diagnoses were non-significant. Temperature did not have a clear pattern with TB diagnoses, but rainfall and influenza cases correlated with the primarily clinically diagnosed childhood TB cases.
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Affiliation(s)
- Devan Jaganath
- Division of Pediatric Infectious Diseases, University of California, San Francisco, San Francisco, United States of America
| | - Eric Wobudeya
- Directorate of Pediatrics and Child Health, Mulago National Referral Hospital, Kampala, Uganda
| | | | - Betty Nsangi
- USAID RHITES-EC, University Research Co. LLC, Kampala, Uganda
| | - Heather Haq
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Adithya Cattamanchi
- Division of Pulmonology and Critical Care Medicine, University of California, San Francisco, San Francisco, United States of America
- Center for Vulnerable Populations, Department of Medicine, University of California, San Francisco, San Francisco, United States of America
- Curry International Tuberculosis Center, University of California, San Francisco, San Francisco, United States of America
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Sumi A, Kobayashi N. Time-series analysis of geographically specific monthly number of newly registered cases of active tuberculosis in Japan. PLoS One 2019; 14:e0213856. [PMID: 30883581 PMCID: PMC6422277 DOI: 10.1371/journal.pone.0213856] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/02/2019] [Indexed: 11/18/2022] Open
Abstract
Background Understanding seasonality of tuberculosis (TB) epidemics may lead to identify potentially modifiable risk factors. Studies conducted outside Japan have found seasonal variation among reported TB cases, with peaks in spring and summer and low prevalence in fall and winter. One hypothesis regarding spring or summer peaks in TB epidemics is that TB transmission likely increases in winter because of indoor crowding and poor ventilation, with development of primary TB among socially vulnerable people in spring and summer. Another plausible explanation is that vitamin D deficiency in winter depresses immunity, increasing the TB reactivation risk in these seasons. Previous studies suggest latitude-dependent factors, including reduced winter sunlight and its effect on vitamin D levels. Here, we investigated mechanisms of seasonality in TB epidemics in Japan, according to the effects of crowding and latitude. Methods We used time-series analysis consisting of spectral analysis and least-squares method, to analyse geographically specific monthly number of newly registered cases of all forms of active TB in all 47 prefectures of Japan during 1998–2015. Results In all power spectral densities for the 47 prefectures, spectral lines were observed at frequency positions corresponding to a 1-year cycle. The degree of this seasonality was associated with population density. We did not detect greater amplitude of seasonality at higher latitudes, suggesting that latitude-dependent factors, including reduced winter sunlight and its potential effect on vitamin D levels, do not contribute significantly to seasonality in Japan. Discussion and conclusion In districts with high population density, measures are needed to address two specific types of active infection risk in adolescents and middle-aged adults: (i) public transport use, and (ii) irregular employment with no periodic medical examinations. To control active TB epidemics, investigating periodic structures in the temporal patterns of active TB in each district and each age group is important.
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Affiliation(s)
- Ayako Sumi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
- * E-mail:
| | - Nobumichi Kobayashi
- Department of Hygiene, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Drivers of Seasonal Variation in Tuberculosis Incidence: Insights from a Systematic Review and Mathematical Model. Epidemiology 2019; 29:857-866. [PMID: 29870427 DOI: 10.1097/ede.0000000000000877] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Seasonality in tuberculosis incidence has been widely observed across countries and populations; however, its drivers are poorly understood. We conducted a systematic review of studies reporting seasonal patterns in tuberculosis to identify demographic and ecologic factors associated with timing and magnitude of seasonal variation. METHODS We identified studies reporting seasonal variation in tuberculosis incidence through PubMed and EMBASE and extracted incidence data and population metadata. We described key factors relating to seasonality and, when data permitted, quantified seasonal variation and its association with metadata. We developed a dynamic tuberculosis natural history and transmission model incorporating seasonal differences in disease progression and/or transmission rates to examine magnitude of variation required to produce observed seasonality in incidence. RESULTS Fifty-seven studies met inclusion criteria. In the majority of studies (n=49), tuberculosis incidence peaked in spring or summer and reached a trough in late fall or winter. A standardized seasonal amplitude was calculated for 34 of the studies, resulting in a mean of 17.1% (range: 2.7-85.5%) after weighting by sample size. Across multiple studies, stronger seasonality was associated with younger patients, extrapulmonary disease, and latitudes farther from the Equator. The mathematical model was generally able to reproduce observed levels of seasonal case variation; however, substantial variation in transmission or disease progression risk was required to replicate several extreme values. CONCLUSIONS We observed seasonal variation in tuberculosis, with consistent peaks occurring in spring, across countries with varying tuberculosis burden. Future research is needed to explore and quantify potential gains from strategically conducting mass screening interventions in the spring.
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Tuberculosis evolution and climate change: How much work is ahead? Acta Trop 2019; 190:157-158. [PMID: 30452890 DOI: 10.1016/j.actatropica.2018.11.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/15/2018] [Accepted: 11/15/2018] [Indexed: 01/29/2023]
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Gashu Z, Jerene D, Datiko DG, Hiruy N, Negash S, Melkieneh K, Bekele D, Nigussie G, Suarez PG, Hadgu A. Seasonal patterns of tuberculosis case notification in the tropics of Africa: A six-year trend analysis in Ethiopia. PLoS One 2018; 13:e0207552. [PMID: 30475836 PMCID: PMC6261032 DOI: 10.1371/journal.pone.0207552] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/01/2018] [Indexed: 11/19/2022] Open
Abstract
Objective Seasonal variations affect the health system’s functioning, including tuberculosis (TB) services, but there is little evidence about seasonal variations in TB case notification in tropical countries, including Ethiopia. This study sought to fill this gap in knowledge using TB data reported from 10 zones, 5 each from Amhara and Oromia regions. Methods Notified TB cases for 2010–2016 were analyzed using SPSS version 20. We calculated the quarterly and annual average TB case notification rates and the proportion of seasonal amplitudes. We applied Winters’ multiplicative method of exponential smoothing to break down the original time series into seasonal, trend, and irregular components and to build a suitable model for forecasting. Results A total of 205,575 TB cases were identified (47.8% from Amhara, 52.2% from Oromia), with a male-to-female ratio of 1.2:1. The means of 8,200 (24%), 7,992 (23%), 8,849 (26%), and 9,222 (27%) TB cases were reported during July-September, October-December, January-March, and April-June, respectively. The seasonal component of our model indicated a peak in April-June and a trough in October-December. The seasonal amplitude in Amhara region is 10% greater than that of Oromia (p < 0.05). Conclusions TB is shown to be a seasonal disease in Ethiopia, with a peak in quarter four and a low in quarter two of the fiscal year. The peak TB case notification rate corresponds with the end of the dry season in the two agrarian regions of Ethiopia. TB prevention and control interventions, such as efforts to increase community TB awareness about TB transmission and contact tracing, should consider seasonal variation. Regional variations in TB seasonality may require consideration of geographic-specific TB case-finding strategies. The mechanisms underlying the seasonal variation of TB are complex, and further study is needed.
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Affiliation(s)
- Z. Gashu
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
- * E-mail:
| | - D. Jerene
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - D. G. Datiko
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - N. Hiruy
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - S. Negash
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - K. Melkieneh
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
| | - D. Bekele
- Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | - G. Nigussie
- Amhara Regional Health Bureau, Addis Ababa, Ethiopia
| | - P. G. Suarez
- Management Sciences for Health, Arlington, Virginia, United States of America
| | - A. Hadgu
- Management Sciences for Health, USAID Challenge TB Project, Addis Ababa, Ethiopia
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Aryee G, Kwarteng E, Essuman R, Nkansa Agyei A, Kudzawu S, Djagbletey R, Owusu Darkwa E, Forson A. Estimating the incidence of tuberculosis cases reported at a tertiary hospital in Ghana: a time series model approach. BMC Public Health 2018; 18:1292. [PMID: 30477460 PMCID: PMC6258486 DOI: 10.1186/s12889-018-6221-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 11/14/2018] [Indexed: 11/17/2022] Open
Abstract
Background The incidence of Tuberculosis (TB) differs among countries and contributes to morbidity and mortality especially in the developing countries. Trends and seasonal changes in the number of patients presenting with TB have been studied worldwide including sub-Saharan Africa. However, these changes are unknown at the Korle-Bu Teaching Hospital (KBTH). The aim of this study was to obtain a time series model to estimate the incidence of TB cases at the chest clinic of the Korle-Bu Teaching hospital. Methods A time series analysis using a Box-Jenkins approach propounded as an autoregressive moving average (ARIMA) was conducted on the monthly TB cases reported at the KBTH from 2008 to 2017. Various models were stated and compared and the best was found to be based on the Akaike Information Criterion and Bayesian Information Criterion. Results There was no evidence of obvious increasing or decreasing trend in the TB data. The log-transformed of the data achieved stationarity with fairly stable variations around the mean of the series. ARIMA (1, 0, 1) or ARMA (1,1) was obtained as the best model. The monthly forecasted values of the best model ranged from 53 to 55 for the year 2018; however, the best model does not always produce the best results with respect to the mean absolute and mean square errors. Conclusions Irregular fluctuations were observed in the 10 -year data studied. The model equation to estimate the expected monthly TB cases at KBTH produced an AR coefficient of 0.971 plus an MA coefficient of − 0.826 with a constant value of 4.127. The result is important for developing a hypothesis to explain the dynamics of TB occurrence so as to outline prevention programmes, optimal use of resources and effective service delivery. Electronic supplementary material The online version of this article (10.1186/s12889-018-6221-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- George Aryee
- Department of Anaesthesia, School of Medicine and Dentistry, University of Ghana, Legon, Ghana.
| | - Ernest Kwarteng
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, University of Ghana, Legon, Ghana
| | - Raymond Essuman
- Department of Anaesthesia, School of Medicine and Dentistry, University of Ghana, Legon, Ghana
| | - Adwoa Nkansa Agyei
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, University of Ghana, Legon, Ghana
| | - Samuel Kudzawu
- Department of Chest and Infectious Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Robert Djagbletey
- Department of Anaesthesia, School of Medicine and Dentistry, University of Ghana, Legon, Ghana
| | - Ebenezer Owusu Darkwa
- Department of Anaesthesia, School of Medicine and Dentistry, University of Ghana, Legon, Ghana
| | - Audrey Forson
- Department of Medicine and Therapeutics, School of Medicine and Dentistry, University of Ghana, Legon, Ghana
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43
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Liu MY, Li QH, Zhang YJ, Ma Y, Liu Y, Feng W, Hou CB, Amsalu E, Li X, Wang W, Li WM, Guo XH. Spatial and temporal clustering analysis of tuberculosis in the mainland of China at the prefecture level, 2005-2015. Infect Dis Poverty 2018; 7:106. [PMID: 30340513 PMCID: PMC6195697 DOI: 10.1186/s40249-018-0490-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 10/04/2018] [Indexed: 12/25/2022] Open
Abstract
Background Tuberculosis (TB) is still one of the most serious infectious diseases in the mainland of China. So it was urgent for the formulation of more effective measures to prevent and control it. Methods The data of reported TB cases in 340 prefectures from the mainland of China were extracted from the China Information System for Disease Control and Prevention (CISDCP) during January 2005 to December 2015. The Kulldorff’s retrospective space-time scan statistics was used to identify the temporal, spatial and spatio-temporal clusters of reported TB in the mainland of China by using the discrete Poisson probability model. Spatio-temporal clusters of sputum smear-positive (SS+) reported TB and sputum smear-negative (SS-) reported TB were also detected at the prefecture level. Results A total of 10 200 528 reported TB cases were collected from 2005 to 2015 in 340 prefectures, including 5 283 983 SS- TB cases and 4 631 734 SS + TB cases with specific sputum smear results, 284 811 cases without sputum smear test. Significantly TB clustering patterns in spatial, temporal and spatio-temporal were observed in this research. Results of the Kulldorff’s scan found twelve significant space-time clusters of reported TB. The most likely spatio-temporal cluster (RR = 3.27, P < 0.001) was mainly located in Xinjiang Uygur Autonomous Region of western China, covering five prefectures and clustering in the time frame from September 2012 to November 2015. The spatio-temporal clustering results of SS+ TB and SS- TB also showed the most likely clusters distributed in the western China. However, the clustering time of SS+ TB was concentrated before 2010 while SS- TB was mainly concentrated after 2010. Conclusions This study identified the time and region of TB, SS+ TB and SS- TB clustered easily in 340 prefectures in the mainland of China, which is helpful in prioritizing resource assignment in high-risk periods and high-risk areas, and to formulate powerful strategy to prevention and control TB. Electronic supplementary material The online version of this article (10.1186/s40249-018-0490-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Meng-Yang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Qi-Huan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Ying-Jie Zhang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yuan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Yue Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Wei Feng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Cheng-Bei Hou
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Endawoke Amsalu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne, 3086, Australia
| | - Wei Wang
- School of Medical Sciences and Health, Edith Cowan University, WA6027, Perth, Australia
| | - Wei-Min Li
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China. .,National Tuberculosis Clinical Laboratory of China, Beijing Chest Hospital, Capital Medical University, Beijing, 101149, China. .,Beijing Tuberculosis and Thoracic Tumour Research Institute, Beijing, 101149, China.
| | - Xiu-Hua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, 100069, China. .,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China.
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44
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Kim EH, Bae JM. Seasonality of tuberculosis in the Republic of Korea, 2006-2016. Epidemiol Health 2018; 40:e2018051. [PMID: 30486553 PMCID: PMC6288684 DOI: 10.4178/epih.e2018051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 10/20/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES While the seasonality of notified tuberculosis has been identified in several populations, there is not a descriptive epidemiological study on the seasonality of tuberculosis in Korea. This study aimed to evaluate the seasonality of tuberculosis in Korea from 2006 to 2016. METHODS Data regarding notified cases of tuberculosis by year and month was obtained from the Infectious Diseases Surveillance Yearbook, 2017 published by the Korea Centers for Disease Control and Prevention. Seasonal decomposition was conducted using the method of structural model of time series analysis with simple moving averages. RESULTS While the trough season was winter from 2006 to 2016, the peak season was summer between 2006 and 2012, but shifted to spring between 2013 and 2016. CONCLUSIONS Notified tuberculosis in Korea also showed seasonality. It is necessary to evaluate factors related to the seasonality of tuberculosis for controlling tuberculosis.
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Affiliation(s)
- Eun Hee Kim
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jong-Myon Bae
- Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea
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45
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Abhimanyu, Coussens AK. The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochem Photobiol Sci 2018; 16:314-338. [PMID: 28078341 DOI: 10.1039/c6pp00355a] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The seasonality of infectious disease outbreaks suggests that environmental conditions have a significant effect on disease risk. One of the major environmental factors that can affect this is solar radiation, primarily acting through ultraviolet radiation (UVR), and its subsequent control of vitamin D production. Here we show how UVR and vitamin D, which are modified by latitude and season, can affect host and pathogen fitness and relate them to the outcomes of bacterial, viral and vector-borne infections. We conducted a thorough comparison of the molecular and cellular mechanisms of action of UVR and vitamin D on pathogen fitness and host immunity and related these to the effects observed in animal models and clinical trials to understand their independent and complementary effects on infectious disease outcome. UVR and vitamin D share common pathways of innate immune activation primarily via antimicrobial peptide production, and adaptive immune suppression. Whilst UVR can induce vitamin D-independent effects in the skin, such as the generation of photoproducts activating interferon signaling, vitamin D has a larger systemic effect due to its autocrine and paracrine modulation of cellular responses in a range of tissues. However, the seasonal patterns in infectious disease prevalence are not solely driven by variation in UVR and vitamin D levels across latitudes. Vector-borne pathogens show a strong seasonality of infection correlated to climatic conditions favoring their replication. Conversely, pathogens, such as influenza A virus, Mycobacterium tuberculosis and human immunodeficiency virus type 1, have strong evidence to support their interaction with vitamin D. Thus, UVR has both vitamin D-dependent and independent effects on infectious diseases; these effects vary depending on the pathogen of interest and the effects can be complementary or antagonistic.
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Affiliation(s)
- Abhimanyu
- Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa.
| | - Anna K Coussens
- Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa. and Division of Medical Microbiology, Department of Pathology, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa
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46
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Zhu M, Han G, Takiff HE, Wang J, Ma J, Zhang M, Liu S. Times series analysis of age-specific tuberculosis at a rapid developing region in China, 2011-2016. Sci Rep 2018; 8:8727. [PMID: 29880836 PMCID: PMC5992177 DOI: 10.1038/s41598-018-27024-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 05/21/2018] [Indexed: 12/23/2022] Open
Abstract
The city of Shenzhen has recently experienced extraordinary economic growth accompanied by a huge internal migrant influx. We investigated the local dynamics of tuberculosis (TB) epidemiology in the Nanshan District of Shenzhen to provide insights for TB control strategies for this district and other rapidly developing regions in China. We analyzed the age-specific incidence and number of TB cases in the Nanshan District from 2011 to 2016. Over all, the age-standardized incidence of TB decreased at an annual rate of 3.4%. The incidence was lowest amongst the age group 0-14 and showed no increase in this group over the six-year period (P = 0.587). The fastest decreasing incidence was among the 15-24 age group, with a yearly decrease of 13.3% (β = 0.867, P < 0.001). In contrast, the TB incidence increased in the age groups 45-54, 55-54, and especially in those aged ≥65, whose yearly increase was 13.1% (β = 1.131, P < 0.001). The peak time of TB case presentation was in April, May, and June for all age groups, except in August for the 45-54 cohort. In the rapidly developing Nanshan District, TB control policies targeted to those aged 45 years and older should be considered. The presentation of TB cases appears to peak in the spring months.
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Affiliation(s)
- Minmin Zhu
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.
| | - Guiyuan Han
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Howard Eugene Takiff
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.,Institut Pasteur, Unité de Génétique Mycobacterienne, Paris, 75015, France.,Instituto Venezolano de Investigaciones Cientificas, Caracas, Venezuela
| | - Jian Wang
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Jianping Ma
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Min Zhang
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China
| | - Shengyuan Liu
- Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, 518054, China.
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47
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Wang H, Tian CW, Wang WM, Luo XM. Time-series analysis of tuberculosis from 2005 to 2017 in China. Epidemiol Infect 2018; 146:935-939. [PMID: 29708082 PMCID: PMC9184947 DOI: 10.1017/s0950268818001115] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Seasonal autoregressive integrated moving average (SARIMA) has been used to model nationwide tuberculosis (TB) incidence in other countries. This study aimed to characterise monthly TB notification rate in China. Monthly TB notification rate from 2005 to 2017 was used. Time-series analysis was based on a SARIMA model and a hybrid model of SARIMA-generalised regression neural network (GRNN) model. A decreasing trend (3.17% per years, P < 0.01) and seasonal variation of TB notification rate were found from 2005 to 2016 in China, with a predominant peak in spring. A SARIMA model of ARIMA (0,1,1) (0,1,1)12 was identified. The mean error rate of the single SARIMA model and the SARIMA-GRNN combination model was 6.07% and 2.56%, and the determination coefficient was 0.73 and 0.94, respectively. The better performance of the SARIMA-GRNN combination model was further confirmed with the forecasting dataset (2017). TB is a seasonal disease in China, with a predominant peak in spring, and the trend of TB decreased by 3.17% per year. The SARIMA-GRNN model was more effective than the widely used SARIMA model at predicting TB incidence.
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Affiliation(s)
- H. Wang
- Kunshan Centers for Disease Control and Prevention, Kunshan, China
| | - C. W. Tian
- Kunshan Centers for Disease Control and Prevention, Kunshan, China
- Author for correspondence: C. W. Tian, E-mail:
| | - W. M. Wang
- Kunshan Centers for Disease Control and Prevention, Kunshan, China
| | - X. M. Luo
- Kunshan Centers for Disease Control and Prevention, Kunshan, China
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48
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Mao Q, Zhang K, Yan W, Cheng C. Forecasting the incidence of tuberculosis in China using the seasonal auto-regressive integrated moving average (SARIMA) model. J Infect Public Health 2018; 11:707-712. [PMID: 29730253 PMCID: PMC7102794 DOI: 10.1016/j.jiph.2018.04.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 03/23/2018] [Accepted: 04/08/2018] [Indexed: 12/03/2022] Open
Abstract
Objectives The aims of this study were to develop a forecasting model for the incidence of tuberculosis (TB) and analyze the seasonality of infections in China; and to provide a useful tool for formulating intervention programs and allocating medical resources. Methods Data for the monthly incidence of TB from January 2004 to December 2015 were obtained from the National Scientific Data Sharing Platform for Population and Health (China). The Box–Jenkins method was applied to fit a seasonal auto-regressive integrated moving average (SARIMA) model to forecast the incidence of TB over the subsequent six months. Results During the study period of 144 months, 12,321,559 TB cases were reported in China, with an average monthly incidence of 6.4426 per 100,000 of the population. The monthly incidence of TB showed a clear 12-month cycle, and a seasonality with two peaks occurring in January and March and a trough in December. The best-fit model was SARIMA (1,0,0)(0,1,1)12, which demonstrated adequate information extraction (white noise test, p > 0.05). Based on the analysis, the incidence of TB from January to June 2016 were 6.6335, 4.7208, 5.8193, 5.5474, 5.2202 and 4.9156 per 100,000 of the population, respectively. Conclusions According to the seasonal pattern of TB incidence in China, the SARIMA model was proposed as a useful tool for monitoring epidemics.
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Affiliation(s)
- Qiang Mao
- Institute of Occupational Health and Environmental Hygiene, School of Public Health, Lanzhou University, Lanzhou 730000, PR China.
| | - Kai Zhang
- Institute of Occupational Health and Environmental Hygiene, School of Public Health, Lanzhou University, Lanzhou 730000, PR China
| | - Wu Yan
- Institute of Social Medical and Health Management, School of Public Health, Lanzhou University, Lanzhou 730000, PR China
| | - Chaonan Cheng
- Institute of Occupational Health and Environmental Hygiene, School of Public Health, Lanzhou University, Lanzhou 730000, PR China
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49
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Keerqinfu, Zhang Q, Yan L, He J. Time series analysis of correlativity between pulmonary tuberculosis and seasonal meteorological factors based on theory of Human-Environmental Inter Relation. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2018. [DOI: 10.1016/j.jtcms.2018.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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50
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Ballif M, Zürcher K, Reid SE, Boulle A, Fox MP, Prozesky HW, Chimbetete C, Zwahlen M, Egger M, Fenner L. Seasonal variations in tuberculosis diagnosis among HIV-positive individuals in Southern Africa: analysis of cohort studies at antiretroviral treatment programmes. BMJ Open 2018; 8:e017405. [PMID: 29330173 PMCID: PMC5780693 DOI: 10.1136/bmjopen-2017-017405] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Seasonal variations in tuberculosis diagnoses have been attributed to seasonal climatic changes and indoor crowding during colder winter months. We investigated trends in pulmonary tuberculosis (PTB) diagnosis at antiretroviral therapy (ART) programmes in Southern Africa. SETTING Five ART programmes participating in the International Epidemiology Database to Evaluate AIDS in South Africa, Zambia and Zimbabwe. PARTICIPANTS We analysed data of 331 634 HIV-positive adults (>15 years), who initiated ART between January 2004 and December 2014. PRIMARY OUTCOME MEASURE We calculated aggregated averages in monthly counts of PTB diagnoses and ART initiations. To account for time trends, we compared deviations of monthly event counts to yearly averages, and calculated correlation coefficients. We used multivariable regressions to assess associations between deviations of monthly ART initiation and PTB diagnosis counts from yearly averages, adjusted for monthly air temperatures and geographical latitude. As controls, we used Kaposi sarcoma and extrapulmonary tuberculosis (EPTB) diagnoses. RESULTS All programmes showed monthly variations in PTB diagnoses that paralleled fluctuations in ART initiations, with recurrent patterns across 2004-2014. The strongest drops in PTB diagnoses occurred in December, followed by April-May in Zimbabwe and South Africa. This corresponded to holiday seasons, when clinical activities are reduced. We observed little monthly variation in ART initiations and PTB diagnoses in Zambia. Correlation coefficients supported parallel trends in ART initiations and PTB diagnoses (correlation coefficient: 0.28, 95% CI 0.21 to 0.35, P<0.001). Monthly temperatures and latitude did not substantially change regression coefficients between ART initiations and PTB diagnoses. Trends in Kaposi sarcoma and EPTB diagnoses similarly followed changes in ART initiations throughout the year. CONCLUSIONS Monthly variations in PTB diagnosis at ART programmes in Southern Africa likely occurred regardless of seasonal variations in temperatures or latitude and reflected fluctuations in clinical activities and changes in health-seeking behaviour throughout the year, rather than climatic factors.
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Affiliation(s)
- Marie Ballif
- Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland
| | - Kathrin Zürcher
- Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland
| | - Stewart E Reid
- Division of Infection Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Tuberculosis Department Unit, Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | - Andrew Boulle
- Centre for Infectious Disease Epidemiology and Research (CIDER), School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Médecins Sans Frontières, Khayelitsha, South Africa
| | - Matthew P Fox
- Departments of Epidemiology and Global Health, Boston University, Boston, USA
- Department of Internal Medicine, Health Economics and Epidemiology Research Office, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Hans W Prozesky
- Division of Infectious Diseases, Department of Medicine, University of Stellenbosch & Tygerberg Academic Hospital, Cape Town, South Africa
| | | | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland
- Centre for Infectious Disease Epidemiology and Research (CIDER), School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Lukas Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, BE, Switzerland
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