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Lai P, Cai W, Qu L, Hong C, Lin K, Tan W, Zhao Z. Pulmonary Tuberculosis Notification Rate Within Shenzhen, China, 2010-2019: Spatial-Temporal Analysis. JMIR Public Health Surveill 2024; 10:e57209. [PMID: 38875687 DOI: 10.2196/57209] [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] [Received: 02/08/2024] [Revised: 03/05/2024] [Accepted: 05/07/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Pulmonary tuberculosis (PTB) is a chronic communicable disease of major public health and social concern. Although spatial-temporal analysis has been widely used to describe distribution characteristics and transmission patterns, few studies have revealed the changes in the small-scale clustering of PTB at the street level. OBJECTIVE The aim of this study was to analyze the temporal and spatial distribution characteristics and clusters of PTB at the street level in the Shenzhen municipality of China to provide a reference for PTB prevention and control. METHODS Data of reported PTB cases in Shenzhen from January 2010 to December 2019 were extracted from the China Information System for Disease Control and Prevention to describe the epidemiological characteristics. Time-series, spatial-autocorrelation, and spatial-temporal scanning analyses were performed to identify the spatial and temporal patterns and high-risk areas at the street level. RESULTS A total of 58,122 PTB cases from 2010 to 2019 were notified in Shenzhen. The annual notification rate of PTB decreased significantly from 64.97 per 100,000 population in 2010 to 43.43 per 100,000 population in 2019. PTB cases exhibited seasonal variations with peaks in late spring and summer each year. The PTB notification rate was nonrandomly distributed and spatially clustered with a Moran I value of 0.134 (P=.02). One most-likely cluster and 10 secondary clusters were detected, and the most-likely clustering area was centered at Nanshan Street of Nanshan District covering 6 streets, with the clustering time spanning from January 2010 to November 2012. CONCLUSIONS This study identified seasonal patterns and spatial-temporal clusters of PTB cases at the street level in the Shenzhen municipality of China. Resources should be prioritized to the identified high-risk areas for PTB prevention and control.
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Affiliation(s)
- Peixuan Lai
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Weicong Cai
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Lin Qu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chuangyue Hong
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Kaihao Lin
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Weiguo Tan
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Zhiguang Zhao
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
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Bekele D, Aragie S, Alene KA, Dejene T, Warkaye S, Mezemir M, Abdena D, Kebebew T, Botore A, Mekonen G, Gutema G, Dufera B, Gemede K, Kenate B, Gobena D, Alemu B, Hailemariam D, Muleta D, Siu GKH, Tafess K. Spatiotemporal Distribution of Tuberculosis in the Oromia Region of Ethiopia: A Hotspot Analysis. Trop Med Infect Dis 2023; 8:437. [PMID: 37755898 PMCID: PMC10536582 DOI: 10.3390/tropicalmed8090437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/29/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023] Open
Abstract
Tuberculosis (TB) is a major public health concern in low- and middle-income countries including Ethiopia. This study aimed to assess the spatiotemporal distribution of TB and identify TB risk factors in Ethiopia's Oromia region. Descriptive and spatiotemporal analyses were conducted. Bayesian spatiotemporal modeling was used to identify covariates that accounted for variability in TB and its spatiotemporal distribution. A total of 206,278 new pulmonary TB cases were reported in the Oromia region between 2018 and 2022, with the lowest annual TB case notification (96.93 per 100,000 population) reported in 2020 (i.e., during the COVID-19 pandemic) and the highest TB case notification (106.19 per 100,000 population) reported in 2019. Substantial spatiotemporal variations in the distribution of notified TB case notifications were observed at zonal and district levels with most of the hotspot areas detected in the northern and southern parts of the region. The spatiotemporal distribution of notified TB incidence was positively associated with different ecological variables including temperature (β = 0.142; 95% credible interval (CrI): 0.070, 0.215), wind speed (β = -0.140; 95% CrI: -0.212, -0.068), health service coverage (β = 0.426; 95% CrI: 0.347, 0.505), and population density (β = 0.491; 95% CrI: 0.390, 0.594). The findings of this study indicated that preventive measures considering socio-demographic and health system factors can be targeted to high-risk areas for effective control of TB in the Oromia region. Further studies are needed to develop effective strategies for reducing the burden of TB in hotspot areas.
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Affiliation(s)
- Dereje Bekele
- Communicable and Non-Communicable Diseases Prevention and Control Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (D.A.); (G.M.); (K.G.); (B.A.); (D.H.)
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia; (S.A.); (G.G.); (B.D.)
| | - Solomon Aragie
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia; (S.A.); (G.G.); (B.D.)
| | - Kefyalew Addis Alene
- Geospatial and Tuberculosis Team, Telethon Kids Institute, Perth, WA 6009, Australia;
- School of Public Health, Faculty of Public Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Tariku Dejene
- Center for Population Studies, College of Development Studies, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia;
| | - Samson Warkaye
- Ethiopian Public Health Institute, National Data Management Center for Health, Addis Ababa P.O. Box 1242, Ethiopia;
| | - Melat Mezemir
- Health Promotion and Diseases Prevention Directorate, Addis Ababa City Administration Health Bureau, Addis Ababa P.O. Box 30738, Ethiopia;
| | - Dereje Abdena
- Communicable and Non-Communicable Diseases Prevention and Control Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (D.A.); (G.M.); (K.G.); (B.A.); (D.H.)
| | - Tesfaye Kebebew
- Public Health Emergency Management, Research, and Blood Bank Service Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (T.K.); (A.B.); (B.K.); (D.G.); (D.M.)
| | - Abera Botore
- Public Health Emergency Management, Research, and Blood Bank Service Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (T.K.); (A.B.); (B.K.); (D.G.); (D.M.)
| | - Geremew Mekonen
- Communicable and Non-Communicable Diseases Prevention and Control Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (D.A.); (G.M.); (K.G.); (B.A.); (D.H.)
| | - Gadissa Gutema
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia; (S.A.); (G.G.); (B.D.)
- National HIV/AIDS and TB Research Directorate, Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia
| | - Boja Dufera
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa P.O. Box 1176, Ethiopia; (S.A.); (G.G.); (B.D.)
- Bacterial, Parasitic, and Zoonotic Research Directorate, Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia
| | - Kolato Gemede
- Communicable and Non-Communicable Diseases Prevention and Control Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (D.A.); (G.M.); (K.G.); (B.A.); (D.H.)
| | - Birhanu Kenate
- Public Health Emergency Management, Research, and Blood Bank Service Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (T.K.); (A.B.); (B.K.); (D.G.); (D.M.)
| | - Dabesa Gobena
- Public Health Emergency Management, Research, and Blood Bank Service Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (T.K.); (A.B.); (B.K.); (D.G.); (D.M.)
| | - Bizuneh Alemu
- Communicable and Non-Communicable Diseases Prevention and Control Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (D.A.); (G.M.); (K.G.); (B.A.); (D.H.)
| | - Dagnachew Hailemariam
- Communicable and Non-Communicable Diseases Prevention and Control Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (D.A.); (G.M.); (K.G.); (B.A.); (D.H.)
| | - Daba Muleta
- Public Health Emergency Management, Research, and Blood Bank Service Directorate, Oromia Region Health Bureau, Addis Ababa P.O. Box 24341, Ethiopia; (T.K.); (A.B.); (B.K.); (D.G.); (D.M.)
| | - Gilman Kit Hang Siu
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong;
| | - Ketema Tafess
- Department of Applied Biology, School of Applied Natural Science, Adama Science and Technology University, Adama P.O. Box 1888, Ethiopia;
- Institute of Pharmaceutical Science, Adama Science and Technology University, Adama P.O. Box 1888, Ethiopia
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Teibo TKA, Andrade RLDP, Rosa RJ, Tavares RBV, Berra TZ, Arcêncio RA. Geo-spatial high-risk clusters of Tuberculosis in the global general population: a systematic review. BMC Public Health 2023; 23:1586. [PMID: 37598144 PMCID: PMC10439548 DOI: 10.1186/s12889-023-16493-y] [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] [Received: 06/08/2023] [Accepted: 08/09/2023] [Indexed: 08/21/2023] Open
Abstract
INTRODUCTION The objective of this systematic review is to identify tuberculosis (TB) high-risk among the general population globally. The review was conducted using the following steps: elaboration of the research question, search for relevant publications, selection of studies found, data extraction, analysis, and evidence synthesis. METHODS The studies included were those published in English, from original research, presented findings relevant to tuberculosis high-risk across the globe, published between 2017 and 2023, and were based on geospatial analysis of TB. Two reviewers independently selected the articles and were blinded to each other`s comments. The resultant disagreement was resolved by a third blinded reviewer. For bibliographic search, controlled and free vocabularies that address the question to be investigated were used. The searches were carried out on PubMed, LILACS, EMBASE, Scopus, and Web of Science. and Google Scholar. RESULTS A total of 79 published articles with a 40-year study period between 1982 and 2022 were evaluated. Based on the 79 studies, more than 40% of all countries that have carried out geospatial analysis of TB were from Asia, followed by South America with 23%, Africa had about 15%, and others with 2% and 1%. Various maps were used in the various studies and the most used is the thematic map (32%), rate map (26%), map of temporal tendency (20%), and others like the kernel density map (6%). The characteristics of the high-risk and the factors that affect the hotspot's location are evident through studies related to poor socioeconomic conditions constituting (39%), followed by high population density (17%), climate-related clustering (15%), high-risk spread to neighbouring cities (13%), unstable and non-random cluster (11%). CONCLUSION There exist specific high-risk for TB which are areas that are related to low socioeconomic conditions and spectacular weather conditions, these areas when well-known will be easy targets for intervention by policymakers. We recommend that more studies making use of spatial, temporal, and spatiotemporal analysis be carried out to point out territories and populations that are vulnerable to TB.
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Affiliation(s)
- Titilade Kehinde Ayandeyi Teibo
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil.
| | - Rubia Laine de Paula Andrade
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Rander Junior Rosa
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Reginaldo Bazon Vaz Tavares
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Thais Zamboni Berra
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Ricardo Alexandre Arcêncio
- Department of Maternal-Infant and Public Health Nursing, Ribeirão Preto College of Nursing, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
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Wu Z, Fu G, Wen Q, Wang Z, Shi LE, Qiu B, Wang J. Spatiotemporally Comparative Analysis of HIV, Pulmonary Tuberculosis, HIV-Pulmonary Tuberculosis Coinfection in Jiangsu Province, China. Infect Drug Resist 2023; 16:4039-4052. [PMID: 37383602 PMCID: PMC10296641 DOI: 10.2147/idr.s412870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023] Open
Abstract
Purpose Pulmonary tuberculosis (PTB) is a severe chronic communicable disease that causes a heavy disease burden in China. Human Immunodeficiency Virus (HIV) and PTB coinfection dramatically increases the risk of death. This study analyzes the spatiotemporal dynamics of HIV, PTB and HIV-PTB coinfection in Jiangsu Province, China, and explores the impact of socioeconomic determinants. Patients and Methods The data on all notified HIV, PTB and HIV-PTB coinfection cases were extracted from Jiangsu Provincial Center for Disease Control and Prevention. We applied the seasonal index to identify high-risk periods of the disease. Time trend, spatial autocorrelation and SaTScan were used to analyze temporal trends, hotspots and spatiotemporal clusters of diseases. The Bayesian space-time model was conducted to examine the socioeconomic determinants. Results The case notification rate (CNR) of PTB decreased from 2011 to 2019 in Jiangsu Province, but the CNR of HIV and HIV-PTB coinfection had an upward trend. The seasonal index of PTB was the highest in March, and its hotspots were mainly distributed in the central and northern parts, such as Xuzhou, Suqian, Lianyungang and Taizhou. HIV had the highest seasonal index in July and HIV-PTB coinfection had the highest seasonal index in June, with their hotspots mainly distributed in southern Jiangsu, involving Nanjing, Suzhou, Wuxi and Changzhou. The Bayesian space-time interaction model showed that socioeconomic factor and population density were negatively correlated with the CNR of PTB, and positively associated with the CNR of HIV and HIV-PTB coinfection. Conclusion The spatial heterogeneity and spatiotemporal clusters of PTB, HIV and HIV-PTB coinfection are exhibited obviously in Jiangsu. More comprehensive interventions should be applied to target TB in the northern part. While in southern Jiangsu, where the economic level is well-developed and the population density is high, we should strengthen the prevention and control of HIV and HIV-PTB coinfection.
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Affiliation(s)
- Zhuchao Wu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People’s Republic of China
| | - Gengfeng Fu
- Department of STI and HIV Control and Prevention, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009, People’s Republic of China
| | - Qin Wen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People’s Republic of China
| | - Zheyue Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People’s Republic of China
| | - Lin-en Shi
- Department of STI and HIV Control and Prevention, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009, People’s Republic of China
| | - Beibei Qiu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People’s Republic of China
| | - Jianming Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People’s Republic of China
- Department of Epidemiology, Gusu School, Nanjing Medical University, Nanjing, 211166, People’s Republic of China
- Changzhou Medical Center, Nanjing Medical University, Nanjing, 211166, People’s Republic of China
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Wang J, Liu X, Jing Z, Yang J. Spatial and temporal clustering analysis of pulmonary tuberculosis and its associated risk factors in southwest China. GEOSPATIAL HEALTH 2023; 18. [PMID: 37246542 DOI: 10.4081/gh.2023.1169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/30/2023] [Indexed: 05/30/2023]
Abstract
Pulmonary tuberculosis (PTB) remains a serious public health problem, especially in areas of developing countries. This study aimed to explore the spatial-temporal clusters and associated risk factors of PTB in south-western China. Space-time scan statistics were used to explore the spatial and temporal distribution characteristics of PTB. We collected data on PTB, population, geographic information and possible influencing factors (average temperature, average rainfall, average altitude, planting area of crops and population density) from 11 towns in Mengzi, a prefecture-level city in China, between 1 January 2015 and 31 December 2019. A total of 901 reported PTB cases were collected in the study area and a spatial lag model was conducted to analyse the association between these variables and the PTB incidence. Kulldorff's scan results identified two significant space-time clusters, with the most likely cluster (RR = 2.24, p < 0.001) mainly located in northeastern Mengzi involving five towns in the time frame June 2017 - November 2019. A secondary cluster (RR = 2.09, p < 0.05) was located in southern Mengzi, covering two towns and persisting from July 2017 to December 2019. The results of the spatial lag model showed that average rainfall was associated with PTB incidence. Precautions and protective measures should be strengthened in high-risk areas to avoid spread of the disease.
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Affiliation(s)
- Jianjiao Wang
- Institution of Health Statistics and Epidemiology, School of Public Health, Lanzhou University, Gansu.
| | - Xiaoning Liu
- Institution of Health Statistics and Epidemiology, School of Public Health, Lanzhou University, Gansu.
| | - Zhengchao Jing
- Mengzi Center for Disease Control and Prevention, Yunnan.
| | - Jiawai Yang
- Mengzi Center for Disease Control and Prevention, Yunnan.
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Zhang Q, Ding H, Gao S, Zhang S, Shen S, Chen X, Xu Z. Spatiotemporal Changes in Pulmonary Tuberculosis Incidence in a Low-Epidemic Area of China in 2005-2020: Retrospective Spatiotemporal Analysis. JMIR Public Health Surveill 2023; 9:e42425. [PMID: 36884278 PMCID: PMC10034607 DOI: 10.2196/42425] [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] [Received: 09/03/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND In China, tuberculosis (TB) is still a major public health problem, and the incidence of TB has significant spatial heterogeneity. OBJECTIVE This study aimed to investigate the temporal trends and spatial patterns of pulmonary tuberculosis (PTB) in a low-epidemic area of eastern China, Wuxi city, from 2005 to 2020. METHODS The data of PTB cases from 2005 to 2020 were obtained from the Tuberculosis Information Management System. The joinpoint regression model was used to identify the changes in the secular temporal trend. Kernel density analysis and hot spot analysis were used to explore the spatial distribution characteristics and clusters of the PTB incidence rate. RESULTS A total of 37,592 cases were registered during 2005-2020, with an average annual incidence rate of 34.6 per 100,000 population. The population older than 60 years had the highest incidence rate of 59.0 per 100,000 population. In the study period, the incidence rate decreased from 50.4 to 23.9 per 100,000 population, with an average annual percent change of -4.9% (95% CI -6.8% to -2.9%). The incidence rate of pathogen-positive patients increased during 2017-2020, with an annual percent change of 13.4% (95% CI 4.3%-23.2%). The TB cases were mainly concentrated in the city center, and the incidence of hot spots areas gradually changed from rural areas to urban areas during the study period. CONCLUSIONS The PTB incidence rate in Wuxi city has been declining rapidly with the effective implementation of strategies and projects. The populated urban centers will become key areas of TB prevention and control, especially in the older population.
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Affiliation(s)
- Qi Zhang
- Department of Chronic Communicable Disease, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Huan Ding
- Department of Chronic Communicable Disease, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Song Gao
- Department of Chronic Communicable Disease, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Shipeng Zhang
- Department of Chronic Communicable Disease, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Shiya Shen
- Department of Chronic Communicable Disease, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Xiaoyan Chen
- Department of Chronic Communicable Disease, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, China
| | - Zhuping Xu
- Department of Chronic Communicable Disease, The Affiliated Wuxi Center for Disease Control and Prevention of Nanjing Medical University, Wuxi Center for Disease Control and Prevention, Wuxi, China
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Chen S, Wang X, Zhao J, Zhang Y, Kan X. Application of the ARIMA Model in Forecasting the Incidence of Tuberculosis in Anhui During COVID-19 Pandemic from 2021 to 2022. Infect Drug Resist 2022; 15:3503-3512. [PMID: 35813085 PMCID: PMC9268244 DOI: 10.2147/idr.s367528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Forecasting the seasonality and trend of pulmonary tuberculosis is important for the rational allocation of health resources. In this study, we predict the incidence of pulmonary tuberculosis by establishing the autoregressive integrated moving average (ARIMA) model and providing support for pulmonary tuberculosis prevention and control during COVID-19 pandemic. Methods Registered tuberculosis(TB) cases from January 2013 to December 2020 in Anhui province were analysed using traditional descriptive epidemiological methods. Then we used the monthly incidence rate of TB from January 2013 through June 2020 to construct ARIMA model, and used the incidence rate from July 2020 to December 2020 to evaluate the forecasting accuracy. Ljung Box test, Akaike's information criterion(AICc), Bayesian information criterion(BIC) and Realtive error were used to evaluate the model fitting and forecasting effect, Finally, the optimal model was used to forecast the expected monthly incidence of tuberculosis for 2021 and 2022 to learn about the incidence trend. Results A total of 255,656 TB cases were registered. The reported rate of tuberculosis was highest in 2013 and lowest in 2020. The peak incidence was in March, Tongling (71.97/100,000), Chizhou (59.93/100,000), and Huainan (58.36/100,000) had the highest number of cases. The ratio of male to female incidence was 2.59:1, with the largest proportion of people being between 66 and 75 years old. The main occupation of patients was farmer. ARIMA (0, 1, 1) (0, 1, 1)12 model was the optimal model to forecast the incidence trend of TB. Conclusion Tongling, Chizhou, and Huainan should strengthen measures for TB. In particular, the government should pay more attention on elderly people to prevent tuberculosis infections. The rate of TB patient registration and reporting has decreased under the pandemic of COVID-19. The ARIMA model can be a useful tool for predicting future TB cases.
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Affiliation(s)
- Shuangshuang Chen
- Department of Scientific Research and Education, Anhui Chest Hospital (Anhui Provincial Tuberculosis Institute), Hefei, People’s Republic of China
| | - Xinqiang Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People’s Republic of China
| | - Jiawen Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People’s Republic of China
| | - Yongzhong Zhang
- Department of Tuberculosis Prevent and Control, Anhui Provincial Tuberculosis Institute, Hefei, People’s Republic of China
| | - Xiaohong Kan
- Department of Scientific Research and Education, Anhui Chest Hospital (Anhui Provincial Tuberculosis Institute), Hefei, People’s Republic of China
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, People’s Republic of China
- Correspondence: Xiaohong Kan, Department of Scientific Research and Education, Anhui Chest Hospital (Anhui Provincial Tuberculosis Institute), Hefei, 230022, People’s Republic of China, Tel +86 0551-63615340, Email
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Ma K, Lin Y, Zhang X, Fang F, Zhang Y, Li J, Yao Y, Ge L, Tan H, Wang F. Spatiotemporal Distribution and Evolution of Digestive Tract Cancer Cases in Lujiang County, China since 2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127451. [PMID: 35742697 PMCID: PMC9223376 DOI: 10.3390/ijerph19127451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022]
Abstract
This study aims to analyze the spatiotemporal distribution and evolution of digestive tract cancer (DTC) in Lujiang County, China by using the geographic information system technology. Results of this study are expected to provide a scientific basis for effective prevention and control of DTC. The data on DTC cases in Lujiang County, China, were downloaded from the Data Center of the Center for Disease Control and Prevention in Hefei, Anhui Province, China, while the demographic data were sourced from the demographic department in China. Systematic statistical analyses, including the spatial empirical Bayes smoothing, spatial autocorrelation, hotspot statistics, and Kulldorff's retrospective space-time scan, were used to identify the spatial and spatiotemporal clusters of DTC. GM(1,1) and standard deviation ellipses were then applied to predict the future evolution of the spatial pattern of the DTC cases in Lujiang County. The results showed that DTC in Lujiang County had obvious spatiotemporal clustering. The spatial distribution of DTC cases increases gradually from east to west in the county in a stepwise pattern. The peak of DTC cases occurred in 2012-2013, and the high-case spatial clusters were located mainly in the northwest of Lujiang County. At the 99% confidence interval, two spatiotemporal clusters were identified. From 2012 to 2017, the cases of DTC in Lujiang County gradually shifted to the high-incidence area in the northwest, and the spatial distribution range experienced a process of "dispersion-clustering". The cases of DTC in Lujiang County will continue to move to the northwest from 2018 to 2025, and the predicted spatial clustering tends to be more obvious.
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Affiliation(s)
- Kang Ma
- Key Laboratory of Earth Surface Processes and Response in the Yangtze-Huaihe River Basin, School of Geography and Tourism, Anhui Normal University, Wuhu 241002, China; (K.M.); (Y.L.); (Y.Y.); (L.G.); (H.T.); (F.W.)
| | - Yuesheng Lin
- Key Laboratory of Earth Surface Processes and Response in the Yangtze-Huaihe River Basin, School of Geography and Tourism, Anhui Normal University, Wuhu 241002, China; (K.M.); (Y.L.); (Y.Y.); (L.G.); (H.T.); (F.W.)
| | - Xiaopeng Zhang
- Hefei Center for Disease Control and Prevention, Hefei 230022, China; (X.Z.); (J.L.)
| | - Fengman Fang
- Key Laboratory of Earth Surface Processes and Response in the Yangtze-Huaihe River Basin, School of Geography and Tourism, Anhui Normal University, Wuhu 241002, China; (K.M.); (Y.L.); (Y.Y.); (L.G.); (H.T.); (F.W.)
- Correspondence: ; Tel.: +86-(0553)-5910687
| | - Yong Zhang
- Department of Geological Sciences, University of Alabama, Tuscaloosa, AL 35487, USA;
| | - Jiajia Li
- Hefei Center for Disease Control and Prevention, Hefei 230022, China; (X.Z.); (J.L.)
| | - Youru Yao
- Key Laboratory of Earth Surface Processes and Response in the Yangtze-Huaihe River Basin, School of Geography and Tourism, Anhui Normal University, Wuhu 241002, China; (K.M.); (Y.L.); (Y.Y.); (L.G.); (H.T.); (F.W.)
| | - Lei Ge
- Key Laboratory of Earth Surface Processes and Response in the Yangtze-Huaihe River Basin, School of Geography and Tourism, Anhui Normal University, Wuhu 241002, China; (K.M.); (Y.L.); (Y.Y.); (L.G.); (H.T.); (F.W.)
| | - Huarong Tan
- Key Laboratory of Earth Surface Processes and Response in the Yangtze-Huaihe River Basin, School of Geography and Tourism, Anhui Normal University, Wuhu 241002, China; (K.M.); (Y.L.); (Y.Y.); (L.G.); (H.T.); (F.W.)
| | - Fei Wang
- Key Laboratory of Earth Surface Processes and Response in the Yangtze-Huaihe River Basin, School of Geography and Tourism, Anhui Normal University, Wuhu 241002, China; (K.M.); (Y.L.); (Y.Y.); (L.G.); (H.T.); (F.W.)
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Yun W, Huijuan C, Long L, Xiaolong L, Aihua Z. Time trend prediction and spatial-temporal analysis of multidrug-resistant tuberculosis in Guizhou Province, China, during 2014-2020. BMC Infect Dis 2022; 22:525. [PMID: 35672746 PMCID: PMC9171477 DOI: 10.1186/s12879-022-07499-9] [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: 10/18/2021] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Guizhou is located in the southwest of China with high multidrug-resistant tuberculosis (MDR-TB) epidemic. To fight this disease, Guizhou provincial authorities have made efforts to establish MDR-TB service system and perform the strategies for active case finding since 2014. The expanded case finding starting from 2019 and COVID-19 pandemic may affect the cases distribution. Thus, this study aims to analyze MDR-TB epidemic status from 2014 to 2020 for the first time in Guizhou in order to guide control strategies. Methods Data of notified MDR-TB cases were extracted from the National TB Surveillance System correspond to population information for each county of Guizhou from 2014 to 2020. The percentage change was calculated to quantify the change of cases from 2014 to 2020. Time trend and seasonality of case series were analyzed by a seasonal autoregressive integrated moving average (SARIMA) model. Spatial–temporal distribution at county-level was explored by spatial autocorrelation analysis and spatial–temporal scan statistic. Results Guizhou has 9 prefectures and 88 counties. In this study, 1,666 notified MDR-TB cases were included from 2014–2020. The number of cases increased yearly. Between 2014 and 2019, the percentage increase ranged from 6.7 to 21.0%. From 2019 to 2020, the percentage increase was 62.1%. The seasonal trend illustrated that most cases were observed during the autumn with the trough in February. Only in 2020, a peak admission was observed in June. This may be caused by COVID-19 pandemic restrictions being lifted until May 2020. The spatial–temporal heterogeneity revealed that over the years, most MDR-TB cases stably aggregated over four prefectures in the northwest, covering Bijie, Guiyang, Liupanshui and Zunyi. Three prefectures (Anshun, Tongren and Qiandongnan) only exhibited case clusters in 2020. Conclusion This study identified the upward trend with seasonality and spatial−temporal clusters of MDR-TB cases in Guizhou from 2014 to 2020. The fast rising of cases and different distribution from the past in 2020 were affected by the expanded case finding from 2019 and COVID-19. The results suggest that control efforts should target at high-risk periods and areas by prioritizing resources allocation to increase cases detection capacity and better access to treatment.
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Affiliation(s)
- Wang Yun
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, Guizhou, China
| | - Chen Huijuan
- Department of Tuberculosis Prevention and Control, Guizhou Center for Disease Prevention and Control, Guiyang, Guizhou, China.
| | - Liao Long
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, Guizhou, China
| | - Lu Xiaolong
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, Guizhou, China
| | - Zhang Aihua
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, Guizhou, China
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Fang XE, Chen DP, Tang LL, Mao YJ. Association between depression and malnutrition in pulmonary tuberculosis patients: A cross-sectional study. World J Clin Cases 2022; 10:4395-4403. [PMID: 35663071 PMCID: PMC9125260 DOI: 10.12998/wjcc.v10.i14.4395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/26/2021] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Depression has been reported to be prevalent in patients with pulmonary tuberculosis (PTB). Moreover, several clinical symptoms of PTB and depression overlap, such as loss of appetite and malnutrition. However, the association between depression and malnutrition in TB patients has not been fully elucidated. AIM To explore the association between depression and malnutrition in patients with PTB. METHODS This hospital-based cross-sectional study included patients with PTB in Shanghai Pulmonary Hospital Affiliated to Tongji University from April 2019 to July 2019. The Patient Health Questionnaire-9 (PHQ-9) scale was used to evaluate depre-ssion. The cut-off value was set at 10, and the nutritional state was determined by the body mass index (BMI). In addition, the Quality of Life Instruments for Chronic Diseases was employed to establish the quality of life (QOL). Univariable analysis and multivariable analysis (forward mode) were implemented to identify the independent factors associated with depression. RESULTS A total of 328 PTB patients were screened for analysis. Eight were excluded for missing demographic data, four excluded for missing nutrition status, and sixteen for missing QOL data. Finally, 300 PTB patients were subjected to analysis. We found that depressive state was present in 225 PTB patients (75%). The ratio of malnutrition in the depressive PTB patients was 45.33%. Our results revealed significantly lower BMI, hemoglobin, and prealbumin in the depression group than in the control group (P < 0.05). Moreover, the social status differed significantly (P < 0.05) between the groups. In addition, glutamic pyruvic transaminase and glutamic oxaloacetic transaminase in the depression group were significantly higher than those in the control group (P < 0.05). Multivariable logistic regression analysis showed that BMI [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.163-1.257, P < 0.001] and poor social function (OR = 0.95, 95%CI: 0.926-0.974, P = 0.038) were independently associated with depression. CONCLUSION Malnutrition and poor social function are significantly associated with depressive symptoms in PTB patients. A prospective large-scale study is needed to confirm these findings.
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Affiliation(s)
- Xue-E Fang
- Department of Tuberculosis, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200000, Shanghai Province, China
| | - Dan-Ping Chen
- Department of Tuberculosis, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200000, Shanghai Province, China
| | - Ling-Ling Tang
- Department of Tuberculosis, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200000, Shanghai Province, China
| | - Yan-Jun Mao
- Department of Nursing, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai 200000, Shanghai Province, China
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Du G, Li C, Liu Y, Tu F, Yang R, Li R, Shen H, Li W. Study on the Influencing Factors of Knowledge, Attitudes and Practice About Tuberculosis Among Freshmen in Jiangsu, China: A Cross-Sectional Study. Infect Drug Resist 2022; 15:1235-1245. [PMID: 35355621 PMCID: PMC8959873 DOI: 10.2147/idr.s351541] [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: 12/03/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Background Adolescents aged from 19 to 22 are the main high-risk population of pulmonary tuberculosis (PTB). This study aimed to understand the current status of knowledge, attitudes and practices (KAP) about TB among freshmen from Jiangsu colleges and universities. Analyze its influencing factors and explore the interrelationships of KAP. This provides a basis for building a reversing mechanism for health education on tuberculosis prevention and treatment in middle and high schools. Methods A multistage randomly was used to select freshmen to conduct this online survey. The χ 2 test was used to compare the rates. Construct linear regression model, logistic regression model, decision tree model and random forest model, use grid search to adjust the parameters of the model, and use multiple models to explore the influencing factors of the overall awareness rate of students' core knowledge of tuberculosis. Results A total of 6980 freshmen in colleges and universities were investigated. The total awareness rate was 89.02%, and the awareness rate of all core knowledge about TB was 58.94%. It is characterized by general demographic data, and all core knowledge is known as a label to establish a model, based on the f1- of the four models The score believes that the random forest model has the best fitting effect, and the ranking of the influencing factors included in the model is school type (0.72) >father's education (0.15) >family monthly income (0.03) >mother's education, gender, region (0.02); a structural equation model is established, and the modified knowledge and attitude path coefficient is 0.29 (P<0.05); the attitude and behavior path coefficient is 0.64 (P<0.05). Conclusion The total awareness rate of core knowledge of Jiangsu college freshmen reaches the national requirements, but the overall awareness rate is low. It is necessary to strengthen the health education of tuberculosis for those with identified risk factors.
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Affiliation(s)
- Guoping Du
- Department of General Practice, Southeast University Hospital, Nanjing, Jiangsu, People's Republic of China
| | - Chao Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Yangyang Liu
- Key Laboratory of Environmental Medicine Engineering, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Fulai Tu
- Key Laboratory of Environmental Medicine Engineering, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Ruizhe Yang
- Department of Prevention and Health Care, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Rui Li
- Key Laboratory of Environmental Medicine Engineering, Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Hongbing Shen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
| | - Wei Li
- Department of Quality Management, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, People's Republic of China
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Efficacy of integrating short-course chemotherapy with Chinese herbs to treat multi-drug resistant pulmonary tuberculosis in China: a study protocol. Infect Dis Poverty 2021; 10:131. [PMID: 34742353 PMCID: PMC8572065 DOI: 10.1186/s40249-021-00913-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/20/2021] [Indexed: 02/03/2023] Open
Abstract
Background Tuberculosis (TB) caused Mycobacterium tuberculosis (M.tb) is one of infectious disease that lead a large number of morbidity and mortality all over the world. Although no reliable evidence has been found, it is considered that combining chemotherapeutic drugs with Chinese herbs can significantly improves the cure rate and the clinical therapeutic effect. Methods Multi-drug resistant pulmonary tuberculosis (MDR-PTB, n = 258) patients with Qi-yin deficiency syndrome will be randomly assigned into a treatment group (n = 172) or control/placebo group (n = 86). The treatment group will receive the chemotherapeutic drugs combined with Chinese herbs granules (1 + 3 granules), while the control group will receive the chemotherapeutic drugs combined with Chinese herbs placebo (1 + 3 placebo granules). In addition, MDR-PTB (n = 312) patients with Yin deficiency lung heat syndrome will be randomly assigned to a treatment (n = 208) or control/placebo (n = 104) group. The treatment group will receive the chemotherapeutic regimen combined with Chinese herbs granules (2 + 4 granules), while the control group will receive the chemotherapeutic drugs and Chinese herbs placebo (2 + 4 placebo granules). The primary outcome is cure rate, the secondary outcomes included time to sputum culture conversion, lesion absorption rate and cavity closure rate. BACTEC™ MGIT™ automated mycobacterial detection system will be used to evaluate the M.tb infection and drug resistance. Chi-square test and Cox regression will be conducted with SAS 9.4 Statistical software to analyze the data. Discussion The treatment cycle for MDR-PTB using standardized modern medicine could cause lengthy substantial side effects. Chinese herbs have been used for many years to treat MDR-PTB, but are without high-quality evidence. Hence, it is unknown whether Chinese herbs enhances the clinical therapeutic effect of synthetic drugs for treating MDR-PTB. Therefore, this study will be conducted to evaluate the clinical therapeutic effect of combining Chinese herbs and chemotherapeutic drugs to treat MDR-PTB cases. It will assist in screening new therapeutic drugs and establishing treatment plan that aims to improve the clinical therapeutic effect for MDR-PTB patients. Trial registration This trial was registered at ClinicalTrials.gov (ChiCTR1900027720) on 24 November 2019 (prospective registered). Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-021-00913-5.
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Li X, Chen D, Zhang Y, Xue X, Zhang S, Chen M, Liu X, Ding G. Analysis of spatial-temporal distribution of notifiable respiratory infectious diseases in Shandong Province, China during 2005-2014. BMC Public Health 2021; 21:1597. [PMID: 34461855 PMCID: PMC8403828 DOI: 10.1186/s12889-021-11627-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 08/12/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Little comprehensive information on overall epidemic trend of notifiable respiratory infectious diseases is available in Shandong Province, China. This study aimed to determine the spatiotemporal distribution and epidemic characteristics of notifiable respiratory infectious diseases. METHODS Time series was firstly performed to describe the temporal distribution feature of notifiable respiratory infectious diseases during 2005-2014 in Shandong Province. GIS Natural Breaks (Jenks) was applied to divide the average annual incidence of notifiable respiratory infectious diseases into five grades. Spatial empirical Bayesian smoothed risk maps and excess risk maps were further used to investigate spatial patterns of notifiable respiratory infectious diseases. Global and local Moran's I statistics were used to measure the spatial autocorrelation. Spatial-temporal scanning was used to detect spatiotemporal clusters and identify high-risk locations. RESULTS A total of 537,506 cases of notifiable respiratory infectious diseases were reported in Shandong Province during 2005-2014. The morbidity of notifiable respiratory infectious diseases had obvious seasonality with high morbidity in winter and spring. Local Moran's I analysis showed that there were 5, 23, 24, 4, 20, 8, 14, 10 and 7 high-risk counties determined for influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella, respectively. The spatial-temporal clustering analysis determined that the most likely cluster of influenza A (H1N1), measles, tuberculosis, meningococcal meningitis, pertussis, scarlet fever, influenza, mumps and rubella included 74, 66, 58, 56, 22, 64, 2, 75 and 56 counties, and the time frame was November 2009, March 2008, January 2007, February 2005, July 2007, December 2011, November 2009, June 2012 and May 2005, respectively. CONCLUSIONS There were obvious spatiotemporal clusters of notifiable respiratory infectious diseases in Shandong during 2005-2014. More attention should be paid to the epidemiological and spatiotemporal characteristics of notifiable respiratory infectious diseases to establish new strategies for its control.
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Affiliation(s)
- Xiaomei Li
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, No.619 Changcheng Road, Taian, 271016, Shandong Province, China
| | - Dongzhen Chen
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, No.619 Changcheng Road, Taian, 271016, Shandong Province, China.,Liaocheng Center for Disease Control and Prevention, Liaocheng, 252100, Shandong Province, China
| | - Yan Zhang
- Guiqian International General Hospital, Guiyang, 550018, Guizhou Province, China
| | - Xiaojia Xue
- Qingdao Municipal Center for Disease Control & Prevention, Qingdao, 266033, Shandong Province, China
| | - Shengyang Zhang
- Shandong Center for Disease control and Prevention, Jinan, 250014, Shandong Province, China
| | - Meng Chen
- Jining Center for Disease Control and Prevention, Qingdao, 272113, Shandong Province, China
| | - Xuena Liu
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, No.619 Changcheng Road, Taian, 271016, Shandong Province, China.
| | - Guoyong Ding
- School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, No.619 Changcheng Road, Taian, 271016, Shandong Province, China.
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Rao HX, Li DM, Zhao XY, Yu J. Spatiotemporal clustering and meteorological factors affected scarlet fever incidence in mainland China from 2004 to 2017. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 777:146145. [PMID: 33684741 DOI: 10.1016/j.scitotenv.2021.146145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/21/2021] [Accepted: 02/21/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To analyze the spatiotemporal dynamic distribution and detect the related meteorological factors of scarlet fever from an ecological perspective, which could provide scientific information for effective prevention and control of this disease. METHODS The data on scarlet fever cases in mainland China were downloaded from the Data Center of the China Public Health Science, while monthly meteorological data were extracted from the official website of the National Bureau of Statistics. Global Moran's I, local Getis-Ord Gi⁎ hotspot statistics, and Kulldorff's retrospective space-time scan statistical analysis were used to detect the spatial and spatiotemporal clusters of scarlet fever across all settings. A spatial panel data model was conducted to estimate the impact of meteorological factors on scarlet fever incidence. RESULTS Scarlet fever in China had obvious spatial, temporal, and spatiotemporal clustering, high-incidence spatial clusters were located mainly in the north and northeast of China. Nine spatiotemporal clusters were identified. A spatial lag fixed effects panel data model was the best fit for regression analysis. After adjusting for spatial individual effects and spatial autocorrelation (ρ = 0.5623), scarlet fever incidence was positively associated with a one-month lag of average temperature, precipitation, and total sunshine hours (all P-values < 0.05). Each 10 °C, 2 cm, and 10 h increase in temperature, precipitation, and sunshine hours, respectively, was associated with a 6.41% increment and 1.04% and 1.41% decrement in scarlet fever incidence, respectively. CONCLUSION The incidence of scarlet fever in China showed an upward trend in recent years. It had obvious spatiotemporal clustering, with the high-risk areas mainly concentrated in the north and northeast of China. Areas with high temperature and with low precipitation and sunshine hours tended to have a higher scarlet fever incidence, and we should pay more attention to prevention and control in these places.
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Affiliation(s)
- Hua-Xiang Rao
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi 046000, China.
| | - Dong-Mei Li
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Xiao-Yin Zhao
- Department of Public Health and Preventive Medicine, Changzhi Medical College, Changzhi 046000, China.
| | - Juan Yu
- Department of Basic Medical Sciences, Changzhi Medical College, Changzhi 046000, China.
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Tusun D, Abulimiti M, Mamuti X, Liu Z, Xu D, Li G, Peng X, Abudureyimu T, Zhang L, Zhao Y, Ou X. The Epidemiological Characteristics of Pulmonary Tuberculosis - Kashgar Prefecture, Xinjiang Uygur Autonomous Region, China, 2011-2020. China CDC Wkly 2021; 3:557-561. [PMID: 34594935 PMCID: PMC8392941 DOI: 10.46234/ccdcw2021.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/18/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction: National Notifiable Disease Reporting System (NNDRS) plays an important role in the early detection and control of tuberculosis (TB) in China. This study analyzed the epidemiological characteristics of pulmonary tuberculosis (PTB) in Kashgar Prefecture, Xinjiang Uygur Autnomous Region, China from 2011 to 2020 to provide a scientific basis for developing TB control strategies and measures in Kashgar.
Methods:The data were collected from the NNDRS, which included the geographical distribution, age, sex, occupation, and pathogenic classification of reported PTB cases in 12 counties/cities of Kashgar Prefecture from 2011 to 2020. Descriptive statistics were used to describe the characteristic of PTB epidemic in Kashgar.
Results: There were 189,416 PTB cases reported during 2011–2020, with a mean annual PTB case notification rate (CNR) of 451.29/100,000. A rising trend in the rate of reported PTB between 2011 and 2017 (χ2trend=26.09, P<0.01) and a declining trend between 2018 and 2020 (χ2trend=314.44, P<0.01) were observed. The months with the highest reported number of PTB cases were March to May and November to December. The mean annual rate of reported PTB was 451.88/100,000 for males and 450.67/100,000 for females. In addition, 19.76% of patients were bacteriologically-confirmed (Bac+) cases (37,425/189,416), and the mean annual Bac+ CNR was 89.17/100,000, rising from 64.76/100,000 in 2011 to 139.12/100,000 in 2020 (χ2trend=74.44, P<0.01).
Conclusions: The CNR of reported PTB in Kashgar showed a significant declining trend in the past three years. Males, elderly population, winter and spring, and farmers as an occupation were the main factors associated with high incidence of tuberculosis in Kashgar. Targeted prevention and treatment of TB should be strengthened in key groups in this region.
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Affiliation(s)
- Diermulati Tusun
- Tuberculosis Dispensary of Kashgar Prefecture, Kashgar, Xinjiang Uygur Autonomous Region, China
| | | | - Xirizhati Mamuti
- Tuberculosis Dispensary of Kashgar Prefecture, Kashgar, Xinjiang Uygur Autonomous Region, China
| | - Zhenjiang Liu
- Tuberculosis Dispensary of Kashgar Prefecture, Kashgar, Xinjiang Uygur Autonomous Region, China
| | - Da Xu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guanzhen Li
- Shandong Provincial Hospital, Jinan, Shandong, China
| | - Xiaowang Peng
- Tuberculosis Dispensary of Kashgar Prefecture, Kashgar, Xinjiang Uygur Autonomous Region, China
| | - Tuerhong Abudureyimu
- Tuberculosis Dispensary of Kashgar Prefecture, Kashgar, Xinjiang Uygur Autonomous Region, China
| | - Lijie Zhang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanlin Zhao
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xichao Ou
- Chinese Center for Disease Control and Prevention, Beijing, China
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He R, Zhu B, Liu J, Zhang N, Zhang WH, Mao Y. Women's cancers in China: a spatio-temporal epidemiology analysis. BMC Womens Health 2021; 21:116. [PMID: 33743648 PMCID: PMC7981806 DOI: 10.1186/s12905-021-01260-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 03/10/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Women's cancers, represented by breast and gynecologic cancers, are emerging as a significant threat to women's health, while previous studies paid little attention to the spatial distribution of women's cancers. This study aims to conduct a spatio-temporal epidemiology analysis on breast, cervical and ovarian cancers in China, thus visualizing and comparing their epidemiologic trends and spatio-temporal changing patterns. METHODS Data on the incidence and mortality of women's cancers between January 2010 and December 2015 were obtained from the National Cancer Registry Annual Report. Linear tests and bar charts were used to visualize and compare the epidemiologic trends. Two complementary spatial statistics (Moran's I statistics and Kulldorff's space-time scan statistics) were adopted to identify the spatial-temporal clusters. RESULTS The results showed that the incidence and mortality of breast cancer displayed slow upward trends, while that of cervical cancer increase dramatically, and the mortality of ovarian cancer also showed a fast increasing trend. Significant differences were detected in incidence and mortality of breast, cervical and ovarian cancer across east, central and west China. The average incidence of breast cancer displayed a high-high cluster feature in part of north and east China, and the opposite traits occurred in southwest China. In the meantime, the average incidence and mortality of cervical cancer in central China revealed a high-high cluster feature, and that of ovarian cancer in northern China displayed a high-high cluster feature. Besides, the anomalous clusters were also detected based on the space-time scan statistics. CONCLUSION Regional differences were detected in the distribution of women's cancers in China. An effective response requires a package of coordinated actions that vary across localities regarding the spatio-temporal epidemics and local conditions.
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Affiliation(s)
- Rongxin He
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Beilin District, Xi’an, 710049 China
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10 UZ, 9000 Ghent, Belgium
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an, 710049 China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, 1088 Xueyuan Avenue, Shenzhen, 518055 China
| | - Jinlin Liu
- School of Public Policy and Administration, Northwestern Polytechnical University, 127 Youyin West Road, Beilin District, Xi’an, 710072 China
| | - Ning Zhang
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Beilin District, Xi’an, 710049 China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an, 710049 China
| | - Wei-Hong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10 UZ, 9000 Ghent, Belgium
| | - Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, 28 Xianning West Road, Beilin District, Xi’an, 710049 China
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi’an Jiaotong University, 28 Xianning West Road, Xi’an, 710049 China
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Influential factors and spatial-temporal distribution of tuberculosis in mainland China. Sci Rep 2021; 11:6274. [PMID: 33737676 PMCID: PMC7973528 DOI: 10.1038/s41598-021-85781-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 03/04/2021] [Indexed: 11/17/2022] Open
Abstract
Tuberculosis (TB) is an infectious disease that threatens human safety. Mainland China is an area with a high incidence of tuberculosis, and the task of tuberculosis prevention and treatment is arduous. This paper aims to study the impact of seven influencing factors and spatial–temporal distribution of the relative risk (RR) of tuberculosis in mainland China using the spatial–temporal distribution model and INLA algorithm. The relative risks and confidence intervals (CI) corresponding to average relative humidity, monthly average precipitation, monthly average sunshine duration and monthly per capita GDP were 1.018 (95% CI 1.001–1.034), 1.014 (95% CI 1.006–1.023), 1.026 (95% CI 1.014–1.039) and 1.025 (95% CI 1.011–1.040). The relative risk for average temperature and pressure were 0.956 (95% CI 0.942–0.969) and 0.767 (95% CI 0.664–0.875). Spatially, the two provinces with the highest relative risks are Xinjiang and Guizhou, and the remaining provinces with higher relative risks were mostly concentrated in the Northwest and South China regions. Temporally, the relative risk decreased year by year from 2013 to 2015. It was higher from February to May each year and was most significant in March. It decreased from June to December. Average relative humidity, monthly average precipitation, monthly average sunshine duration and monthly per capita GDP had positive effects on the relative risk of tuberculosis. The average temperature and pressure had negative effects. The average wind speed had no significant effect. Mainland China should adapt measures to local conditions and develop tuberculosis prevention and control strategies based on the characteristics of different regions and time.
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Gu J, Zhu S, Chen T, Tang J, Pan Z, Gong J, Shou J, Yang H, Du Z. Evaluation of the Spring Seedling Project-Zhaotong Program: A study of a novel continuing medical education program for rural doctors in China. Aust J Rural Health 2020; 28:434-442. [PMID: 32985023 PMCID: PMC7756282 DOI: 10.1111/ajr.12659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/08/2020] [Accepted: 07/12/2020] [Indexed: 12/19/2022] Open
Abstract
Objective To evaluate the effectiveness of the Spring Seedling Project‐Zhaotong program, a novel continuing medical education program, to improve the knowledge and skills of rural doctors in China. Design An uncontrolled single‐group pre‐ and post‐intervention design based on quantitative and qualitative methods. Setting Zhaotong is a prefecture‐level city located in Yunnan, China. Participants A total of 1866 country doctors practising in Zhaotong were enrolled. Interventions The Zhaotong program consisted of three stages: remote education, workshops conducted in Zhaotong and field training in Shanghai. Main outcome measures The effectiveness of the remote education and Zhaotong workshop stages was assessed based on differences between pre‐ and post‐training test scores. Qualitative comments were collected to assess the experience of country doctors following the Shanghai field training stage. Results In total, 1866 country doctors (46.9% males; mean age: 38.2 ± 9.2 years) participated in the program. The average score of the post‐training test was higher than that of the pre‐training test, both online (P < .001) and offline (P < .001). In regard to the Zhaotong workshops, with the exception of incisions/suturing, the average scores of cardiopulmonary resuscitation, gynaecological examinations and child growth/development were improved after training (P < .001). Qualitative analysis showed that Shanghai field training enhanced understanding of general practice, with the majority of country doctors indicating that they would apply what they learned in daily practice. Conclusion This study introduced an comprehensive form of continuing medical education for rural doctors in Zhaotong and proved the effectiveness of this program and also provided a reference point for the future development of continuing medical education.
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Affiliation(s)
- Jie Gu
- Zhongshan Hospital Fudan University, Shanghai, China
| | - Shanzhu Zhu
- Zhongshan Hospital Fudan University, Shanghai, China
| | - Taojian Chen
- Shanghai Community Health Association, Shanghai, China
| | - Juntao Tang
- Zhaotong Health and Family Planning Bureau, Yunnan, China
| | - Zhigang Pan
- Zhongshan Hospital Fudan University, Shanghai, China
| | - Jian Gong
- Zhongshan Hospital Fudan University, Shanghai, China
| | - Juan Shou
- Zhongshan Hospital Fudan University, Shanghai, China
| | - Hua Yang
- Zhongshan Hospital Fudan University, Shanghai, China
| | - Zhaohui Du
- Shanghai Pudong Shanggang Community Health Center, Shanghai, 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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Yu Y, Wu B, Wu C, Wang Q, Hu D, Chen W. Spatial-temporal analysis of tuberculosis in Chongqing, China 2011-2018. BMC Infect Dis 2020; 20:531. [PMID: 32698763 PMCID: PMC7374877 DOI: 10.1186/s12879-020-05249-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 07/14/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND China is a country with a high burden of pulmonary tuberculosis (PTB). Chongqing is in the southwest of China, where the notification rate of PTB ranks tenth in China. This study analyzed the temporal and spatial distribution characteristics of PTB in Chongqing in order to improve TB control measures. METHODS A spatial-temporal analysis has been performed based on the data of PTB from 2011 to 2018, which was extracted from the National Surveillance System. The effect of TB control was measured by variation trend of pathogenic positive PTB notification rate and total TB notification rate. Time series, spatial autonomic correlation and spatial-temporal scanning methods were used to identify the temporal trends and spatial patterns at county level. RESULTS A total of 188,528 cases were included in this study. A downward trend was observed in PTB between 2011 and 2018 in Chongqing. The peak of PTB notification occurred in late winter and early spring annually. By calculating the value of Global Moran's I and Local Getis's Gi*, we found that PTB was spatially clustered and some significant hot spots were detected in the southeast and northeast of Chongqing. One most likely cluster and three secondary clusters were identified by Kulldorff's scan spatial-temporal Statistic. CONCLUSIONS This study identified seasonal patterns and spatial-temporal clusters of PTB cases in Chongqing. Priorities should be given to southeast and northeast of Chongqing for better TB control.
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Affiliation(s)
- Ya Yu
- Chongqing Institute of Tuberculosis Control and Prevention, Chongqing, China
- Chinese Field Epidemiology Training Program, Beijing, China
| | - Bo Wu
- Chongqing Institute of Tuberculosis Control and Prevention, Chongqing, China
| | - Chengguo Wu
- Chongqing Institute of Tuberculosis Control and Prevention, Chongqing, China
| | - Qingya Wang
- Chongqing Institute of Tuberculosis Control and Prevention, Chongqing, China
| | - Daiyu Hu
- Chongqing Institute of Tuberculosis Control and Prevention, Chongqing, China.
| | - Wei Chen
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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Yang J, Zhang M, Chen Y, Ma L, Yadikaer R, Lu Y, Lou P, Pu Y, Xiang R, Rui B. A study on the relationship between air pollution and pulmonary tuberculosis based on the general additive model in Wulumuqi, China. Int J Infect Dis 2020; 96:42-47. [PMID: 32200108 DOI: 10.1016/j.ijid.2020.03.032] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 03/08/2020] [Accepted: 03/13/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE This study aimed to explore the impact of atmospheric pollutants on the incidence of tuberculosis (TB), and provide new ideas for the prevention and control of TB in the future. METHODS It explored the relationship between air pollutants and meteorological factors, as well as between air pollutants and heating through Spearman correlation analysis and rank sum test. Additionally, it analyzed the relationship between air pollutants and TB incidence using the general additive model. Statistical analysis results at the p<0.05 level were considered significant. RESULTS Three months after exposure to air pollutants (PM2.5, SO2, NO2, and CO) TB incidence increased. However, TB incidence increased 9 months after exposure to PM10. The single pollutant model showed when concentrations of PM2.5, PM10, SO2, NO2, CO, and O3 increased by 1μg/m3 (or 1mg/m3), the number of TB cases increased by 0.09%, 0.08%, 0.58%, 0.42%, 6.9%, and 0.57%, respectively. The optimal multi-pollutant model was a two-factor model (PM10+NO2). CONCLUSION Air pollutants including PM2.5, PM10, SO2, NO2, CO, and O3 increased the risk of TB. Few studies have been conducted in this area of research, especially regarding the mechanism. The results of this study should contribute to the understanding of TB incidence and prompt additional research.
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Affiliation(s)
- Jiandong Yang
- Department for Tuberculosis Control and Prevention, Wulumuqi Center for Disease Control and Prevention, China.
| | - Mengxi Zhang
- Center for Studies of Displaced Populations, Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health & Tropical Medicine, China
| | - Yanggui Chen
- Department for Tuberculosis Control and Prevention, Wulumuqi Center for Disease Control and Prevention, China
| | - Li Ma
- Department for Tuberculosis Control and Prevention, Wulumuqi Center for Disease Control and Prevention, China
| | - Rayibai Yadikaer
- Health Inspection of Health and Family Planning Commission of Xinjiang Uygur Autonomous Region, China
| | - Yaoqin Lu
- Department of Occupational and Environmental Health, Xinjiang Medical University School of Public Health, China; Science and Education Department, Wulumuqi Center for Disease Control and Prevention, China
| | - Pengwei Lou
- Medical Records Statistics Room, The Fourth Affiliated Hospital of Xinjiang Medical University, China
| | - Yujiao Pu
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, China
| | - Ran Xiang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, China
| | - Baolin Rui
- Department for Tuberculosis Control and Prevention, Wulumuqi Center for Disease Control and Prevention, China
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Zhu B, Hsieh CW, Mao Y. Spatio-temporal variations of licensed doctor distribution in China: measuring and mapping disparities. BMC Health Serv Res 2020; 20:159. [PMID: 32122387 PMCID: PMC7053041 DOI: 10.1186/s12913-020-4992-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 02/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The licensed doctor misdistribution is one of the major challenges faced by China. However, this subject remains underexplored as spatial distribution characteristics (such as spatial clustering patterns) have not been fully mapped out by existing studies. To fill the void, this study aims to explore the spatio-temporal dynamics and spatial clustering patterns of different subtypes of licensed doctors (i.e., clinicians, traditional Chinese medicine doctors, dentists, public health doctors, general practitioners) in China. METHODS Data on the licensed doctor quantity and population during 2012-2016 was obtained from the National Health (and Family Planning) Yearbook. Functional boxplots were used to visualize and compare the temporal trends of densities of different subtypes of licensed doctors. This study adopted two complementary spatial statistics (space-time scan statistics and Moran's I statistics) to explore the spatio-temporal dynamics and spatial clustering patterns of licensed doctor distribution in China. The former was used to explore the spatial variations in the temporal trends of licensed doctor density during 2012-2016, and the latter was adopted to explore the spatial changing patterns of licensed doctor distribution during the research period. RESULTS The results show that the densities of almost all subtypes of licensed doctors displayed upward trends during 2012-2016, though some provincial units were left behind. Besides, spatial distribution characteristics varied across different subtypes of licensed doctors, with the low-low cluster area of general practitioners being the largest. CONCLUSIONS The misdistribution of licensed doctors is a global problem and China is no exception. In order to achieve a balanced distribution of licensed doctors, the government is suggested to introduce a series of measures, such as deliberative policy design and effective human resource management initiatives to educate, recruit, and retain licensed doctors and prevent a brain drain of licensed doctors from disadvantaged units.
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Affiliation(s)
- Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Beilin District, Xi'an, 710049, China.,Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, SAR, China
| | - Chih-Wei Hsieh
- Department of Public Policy, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong, SAR, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, 28 Xianning West Road, Beilin District, Xi'an, 710049, China.
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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: 10] [Impact Index Per Article: 2.0] [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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Braganza Menezes D, Menezes B, Dedicoat M. Contact tracing strategies in household and congregate environments to identify cases of tuberculosis in low- and moderate-incidence populations. Cochrane Database Syst Rev 2019; 8:CD013077. [PMID: 31461540 PMCID: PMC6713498 DOI: 10.1002/14651858.cd013077.pub2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Tuberculosis is an infectious bacterial disease that is spread via respiratory droplets from infected individuals to susceptible contacts. To eliminate this disease from low- and medium-incidence settings, people who are most likely to be infected (contacts) must be identified. Recently, study authors have examined alternate approaches to contact tracing methods that demonstrate improved detection and prioritization of contacts. The comparative benefit of these methods has not been established. OBJECTIVES To assess the effectiveness of novel methods of contact tracing versus current standard of care to identify latent and active cases in low- to moderate-incidence settings. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, LILACS, Web of Science, and CINAHL up to 15 July 2019. We also searched for clinical trials and examined reference lists and conference proceedings. SELECTION CRITERIA Randomized controlled trials (RCTs) and cluster-RCTs of contact tracing strategies that included alternate approaches (other than standard practice). DATA COLLECTION AND ANALYSIS Two review authors independently assessed identified articles for eligibility and quality using prespecified criteria. MAIN RESULTS No trials met the inclusion criteria of this review. Several study authors described an alternate method for examining contacts and performing social network analysis but did not compare this with the current contact tracing approach. AUTHORS' CONCLUSIONS This Cochrane Review highlights the lack of research in support of the current contact tracing method and the need for RCTs to compare new methods such as social network analysis to improve contact tracing processes.
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Affiliation(s)
- Darryl Braganza Menezes
- University Hospitals Birmingham Foundation TrustHawthorne House, Heartlands Hospital, Bordesley Green EastBirminghamUKB9 5SS
| | - Bunota Menezes
- University Hospitals Birmingham Foundation TrustHawthorne House, Heartlands Hospital, Bordesley Green EastBirminghamUKB9 5SS
| | - Martin Dedicoat
- Birmingham Heartlands HospitalDepartment of InfectionBordesley Green EastBirminghamUKB9 5SS
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Lima SVMA, dos Santos AD, Duque AM, de Oliveira Goes MA, da Silva Peixoto MV, da Conceição Araújo D, Ribeiro CJN, Santos MB, de Araújo KCGM, Nunes MAP. Spatial and temporal analysis of tuberculosis in an area of social inequality in Northeast Brazil. BMC Public Health 2019; 19:873. [PMID: 31272437 PMCID: PMC6610860 DOI: 10.1186/s12889-019-7224-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 06/21/2019] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. It is a disease known worldwide for its vulnerability factors, magnitude and mortality. The objective of the study was to analyze the spatial and temporal dynamics of TB in the area of social inequality in northeast Brazil between the years 2001 and 2016. METHODS An ecological time series study with the use of spatial analysis techniques was carried out from 2001 to 2016. The units of analysis were the 75 municipalities in the state of Sergipe. Data from the Notification of Injury Information System were used. For the construction of the maps, the cartographic base of the state of Sergipe, obtained at the Instituto Brasileiro de Geografia e Estatística, was used. Georeferenced data were analysed using TerraView 4.2.2 software (Instituto Nacional de Pesquisas Espaciais) and QGis 2.18.2 (Open Source Geospatial Foundation). Spatial analyses included the empirical Bayesian model and the global and local Moran indices. The time trend analyses were performed by the software Joinpoint Regression, Version 4.5.0.1, with the variables of sex, age, cure and abandonment. RESULTS There was an increasing trend of tuberculosis cases in patients under 20 years old and 20-39 years old, especially in males. Cured cases showed a decreasing trend, and cases of treatment withdrawal were stationary. A spatial dependence was observed in almost all analysed territories but with different concentrations. Significant spatial correlations with the formation of clusters in the southeast and northeast of the state were observed. The probability of illness among municipalities was determined not to occur in a random way. CONCLUSION The identification of risk areas and priority groups can help health planning by refining the focus of attention to tuberculosis control. Understanding the epidemiological, spatial and temporal dynamics of tuberculosis can allow for improved targeting of strategies for disease prevention and control.
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Affiliation(s)
| | - Allan Dantas dos Santos
- Nursing Department, Federal University of Sergipe, Avenida Universitária Marcelo Deda Chagas, 330, Lagarto, SE 49.400-000 Brazil
| | - Andrezza Marques Duque
- Program in Health Sciences, Federal University of Sergipe, Brazil Cláudio Batista, s/n, Cidade Nova, Aracaju, SE 49060-108 Brazil
| | - Marco Aurélio de Oliveira Goes
- Program in Health Sciences, Federal University of Sergipe, Brazil Cláudio Batista, s/n, Cidade Nova, Aracaju, SE 49060-108 Brazil
| | - Marcus Valerius da Silva Peixoto
- Program in Health Sciences, Federal University of Sergipe, Brazil Cláudio Batista, s/n, Cidade Nova, Aracaju, SE 49060-108 Brazil
| | - Damião da Conceição Araújo
- Program in Health Sciences, Federal University of Sergipe, Brazil Cláudio Batista, s/n, Cidade Nova, Aracaju, SE 49060-108 Brazil
| | - Caíque Jordan Nunes Ribeiro
- Program in Health Sciences, Federal University of Sergipe, Brazil Cláudio Batista, s/n, Cidade Nova, Aracaju, SE 49060-108 Brazil
| | - Márcio Bezerra Santos
- Department of Health education, Federal University of Sergipe, Avenida Universitária Marcelo Deda Chagas 330, Lagarto, SE 49.400-000 Brazil
| | | | - Marco Antônio Prado Nunes
- Program in Health Sciences, Federal University of Sergipe, Brazil Cláudio Batista, s/n, Cidade Nova, Aracaju, SE 49060-108 Brazil
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Mao Q, Zeng C, Zheng D, Yang Y. Analysis on spatial-temporal distribution characteristics of smear positive pulmonary tuberculosis in China, 2004-2015. Int J Infect Dis 2019; 80S:S36-S44. [PMID: 30825654 DOI: 10.1016/j.ijid.2019.02.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/23/2019] [Accepted: 02/25/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND In China, tuberculosis (TB) is still a major infectious disease threatening people's health. Smear positive pulmonary TB is one of the most common infectious forms of TB and it might easily cause the outbreak in some areas. With a better understanding of the spatial-temporal variations of smear positive PTB, we would reach the targets for TB prevention and controlling, identify high-risk areas and periods. Thus, the aim of this study was to investigate the spatial-temporal variations of smear positive PTB. METHODS Provincial level data of reported smear positive PTB monthly cases and incidence from January 2004 to December 2015 were obtained from the National Scientific Data Sharing Platform for Population and Health of China. Purely spatial-temporal descriptive analysis was used to characterize the distribution patterns of smear positive PTB. The global spatial auto-correlation statistics (Moran's I) and the local indicators of spatial association (LISA) were conducted to identify the spatial auto-correlation and high risk areas of smear positive PTB cases. Furthermore, the space-time scan statistic was adopted to detect the spatial-temporal clusters in different periods. RESULTS A total of 4,711,571 smear positive PTB cases were notified in China with an average annual incidence of 29.59/100,000. The proportion of male in different age groups were obviously higher than that of women. The largest number of cases was reported in the 20-24 years age group. Time-series analysis indicated that monthly incidence appeared a clearly seasonality and periodicity, which the seasonal peaks occurred in January and March. Smear positive PTB cases had a positive global spatial auto-correlation in 2013-2015 (Moran's I=0.186, P=0.046). Spatial clusters were identified in four periods, located in the different regions. The time period of 2004-2006, the most likely spatial-temporal cluster (RR=1.69, P<0.001) was mainly located in Hubei, Hunan, Jiangxi and Anhui of central China, clustering in the time frame from January 2005 to June 2006. During 2007-2009, the most likely spatial-temporal cluster (RR=5.65, P<0.001) was located in Guizhou, clustering in the time frame from January to December 2009. The spatial-temporal clustering in the years 2010-2012 showed the most likely cluster (RR=1.44, P<0.001) was distributed in Anhui, Hunan, Hubei, Jiangxi and Guangdong with the time frame from January 2010 to June 2011. During 2013-2015, the most likely cluster (RR=1.86, P<0.001) was detected in Hunan, Hubei, Jiangxi and Guangdong from February 2013 to June 2014. CONCLUSIONS This study identified the spatial-temporal patterns of smear positive PTB in China and demonstrated the capability and utility of the spatial-temporal approach in epidemiology. The results of this study would contribute to estimating the high risk periods and areas, and to providing more useful information for policy-making.
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Affiliation(s)
- Qiang Mao
- Department of Medical Records Statistics, The First People's Hospital of Jingmen, Jingmen 448000, China.
| | - Chenghui Zeng
- Department of Medical Records Statistics, The First People's Hospital of Jingmen, Jingmen 448000, China
| | - Dacheng Zheng
- Department of Medical Records Statistics, The First People's Hospital of Jingmen, Jingmen 448000, China
| | - Yahong Yang
- Department of Infection Management, Gansu Provincial People's Hospital, Lanzhou 730000, China.
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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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Huang L, Abe EM, Li XX, Bergquist R, Xu L, Xue JB, Ruan Y, Cao CL, Li SZ. Space-time clustering and associated risk factors of pulmonary tuberculosis in southwest China. Infect Dis Poverty 2018; 7:91. [PMID: 30115099 PMCID: PMC6097331 DOI: 10.1186/s40249-018-0470-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 07/30/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Pulmonary tuberculosis (PTB,both smear positive and smear negative) is an airborne infectious disease of major public health concern in China and other parts of the world where PTB endemicity is reported. This study aims at identifying PTB spatio-temporal clusters and associated risk factors in Zhaotong prefecture-level city, located in southwest China, where the PTB notification rate was higher than the average rate in the entire country. METHODS Space-time scan statistics were carried out using PTB registered data in the nationwide TB online registration system from 2011 to 2015, to identify spatial clusters. PTB patients diagnosed between October 2015 and February 2016 were selected and a structured questionnaire was administered to collect a set of variables that includes socio-economic status, behavioural characteristics, local environmental and biological characteristics. Based on the discovery of detailed town-level spatio-temporal PTB clusters, we divided selected subjects into two groups including the cases that resides within and outside identified clusters. Then, logistic regression analysis was applied comparing the results of variables between the two groups. RESULTS A total of 1508 subjects consented and participated in the survey. Clusters for PTB cases were identified in 38 towns distributed over south-western Zhaotong. Logistic regression analysis showed that history of chronic bronchitis (OR = 3.683, 95% CI: 2.180-6.223), living in an urban area (OR = 5.876, 95% CI: 2.381-14.502) and using coal as the main fuel (OR = 9.356, 95% CI: 5.620-15.576) were independently associated with clustering. While, not smoking (OR = 0.340, 95% CI: 0.137-0.843) is the protection factor of spatial clustering. CONCLUSIONS We found PTB specially clustered in south-western Zhaotong. The strong associated factors influencing the PTB spatial cluster including: the history of chronic bronchitis, living in the urban area, smoking and the use of coal as the main fuel for cooking and heating. Therefore, efforts should be made to curtail these associated factors.
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Affiliation(s)
- Li Huang
- Yunnan provincial Center for Disease Control and Prevention, Kunming, China
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Ruijing Er road 207, Shanghai, 200025 China
- National Research Center for Tropical Disease, Shanghai, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Eniola Michael Abe
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Ruijing Er road 207, Shanghai, 200025 China
- National Research Center for Tropical Disease, Shanghai, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Xin-Xu Li
- Center for Drug Evaluation, China Food and Drug Administration, Beijing, China
| | | | - Lin Xu
- Yunnan provincial Center for Disease Control and Prevention, Kunming, China
| | - Jing-Bo Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Ruijing Er road 207, Shanghai, 200025 China
- National Research Center for Tropical Disease, Shanghai, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Yao Ruan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Ruijing Er road 207, Shanghai, 200025 China
- National Research Center for Tropical Disease, Shanghai, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Chun-Li Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Ruijing Er road 207, Shanghai, 200025 China
- National Research Center for Tropical Disease, Shanghai, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Ruijing Er road 207, Shanghai, 200025 China
- National Research Center for Tropical Disease, Shanghai, China
- Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
- WHO Collaborating Center for Tropical Diseases, Shanghai, China
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Sun Y, Yang Z, Wan C, Xu C, Chen L, Xu L, Zhang X, Yan F. Development and validation of the pulmonary tuberculosis scale of the system of Quality of Life Instruments for Chronic Diseases (QLICD-PT). Health Qual Life Outcomes 2018; 16:137. [PMID: 29996931 PMCID: PMC6042382 DOI: 10.1186/s12955-018-0960-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 06/25/2018] [Indexed: 12/13/2022] Open
Abstract
Background Generic assessments are less responsive to subtle changes due to specific diseases, making it challenging to fully understand the impact of pulmonary tuberculosis (TB) on patient’s quality of life (QOL). Methods We applied programmed decision procedures and theories on instrument development to develop the scale. Two hundred patients with pulmonary TB participated in measuring QOL three times before and after treatments. We assessed the validity, reliability, and responsiveness of QLICD-PT using correlation analysis, factor analysis, multi-trait scaling analysis, randomized block analyses of variance with Least Significant Difference post-hoc tests. Results We composed QLICD-PT with 3 domains (28 items) for general QOL and 1 pulmonary TB specific domain (12 items). Correlation and factor analysis confirmed good structure validity and criterion-related validity when using Chinese version of the Medical Outcomes Short-Form Health Survey (SF-36) as a criterion. The internal consistency of α values were higher than 0.70. The score changes after treatment were of statistical significance for the overall scale, physical domain and specific domain with effect size ranging from 0.32 to 0.72. No floor effects but small ceiling effects were observed at domain level. Conclusions As the first pulmonary TB-specific QOL scale developed by a module approach in Chinese, QLICD-PT has an acceptable degree of validity, reliability and responsiveness, and can be used to measure the life quality of PT patients specifically and sufficiently.
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Affiliation(s)
- Yanchun Sun
- Department of Social Medicine, School of Public Health, National Key Laboratory of Health Technology Assessment (National Health and Family Planning Commission), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, 200032, China
| | - Zheng Yang
- School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Chonghua Wan
- School of Humanities and Management, Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan, 523808, China.
| | - Chuanzhi Xu
- School of Public Health, Kunming Medical University, Kunming, 650500, China
| | - Liuping Chen
- Yunnnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Lin Xu
- Yunnnan Center for Disease Control and Prevention, Kunming, 650022, China
| | - Xiaoqing Zhang
- School of Public Health, Kunming Medical University, Kunming, 650500, China
| | - Fei Yan
- Department of Social Medicine, School of Public Health, National Key Laboratory of Health Technology Assessment (National Health and Family Planning Commission), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, 200032, China.
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Zhu B, Fu Y, Liu J, Mao Y. Spatial distribution of 12 class B notifiable infectious diseases in China: A retrospective study. PLoS One 2018; 13:e0195568. [PMID: 29621351 PMCID: PMC5886686 DOI: 10.1371/journal.pone.0195568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 03/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND China is the largest developing country with a relatively developed public health system. To further prevent and eliminate the spread of infectious diseases, China has listed 39 notifiable infectious diseases characterized by wide prevalence or great harm, and classified them into classes A, B, and C, with severity decreasing across classes. Class A diseases have been almost eradicated in China, thus making class B diseases a priority in infectious disease prevention and control. In this retrospective study, we analyze the spatial distribution patterns of 12 class B notifiable infectious diseases that remain active all over China. METHODS Global and local Moran's I and corresponding graphic tools are adopted to explore and visualize the global and local spatial distribution of the incidence of the selected epidemics, respectively. Inter-correlations of clustering patterns of each pair of diseases and a cumulative summary of the high/low cluster frequency of the provincial units are also provided by means of figures and maps. RESULTS Of the 12 most commonly notifiable class B infectious diseases, viral hepatitis and tuberculosis show high incidence rates and account for more than half of the reported cases. Almost all the diseases, except pertussis, exhibit positive spatial autocorrelation at the provincial level. All diseases feature varying spatial concentrations. Nevertheless, associations exist between spatial distribution patterns, with some provincial units displaying the same type of cluster features for two or more infectious diseases. Overall, high-low (unit with high incidence surrounded by units with high incidence, the same below) and high-high spatial cluster areas tend to be prevalent in the provincial units located in western and southwest China, whereas low-low and low-high spatial cluster areas abound in provincial units in north and east China. CONCLUSION Despite the various distribution patterns of 12 class B notifiable infectious diseases, certain similarities between their spatial distributions are present. Substantial evidence is available to support disease-specific, location-specific, and disease-combined interventions. Regarding provinces that show high-high/high-low patterns of multiple diseases, comprehensive interventions targeting different diseases should be established. As to the adjacent provincial units revealing similar patterns, coordinated actions need to be taken across borders.
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Affiliation(s)
- Bin Zhu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Yang Fu
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Jinlin Liu
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Ying Mao
- School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an, Shaanxi, China
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Rao H, Shi X, Zhang X. Using the Kulldorff's scan statistical analysis to detect spatio-temporal clusters of tuberculosis in Qinghai Province, China, 2009-2016. BMC Infect Dis 2017; 17:578. [PMID: 28826399 PMCID: PMC5563899 DOI: 10.1186/s12879-017-2643-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 07/26/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although the incidence of tuberculosis (TB) in most parts of China are well under control now, in less developed areas such as Qinghai, TB still remains a major public health problem. This study aims to reveal the spatio-temporal patterns of TB in the Qinghai province, which could be helpful in the planning and implementing key preventative measures. METHODS We extracted data of reported TB cases in the Qinghai province from the China Information System for Disease Control and Prevention (CISDCP) during January 2009 to December 2016. The Kulldorff's retrospective space-time scan statistics, calculated by using the discrete Poisson probability model, was used to identify the temporal, spatial, and spatio-temporal clusters of TB at the county level in Qinghai. RESULTS A total of 48,274 TB cases were reported from 2009 to 2016 in Qinghai. Results of the Kulldorff's scan revealed that the TB cases in Qinghai were significantly clustered in spatial, temporal, and spatio-temporal distribution. The most likely spatio-temporal cluster (LLR = 2547.64, RR = 4.21, P < 0.001) was mainly concentrated in the southwest of Qinghai, covering seven counties and clustered in the time frame from September 2014 to December 2016. CONCLUSION This study identified eight significant space-time clusters of TB in Qinghai from 2009 to 2016, which could be helpful in prioritizing resource assignment in high-risk areas for TB control and elimination in the future.
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Affiliation(s)
- Huaxiang Rao
- Institute for Communicable Disease Control and Prevention, Qinghai Center for Disease Control and Prevention, No.55 Bayi middle Road, Xining, Qinghai, 810007, China.
| | - Xinyu Shi
- Operational Department, The Second Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Xi Zhang
- Clinical Research Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Road, Shanghai, 200092, China
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