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Liu L, Peng J, Zang D, Zhang Y, Wu Z, Song C, Chen S, Guo D, Lu F, Zheng T, Yang J. The Chinese visceral adiposity index: a novel indicator more closely related to cardiovascular disease than other abdominal obesity indices among postmenopausal women. J Transl Med 2024; 22:855. [PMID: 39313824 PMCID: PMC11421114 DOI: 10.1186/s12967-024-05665-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/04/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Several abdominal obesity indices including waist circumference (WC), waist-hip ratio (WHR), visceral adiposity index (VAI), lipid accumulation product (LAP), and Chinese visceral adiposity index (CVAI) were considered effective and useful predictive markers for cardiovascular disease (CVD) in general populations or diabetic populations. However, studies investigating the associations between these indices among postmenopausal women are limited. Our study aimed to investigate the associations of the five indices with incident CVD and compare the predictive performance of CVAI with other abdominal obesity indices among postmenopausal women. METHODS A total of 1252 postmenopausal women without CVD at baseline were analyzed in our investigation based on a 10-year follow-up prospective cohort study. Link of each abdominal obesity index with CVD were assessed by the Cox regression analysis and the Kaplan-Meier curve. The receiver operating characteristic (ROC) curves were drawn to compare the predictive ability for CVD. RESULTS During the median follow-up of 120.53 months, 121 participants newly developed CVD. Compared to quartile 1 of LAP and CVAI, quartile 4 had increased risk to develop CVD after fully adjusted among postmenopausal women. When WC, VAI and CVAI considered as continuous variables, significant increased hazard ratios (HRs) for developing CVD were observed. The areas under the curve (AUC) of CVAI (0.632) was greatly higher than other indices (WC: 0.580, WHR: 0.538, LAP: 0.573, VAI: 0.540 respectively). CONCLUSIONS This study suggested that the abdominal obesity indices were associated with the risk of CVD excluded WHR and highlighted that CVAI might be the most valuable abdominal obesity indicator for identifying the high risk of CVD in Chinese postmenopausal women.
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Affiliation(s)
- Li Liu
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China
| | - Jie Peng
- Key Laboratory of Cardiovascular Proteomics of Shandong Province, Department of Geriatric Medicine, Qilu Hospital of Shandong University, Jinan, China
| | - Dejin Zang
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China
| | - Yerui Zhang
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China
| | - Zhenguo Wu
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China
| | - Chunfei Song
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China
| | - Sha Chen
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China
| | - Dachuan Guo
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Shandong Academy of Medical Sciences, Jinan, China
| | - Tengfei Zheng
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China.
| | - Jianmin Yang
- National Key Laboratory for Innovation and Transformation of Luobing Theory, The Key Laboratory of Cardiovascular Remodeling and Function Research, Department of Cardiology, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, Qilu Hospital of Shandong University, No 107, Wenhuaxi Road, Jinan, Shandong, China.
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Pan S, Chen L, Xin X, Li S, Zhang Y, Chen Y, Xiao S. Spatiotemporal analysis and seasonality of tuberculosis in Pudong New Area of Shanghai, China, 2014-2023. BMC Infect Dis 2024; 24:761. [PMID: 39085765 PMCID: PMC11293123 DOI: 10.1186/s12879-024-09645-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Spatiotemporal analysis is a vital method that plays an indispensable role in monitoring epidemiological changes in diseases and identifying high-risk clusters. However, there is still a blank space in the spatial and temporal distribution of tuberculosis (TB) incidence rate in Pudong New Area, Shanghai. Consequently, it is crucial to comprehend the spatiotemporal distribution of TB in this district, this will guide the prevention and control of TB in the district. METHODS Our research used Geographic Information System (GIS) visualization, spatial autocorrelation analysis, and space-time scan analysis to analyze the TB incidence reported in the Pudong New Area of Shanghai from 2014 to 2023, and described the spatiotemporal clustering and seasonal hot spot distribution of TB incidence. RESULTS From 2014 to 2023, the incidence of TB in the Pudong New Area decreased, and the mortality was at a low level. The incidence of TB in different towns/streets has declined. The spatial autocorrelation analysis revealed that the incidence of TB was spatially clustered in 2014, 2016-2018, and 2022, with the highest clusters in 2014 and 2022. The high clustering area was mainly concentrated in the northeast. The space-time scan analysis indicated that the most likely cluster was located in 12 towns/streets, with a period of 2014-2018 and a radiation radius of 15.74 km. The heat map showed that there was a correlation between TB incidence and seasonal variations. CONCLUSIONS From 2014 to 2023, the incidence of TB in the Pudong New Area of Shanghai declined, but there were spatiotemporal clusters and seasonal correlations in the incidence area. Local departments should formulate corresponding intervention measures, especially in high-clustering areas, to achieve accurate prevention and control of TB within the most effective time and scope.
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Affiliation(s)
- Shuishui Pan
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Lili Chen
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Xin Xin
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Shihong Li
- Third Branch Center, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yixing Zhang
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Yichen Chen
- General Management Office , Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China
| | - Shaotan Xiao
- Tuberculosis, AIDS and STD Control Department, Shanghai Pudong New Area Center for Disease Control and Prevention, Shanghai, China.
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Nie Y, Yang Z, Lu Y, Bahani M, Zheng Y, Tian M, Zhang L. Interaction between air pollutants and meteorological factors on pulmonary tuberculosis in northwest China: A case study of eight districts in Urumqi. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:691-700. [PMID: 38182774 DOI: 10.1007/s00484-023-02615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024]
Abstract
Meteorological factors and air pollutants are associated with the spread of pulmonary tuberculosis (PTB), but few studies have examined the effects of their interactions on PTB. Therefore, this study investigated the impact of meteorological factors and air pollutants and their interactions on the risk of PTB in Urumqi, a city with a high prevalence of PTB and a high level of air pollution. The number of new PTB cases in eight districts of Urumqi from 2014 to 2019 was collected, along with data on meteorological factors and air pollutants for the same period. A generalized additive model was applied to explore the effects of meteorological factors and air pollutants and their interactions on the risk of PTB incidence. Segmented linear regression was used to estimate the nonlinear characteristics of the impact of meteorological factors on PTB. During 2014-2019, a total of 14,402 new cases of PTB were reported in eight districts, with March to May being the months of high PTB incidence. The exposure-response curves for temperature (Temp), relative humidity (RH), wind speed (WS), air pressure (AP), and diurnal temperature difference (DTR) were generally inverted "U" shaped, with the corresponding threshold values of - 5.411 °C, 52.118%, 3.513 m/s, 1021.625 hPa, and 8.161 °C, respectively. The effects of air pollutants on PTB were linear and lagged. All air pollutants were positively associated with PTB, except for O3, which was not associated with PTB, and the ER values for the effects on PTB were as follows: 0.931 (0.255, 1.612) for PM2.5, 1.028 (0.301, 1.760) for PM10, 5.061 (0.387, 9.952) for SO2, 2.830 (0.512, 5.200) for NO2, and 5.789 (1.508, 10.251) for CO. Meteorological factors and air pollutants have an interactive effect on PTB. The risk of PTB incidence was higher when in high Temp-high air pollutant, high RH-high air pollutant, high WS-high air pollutant, lowAP-high air pollutant, and high DTR-high air pollutant. In conclusion, both meteorological and pollutant factors had an influence on PTB, and the influence on PTB may have an interaction.
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Affiliation(s)
- Yanwu Nie
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Zhen Yang
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yaoqin Lu
- Urumqi Center for Disease Control and Prevention, Urumqi, China
| | - Mailiman Bahani
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yanling Zheng
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Maozai Tian
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Liping Zhang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China.
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Emecen AN, Kıran P, Çağlayan D. Influential Factors of Tuberculosis Notification Rates in Turkey: A Provincial-Level Spatial Analysis. THORACIC RESEARCH AND PRACTICE 2024; 25:68-74. [PMID: 38454202 PMCID: PMC11114173 DOI: 10.5152/thoracrespract.2024.23109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/07/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The total annual count of reported tuberculosis (TB) cases continues to decline throughout Turkey. Recognizing the regions with high and low burdens and revealing the factors affecting TB notification rates may play a role in guiding national control programs. This study aimed to analyze the spatial distribution of TB notification rates from 2005 to 2018 and evaluate the factors contributing to TB rates. MATERIAL AND METHODS In this ecological study, we used freely available open data from the Internet. We employed global and local spatial autocorrelation analysis to identify the spatial distribution and the clusters with low and high burdens. We conducted an ordinary least square regression model, spatial lag model, and spatial error model. The best-fitting model was selected via model parameters. RESULTS Throughout the study period, the provinces in West Marmara Region (Edirne, Kırklareli, Tekirdağ, Çanakkale) were consistently in a high-burden cluster. In univariate ordinary least square regression, population density, the proportion of contacts screened for TB, the proportion of TB contacts who received prophylaxis, TB dispensary count, mean particulate matter 10 levels, and gross domestic product were found to be positively associated with TB notification rate. The best-fitting multivariate spatial lag model revealed that the proportion of contacts screened for TB (β, z-value: 0.89, 2.21) positively affected TB notification rate. CONCLUSION The high TB burden in West Marmara Region should warn policymakers to maintain a focused approach to controlling TB in this area. This study showed the importance of contact tracing efforts to prevent the underdetection of TB cases.
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Affiliation(s)
- Ahmet Naci Emecen
- Dokuz Eylül University Research and Application Hospital, İzmir, Turkey
| | - Pınar Kıran
- Department of Public Health, Epidemiology Subsection, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Derya Çağlayan
- Department of Public Health, Epidemiology Subsection, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
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Yu H, Yang J, Yan Y, Zhang H, Chen Q, Sun L. Factors affecting the incidence of pulmonary tuberculosis based on the GTWR model in China, 2004-2021. Epidemiol Infect 2024; 152:e65. [PMID: 38418421 PMCID: PMC11062777 DOI: 10.1017/s0950268824000335] [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: 07/27/2023] [Revised: 12/26/2023] [Accepted: 01/08/2024] [Indexed: 03/01/2024] Open
Abstract
Contra-posing panel data on the incidence of pulmonary tuberculosis (PTB) at the provincial level in China through the years of 2004-2021 and introducing a geographically and temporally weighted regression (GTWR) model were used to explore the effect of various factors on the incidence of PTB from the perspective of spatial heterogeneity. The principal component analysis (PCA) was used to extract the main information from twenty-two indexes under six macro-factors. The main influencing factors were determined by the Spearman correlation and multi-collinearity tests. After fitting different models, the GTWR model was used to analyse and obtain the distribution changes of regression coefficients. Six macro-factors and incidence of PTB were both correlated, and there was no collinearity between the variables. The fitting effect of the GTWR model was better than ordinary least-squares (OLS) and geographically weighted regression (GWR) models. The incidence of PTB in China was mainly affected by six macro-factors, namely medicine and health, transportation, environment, economy, disease, and educational quality. The influence degree showed an unbalanced trend in the spatial and temporal distribution.
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Affiliation(s)
- Hairu Yu
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, the People’s Republic of China
| | - Jiao Yang
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, the People’s Republic of China
| | - Yexin Yan
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, the People’s Republic of China
| | - Hui Zhang
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, the People’s Republic of China
| | - Qiuyuan Chen
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, the People’s Republic of China
| | - Liang Sun
- Department of Social Medicine and Health Service Management, College of Public Health, Zhengzhou University, Zhengzhou, the People’s Republic of China
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Zhou C, Li T, Du J, Yin D, Li X, Li S. Toward tuberculosis elimination by understanding epidemiologic characteristics and risk factors in Hainan Province, China. Infect Dis Poverty 2024; 13:20. [PMID: 38414000 PMCID: PMC10898115 DOI: 10.1186/s40249-024-01188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The disease burden of tuberculosis (TB) was heavy in Hainan Province, China, and the information on transmission patterns was limited with few studies. This atudy aims to further explore the epidemiological characteristics and influencing factors of TB in Hainan Province, and thereby contribute valuable scientific evidences for TB elimination in Hainan Province. METHODS The TB notification data in Hainan Province from 2013 to 2022 were collected from the Chinese National Disease Control Information System Tuberculosis Surveillance System, along with socio-economic data. The spatial-temporal and population distributions were analyzed, and spatial autocorrelation analysis was conducted to explore TB notification rate clustering. In addition, the epidemiological characteristics of the cases among in-country migrants were described, and the delay pattern in seeking medical care was investigated. Finally, a geographically and temporally weighted regression (GTWR) model was adopted to analyze the relationship between TB notification rate and socio-economic indicators. The tailored control suggestions in different regions for TB elimination was provided by understanding epidemiological characteristics and risk factors obtained by GTWR. RESULTS From 2013 to 2022, 64,042 cases of TB were notified in Hainan Province. The estimated annual percentage change of TB notification rate in Hainan Province from 2013 to 2020 was - 6.88% [95% confidence interval (CI): - 5.30%, - 3.69%], with higher rates in central and southern regions. The majority of patients were males (76.33%) and farmers (67.80%). Cases among in-country migrants primarily originated from Sichuan (369 cases), Heilongjiang (267 cases), Hunan (236 cases), Guangdong (174 cases), and Guangxi (139 cases), accounting for 53%. The majority (98.83%) of TB cases were notified through passive case finding approaches, with delay in seeking care. The GTWR analysis showed that gross domestic product per capita, the number of medical institutions and health personnel per 10,000 people were main factors affecting the high TB notification rates in some regions in Hainan Province. Different regional tailored measures such as more TB specialized hospitals were proposed based on the characteristics of each region. CONCLUSIONS The notification rate of TB in Hainan Province has been declining overall but still remained high in central and southern regions. Particular attention should be paid to the prevalence of TB among males, farmers, and out-of-province migrant populations. The notification rate was also influenced by economic development and medical conditions, indicating the need of more TB specialized hospitals, active surveillance and other tailored prevention and control measures to promote the progress of TB elimination in Hainan Province.
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Affiliation(s)
- Changqiang Zhou
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, Shandong, 250012, People's Republic of China
| | - Tao Li
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Jian Du
- Clinical Center On TB Control, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, People's Republic of China
| | - Dapeng Yin
- Hainan Center for Disease Control and Prevention, Haikou, Hainan, 570203, People's Republic of China.
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, Shandong, 250012, People's Republic of China.
- Research Center for Tuberculosis Control, Shandong University, Jinan, Shandong, People's Republic of China.
| | - Shixue Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, 44# Wenhuaxi Road, Lixia District, Jinan, Shandong, 250012, People's Republic of China.
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Liu L, Peng J, Wang N, Wu Z, Zhang Y, Cui H, Zang D, Lu F, Ma X, Yang J. Comparison of seven surrogate insulin resistance indexes for prediction of incident coronary heart disease risk: a 10-year prospective cohort study. Front Endocrinol (Lausanne) 2024; 15:1290226. [PMID: 38323107 PMCID: PMC10844492 DOI: 10.3389/fendo.2024.1290226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/08/2024] [Indexed: 02/08/2024] Open
Abstract
Background There were seven novel and easily accessed insulin resistance (IR) surrogates established, including the Chinese visceral adiposity index (CVAI), the visceral adiposity index (VAI), lipid accumulation product (LAP), triglyceride glucose (TyG) index, TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC) and TyG-waist to height ratio (TyG-WHtR). We aimed to explore the association between the seven IR surrogates and incident coronary heart disease (CHD), and to compare their predictive powers among Chinese population. Methods This is a 10-year prospective cohort study conducted in China including 6393 participants without cardiovascular disease (CVD) at baseline. We developed Cox regression analyses to examine the association of IR surrogates with CHD (hazard ratio [HR], 95% confidence intervals [CI]). Moreover, the receiver operating characteristic (ROC) curve was performed to compare the predictive values of these indexes for incident CHD by the areas under the ROC curve (AUC). Results During a median follow-up period of 10.25 years, 246 individuals newly developed CHD. Significant associations of the IR surrogates (excepted for VAI) with incident CHD were found in our study after fully adjustment, and the fifth quintile HRs (95% CIs) for incident CHD were respectively 2.055(1.216-3.473), 1.446(0.948-2.205), 1.753(1.099-2.795), 2.013(1.214-3.339), 3.169(1.926-5.214), 2.275(1.391-3.719) and 2.309(1.419-3.759) for CVAI, VAI, LAP, TyG, TyG-BMI, TyG-WC and TyG-WHtR, compared with quintile 1. Furthermore, CVAI showed maximum predictive capacity for CHD among these seven IR surrogates with the largest AUC: 0.632(0.597,0.667). Conclusion The seven IR surrogates (excepted for VAI) were independently associated with higher prevalence of CHD, among which CVAI is the most powerful predictor for CHD incidence in Chinese populations.
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Affiliation(s)
- Li Liu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Jie Peng
- Department of Geriatric Medicine, Qilu Hospital of Shandong University, Key Laboratory of Cardiovascular Proteomics of Shandong Province, Jinan, China
| | - Ning Wang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Zhenguo Wu
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Yerui Zhang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Huiliang Cui
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Dejin Zang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Shandong Academy of Medical Sciences, Jinan, China
| | - Xiaoping Ma
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
- Department of Obstetrics and Gynecology, LiaoCheng People’s Hospital, Liaocheng, China
| | - Jianmin Yang
- The Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, The State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of Cardiology, Qilu Hospital of Shandong University, Jinan, China
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Wu J, Chen L, Guan M, Dai T, Friedrich RE, Sun J, Yang W. Analysis of 5-Year-old children's oral health service utilization and influencing factors in Guizhou Province, China (2019-2020). BMC Oral Health 2023; 23:627. [PMID: 37660033 PMCID: PMC10475195 DOI: 10.1186/s12903-023-03350-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/24/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND This study aimed to investigate the utilization patterns and factors related to oral health care for 5-year-old preschoolers based on Andersen's Behavioural Model in Guizhou Province, Western China. METHOD A cross-sectional study of 4,862 5-year-old preschoolers in 66 kindergartens was conducted in 2019 and 2020. A basic oral examination and a survey of parents and grandparents were conducted to gather data on oral health services. The results were analysed using chi-square tests and logistic regression analysis. RESULT The utilization rate of oral health services for children in Guizhou province was 20.5%. The dmft was 4.43, and the rate of caries was 72.2%. The average cost of a dental visit was higher in rural areas and higher for girls. Logistic regression analysis revealed that dmft ≥ 6 teeth, a history of toothache, starting toothbrushing at age ≤ 3 years and limited parental knowledge were the primary factors impacting dental visits. CONCLUSION Needs factors such as severe oral conditions and pain in children are the main reasons for the utilization of these services. This study underscores the urgency to actively promote the importance of oral health and expand insurance coverage for oral health services.
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Affiliation(s)
- Juanjuan Wu
- Department of Preventive Dentistry, Guiyang Stomatological Hospital, Guiyang, China
| | - Liming Chen
- Department of Preventive Dentistry, Guiyang Stomatological Hospital, Guiyang, China
| | - Min Guan
- Department of Preventive Dentistry, Guiyang Stomatological Hospital, Guiyang, China
| | - Taiming Dai
- Department of Preventive Dentistry, Guiyang Stomatological Hospital, Guiyang, China
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jiangling Sun
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Department of Science and Education, Guiyang Stomatological Hospital, Guizhou, China.
| | - Wei Yang
- Medical College, Guizhou University, Guiyang, Guizhou, China.
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Liu AK, Liu YY, Su J, Gao J, Dong LJ, Lv QY, Yang QH. Self-efficacy and self-management mediate the association of health literacy and quality of life among patients with TB in Tibet, China: a cross-sectional study. Int Health 2023; 15:585-600. [PMID: 37317980 PMCID: PMC10472895 DOI: 10.1093/inthealth/ihad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 02/16/2023] [Accepted: 05/23/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND This study aimed to analyze the relationship between health literacy and quality of life in patients with TB in Tibet and explore the mediating effects of self-efficacy and self-management in the relationship between health literacy and quality of life. METHODS We used a convenience sampling method to select 271 cases of patients with TB in Tibet to conduct a survey of their general information, health literacy, self-management, self-efficacy and quality of life, and to construct structural equation models. RESULTS The total health literacy score of patients with TB in Tibet was 84.28±18.57, while the lowest score was for information acquisition ability (55.99±25.66). Scores for quality of life were generally lower than the norm (patients with chronic diseases from other cities in China) (p<0.01). Moreover, self-efficacy and self-management mediated the relationship between health literacy and quality of life (p<0.05). CONCLUSIONS In Tibet, patients with TB have a low level of health literacy and an average level of quality of life. Emphasis should be placed on improving information access literacy, role-physicals and role-emotional to improve overall quality of life. The mediating roles of self-efficacy and self-management between health literacy and quality of life may provide a basis for further interventions.
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Affiliation(s)
- An-kang Liu
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Yu-yao Liu
- Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, 510630, China
- Internal Medicine, Nyingchi People's Hospital, Nyingchi, Tibet Autonomous Region, 860000, China
| | - Jin Su
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Jing Gao
- Nursing Department, Nyingchi People's Hospital, Nyingchi, Tibet Autonomous Region, 860000, China
| | - Li-juan Dong
- Internal Medicine, Nyingchi People's Hospital, Nyingchi, Tibet Autonomous Region, 860000, China
| | - Qi-yuan Lv
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Qiao-hong Yang
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
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Xue M, Zhong J, Gao M, Pan R, Mo Y, Hu Y, Du J, Huang Z. Analysis of spatial-temporal dynamic distribution and related factors of tuberculosis in China from 2008 to 2018. Sci Rep 2023; 13:4974. [PMID: 36973322 PMCID: PMC10041483 DOI: 10.1038/s41598-023-31430-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/11/2023] [Indexed: 03/29/2023] Open
Abstract
Through spatial-temporal scanning statistics, the spatial-temporal dynamic distribution of pulmonary tuberculosis incidence in 31 provinces and autonomous regions of China from 2008 to 2018 is obtained, and the related factors of spatial-temporal aggregation of tuberculosis in China are analyzed to provide strong scientific basis and data support for the prevention and control of pulmonary tuberculosis. This is a retrospective study, using spatial epidemiological methods to reveal the spatial-temporal clustering distribution characteristics of China's tuberculosis epidemic from 2008 to 2018, in which cases data comes from the China Center for Disease Control and prevention. Office Excel is used for general statistical description, and the single factor correlation analysis adopts χ2 Test (or trend χ2 Inspection). Retrospective discrete Poisson distribution space time scanning statistics of SaTScan 9.6 software are used to analyze the space time dynamic distribution of tuberculosis incidence in 31 provinces, cities and autonomous regions in China from 2008 to 2018. ArcGIS 10.2 software is used to visualize the results. The global spatial autocorrelation analysis adopts Moran's I of ArcGIS Map(Monte Carlo randomization simulation times of 999) is used to analyze high-risk areas, low-risk areas and high-low risk areas. From 2008 to 2018, 10,295,212 cases of pulmonary tuberculosis were reported in China, with an average annual incidence rate of 69.29/100,000 (95% CI: (69.29 ± 9.16)/100,000). The annual GDP (gross domestic product) of each province and city showed an upward trend year by year, and the number of annual medical institutions in each province and city showed a sharp increase in 2009, and then tended to be stable; From 2008 to 2018, the national spatiotemporal scanning statistics scanned a total of 6 clusters, including 23 provinces and cities. The national high-low spatiotemporal scanning statistics of the number of pulmonary tuberculosis cases scanned a total of 2 high-risk and low-risk clusters. The high-risk cluster included 8 provinces and cities, and the low-risk cluster included 12 provinces and cities. The global autocorrelation Moran's I index of the incidence rate of pulmonary tuberculosis in all provinces and cities was greater than the expected value (E (I) = -0.0333); The correlation analysis between the average annual GDP and the number of pulmonary tuberculosis cases in each province and city from 2008 to 2018 was statistically significant. From 2008 to 2018, the spatial and temporal scanning and statistical scanning areas of tuberculosis incidence in China were mainly concentrated in the northwest and southern regions of China. There is an obvious positive spatial correlation between the annual GDP distribution of each province and city, and the aggregation degree of the development level of each province and city is increasing year by year. There is a correlation between the average annual GDP of each province and the number of tuberculosis cases in the cluster area. There is no correlation between the number of medical institutions set up in each province and city and the number of pulmonary tuberculosis cases.
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Affiliation(s)
- Mingjin Xue
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Jinlin Zhong
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Miao Gao
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Rongling Pan
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Yuqian Mo
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Yudi Hu
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Jinlin Du
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong Province, China
- Pension Industry Research Institute, Guangdong Medical University, Dongguan, Guangdong Province, China
| | - Zhigang Huang
- School of Public Health, Guangdong Medical University, Dongguan, Guangdong Province, China.
- Pension Industry Research Institute, Guangdong Medical University, Dongguan, Guangdong Province, China.
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Spatial-temporal analysis of pulmonary tuberculosis in Hubei Province, China, 2011-2021. PLoS One 2023; 18:e0281479. [PMID: 36749779 PMCID: PMC9904469 DOI: 10.1371/journal.pone.0281479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 01/24/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Pulmonary tuberculosis (PTB) is an infectious disease of major public health problem, China is one of the PTB high burden counties in the word. Hubei is one of the provinces having the highest notification rate of tuberculosis in China. This study analyzed the temporal and spatial distribution characteristics of PTB in Hubei province for targeted intervention on TB epidemics. METHODS The data on PTB cases were extracted from the National Tuberculosis Information Management System correspond to population in 103 counties of Hubei Province from 2011 to 2021. The effect of PTB control was measured by variation trend of bacteriologically confirmed PTB notification rate and total PTB 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 of Hubei. RESULTS A total of 436,955 cases were included in this study. The total PTB notification rate decreased significantly from 81.66 per 100,000 population in 2011 to 52.25 per 100,000 population in 2021. The peak of PTB notification occurred in late spring and early summer annually. This disease was spatially clustering with Global Moran's I values ranged from 0.34 to 0.63 (P< 0.01). Local spatial autocorrelation analysis indicated that the hot spots are mainly distributed in the southwest and southeast of Hubei Province. Using the SaTScan 10.0.2 software, results from the staged spatial-temporal analysis identified sixteen clusters. CONCLUSIONS This study identified seasonal patterns and spatial-temporal clusters of PTB cases in Hubei province. High-risk areas in southwestern Hubei still exist, and need to focus on and take targeted control and prevention measures.
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Wang Y, Gao C, Zhao T, Jiao H, Liao Y, Hu Z, Wang L. A comparative study of three models to analyze the impact of air pollutants on the number of pulmonary tuberculosis cases in Urumqi, Xinjiang. PLoS One 2023; 18:e0277314. [PMID: 36649267 PMCID: PMC9844834 DOI: 10.1371/journal.pone.0277314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/25/2022] [Indexed: 01/18/2023] Open
Abstract
In this paper, we separately constructed ARIMA, ARIMAX, and RNN models to determine whether there exists an impact of the air pollutants (such as PM2.5, PM10, CO, O3, NO2, and SO2) on the number of pulmonary tuberculosis cases from January 2014 to December 2018 in Urumqi, Xinjiang. In addition, by using a new comprehensive evaluation index DISO to compare the performance of three models, it was demonstrated that ARIMAX (1,1,2) × (0,1,1)12 + PM2.5 (lag = 12) model was the optimal one, which was applied to predict the number of pulmonary tuberculosis cases in Urumqi from January 2019 to December 2019. The predicting results were in good agreement with the actual pulmonary tuberculosis cases and shown that pulmonary tuberculosis cases obviously declined, which indicated that the policies of environmental protection and universal health checkups in Urumqi have been very effective in recent years.
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Affiliation(s)
- Yingdan Wang
- College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Chunjie Gao
- College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Tiantian Zhao
- Department of Infection Prevention and Control, Puyang People’s Hospital, Puyang, Henan, China
| | - Haiyan Jiao
- College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Ying Liao
- College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zengyun Hu
- State Key Laboratory of Desert and Oasis Ecology, Xinjiang Institute of Ecology and Geography, Chinese Academy of Sciences, Urumqi, Xinjiang, China
| | - Lei Wang
- Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, Xinjiang, China
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Nie Y, Lu Y, Wang C, Yang Z, Sun Y, Zhang Y, Tian M, Rifhat R, Zhang L. Effects and Interaction of Meteorological Factors on Pulmonary Tuberculosis in Urumqi, China, 2013–2019. Front Public Health 2022; 10:951578. [PMID: 35910866 PMCID: PMC9330012 DOI: 10.3389/fpubh.2022.951578] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 06/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Most existing studies have only investigated the delayed effect of meteorological factors on pulmonary tuberculosis (PTB). However, the effect of extreme climate and the interaction between meteorological factors on PTB has been rarely investigated. Methods Newly diagonsed PTB cases and meteorological factors in Urumqi in each week between 2013 and 2019 were collected. The lag-exposure-response relationship between meteorological factors and PTB was analyzed using the distributed lag non-linear model (DLNM). The generalized additive model (GAM) was used to visualize the interaction between meteorological factors. Stratified analysis was used to explore the impact of meteorological factors on PTB in different stratification and RERI, AP and SI were used to quantitatively evaluate the interaction between meteorological factors. Results A total of 16,793 newly diagnosed PTB cases were documented in Urumqi, China from 2013 to 2019. The median (interquartile range) temperature, relative humidity, wind speed, and PTB cases were measured as 11.3°C (−5.0–20.5), 57.7% (50.7–64.2), 4.1m/s (3.4–4.7), and 47 (37–56), respectively. The effects of temperature, relative humidity and wind speed on PTB were non-linear, which were found with the “N”-shaped, “L”-shaped, “N”-shaped distribution, respectively. With the median meteorological factor as a reference, extreme low temperature was found to have a protective effect on PTB. However, extreme high temperature, extreme high relative humidity, and extreme high wind speed were found to increase the risk of PTB and peaked at 31.8°C, 83.2%, and 7.6 m/s respectively. According to the existing monitoring data, no obvious interaction between meteorological factors was found, but low temperature and low humidity (RR = 1.149, 95%CI: 1.003–1.315), low temperature and low wind speed (RR = 1.273, 95%CI: 1.146–1.415) were more likely to cause the high incidence of PTB. Conclusion Temperature, relative humidity and wind speed were found to play vital roles in PTB incidence with delayed and non-linear effects. Extreme high temperature, extreme high relative humidity, and extreme high wind speed could increase the risk of PTB. Moreover, low temperature and low humidity, low temperature and low wind speed may increase the incidence of PTB.
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Affiliation(s)
- Yanwu Nie
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yaoqin Lu
- Urumqi Center for Disease Control and Prevention, Urumqi, China
| | - Chenchen Wang
- Center for Disease Control and Prevention of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Zhen Yang
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yahong Sun
- School of Public Health, Xinjiang Medical University, Urumqi, China
| | - Yuxia Zhang
- Department of Clinical Nutrition, Urumqi Maternal and Child Health Institute, Urumqi, China
| | - Maozai Tian
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Ramziya Rifhat
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Liping Zhang
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
- *Correspondence: Liping Zhang
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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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Hu M, Feng Y, Li T, Zhao Y, Wang J, Xu C, Chen W. The unbalanced risk of pulmonary tuberculosis in China at subnational scale: A spatio-temporal analysis (Preprint). JMIR Public Health Surveill 2022; 8:e36242. [PMID: 35776442 PMCID: PMC9288096 DOI: 10.2196/36242] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 12/05/2022] Open
Abstract
Background China has one of the highest tuberculosis (TB) burdens in the world. However, the unbalanced spatial and temporal trends of TB risk at a fine level remain unclear. Objective We aimed to investigate the unbalanced risks of pulmonary tuberculosis (PTB) at different levels and how they evolved from both temporal and spatial aspects using PTB notification data from 2851 counties over a decade in China. Methods County-level notified PTB case data were collected from 2009 to 2018 in mainland China. A Bayesian hierarchical model was constructed to analyze the unbalanced spatiotemporal patterns of PTB notification rates during this period at subnational scales. The Gini coefficient was calculated to assess the inequality of the relative risk (RR) of PTB across counties. Results From 2009 to 2018, the number of notified PTB cases in mainland China decreased from 946,086 to 747,700. The average number of PTB cases in counties was 301 (SD 26) and the overall average notification rate was 60 (SD 6) per 100,000 people. There were obvious regional differences in the RRs for PTB (Gini coefficient 0.32, 95% CI 0.31-0.33). Xinjiang had the highest PTB notification rate, with a multiyear average of 155/100,000 (RR 2.3, 95% CI 1.6-2.8; P<.001), followed by Guizhou (117/100,000; RR 1.8, 95% CI 1.3-1.9; P<.001) and Tibet (108/100,000; RR 1.7, 95% CI 1.3-2.1; P<.001). The RR for PTB showed a steady downward trend. Gansu (local trend [LT] 0.95, 95% CI 0.93-0.96; P<.001) and Shanxi (LT 0.94, 95% CI 0.92-0.96; P<.001) experienced the fastest declines. However, the RRs for PTB in the western region (such as counties in Xinjiang, Guizhou, and Tibet) were significantly higher than those in the eastern and central regions (P<.001), and the decline rate of the RR for PTB was lower than the overall level (P<.001). Conclusions PTB risk showed significant regional inequality among counties in China, and western China presented a high plateau of disease burden. Improvements in economic and medical service levels are required to boost PTB case detection and eventually reduce PTB risk in the whole country.
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Affiliation(s)
- Maogui Hu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Beijing, China
| | - Yuqing Feng
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Beijing, China
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Tao Li
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanlin Zhao
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Beijing, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Beijing, China
| | - Wei Chen
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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