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Jiao L, Shen T, Han Y, Liu W, Liu W, Dang L, Wei M, Yang Y, Guo J, Miao M, Xu X. The spatial-temporal distribution of hepatitis B virus infection in China,2006-2018. BMC Infect Dis 2024; 24:811. [PMID: 39129008 PMCID: PMC11318140 DOI: 10.1186/s12879-024-09716-z] [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: 06/28/2023] [Accepted: 08/05/2024] [Indexed: 08/13/2024] Open
Abstract
OBJECTIVES Hepatitis B is a liver disease caused by Hepatitis B virus (HBV) infection and is highly prevalent in China. To better understand the epidemiological characteristics of hepatitis B in China and develop effective disease control strategies, we employed temporal and spatial statistical methods. METHODS We obtained HBV incidence data from the Public Health Science Data Center of the Chinese Center for Disease Control and Prevention for the years 2006 to 2018. Using Geographic Information System (GIS) and SaTScan scanning technology, we conducted spatial autocorrelation analysis and spatiotemporal scan analysis to create a map and visualize the distribution of hepatitis B incidence. RESULTS While hepatitis B incidence rebounded in 2011 and 2017, the overall incidence in China decreased.In the trend analysis by item, the incidence varies from high to low. The global spatial autocorrelation analysis revealed a clustered distribution, and the Moran index analysis of spatial autocorrelation within local regions identified five provinces as H-H clusters (hot spots), while one province was an L-L cluster (cold spot). Spatial scan analysis identified 11 significant spatial clusters. CONCLUSIONS We found significant clustering in the spatial distribution of hepatitis B incidence and positive spatial correlation of hepatitis B incidence in China. We also identified high-risk times and regional clusters of hepatitis B incidence.
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Affiliation(s)
- Liping Jiao
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Tuo Shen
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China.
| | - Yingzi Han
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Wen Liu
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Wei Liu
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Lin Dang
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Mingmin Wei
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Yunyun Yang
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Jingjing Guo
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Meirong Miao
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
| | - Xiangming Xu
- Laboratory Department, Weinan Center for Disease Control and Prevention, Weinan, Shaanxi, China
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Wang L, Xu C, Hu M, Wang J, Qiao J, Chen W, Zhu Q, Wang Z. Modeling tuberculosis transmission flow in China, 2010-2012. BMC Infect Dis 2024; 24:784. [PMID: 39103752 DOI: 10.1186/s12879-024-09649-7] [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: 12/05/2022] [Accepted: 07/23/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND China has the third largest number of TB cases in the world, and the average annual floating population in China is more than 200 million, the increasing floating population across regions has a tremendous potential for spreading infectious diseases, however, the role of increasing massive floating population in tuberculosis transmission is yet unclear in China. METHODS 29,667 tuberculosis flow data were derived from the new smear-positive pulmonary tuberculosis cases in China. Spatial variation of TB transmission was measured by geodetector q-statistic and spatial interaction model was used to model the tuberculosis flow and the regional socioeconomic factors. RESULTS Tuberculosis transmission flow presented spatial heterogeneity. The Pearl River Delta in southern China and the Yangtze River Delta along China's east coast presented as the largest destination and concentration areas of tuberculosis inflows. Socioeconomic factors were determinants of tuberculosis flow. Some impact factors showed different spatial associations with tuberculosis transmission flow. A 10% increase in per capita GDP was associated with 10.2% in 2010 or 2.1% in 2012 decrease in tuberculosis outflows from the provinces of origin, and 1.2% in 2010 or 0.5% increase in tuberculosis inflows to the destinations and 18.9% increase in intraprovincial flow in 2012. Per capita net income of rural households and per capita disposable income of urban households were positively associated with tuberculosis flows. A 10% increase in per capita net income corresponded to 14.0% in 2010 or 3.6% in 2012 increase in outflows from the origin, 44.2% in 2010 or 12.8% increase in inflows to the destinations and 47.9% increase in intraprovincial flows in 2012. Tuberculosis incidence had positive impacts on tuberculosis flows. A 10% increase in the number of tuberculosis cases corresponded to 2.2% in 2010 or 1.1% in 2012 increase in tuberculosis inflows to the destinations, 5.2% in 2010 or 2.0% in 2012 increase in outflows from the origins, 11.5% in 2010 or 2.2% in 2012 increase in intraprovincial flows. CONCLUSIONS Tuberculosis flows had clear spatial stratified heterogeneity and spatial autocorrelation, regional socio-economic characteristics had diverse and statistically significant effects on tuberculosis flows in the origin and destination, and income factor played an important role among the determinants.
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Affiliation(s)
- Li Wang
- College of Geography and Environmental Science, Henan University, KaiFeng, 475001, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Ministry of Education, KaiFeng, 475001, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Maogui Hu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China.
| | - Jiajun Qiao
- College of Geography and Environmental Science, Henan University, KaiFeng, 475001, China.
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions, Henan University, Ministry of Education, KaiFeng, 475001, China.
| | - Wei Chen
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Qiankun Zhu
- College of Geography and Environmental Science, Henan University, KaiFeng, 475001, China
| | - Zhipeng Wang
- College of Geography and Environmental Science, Henan University, KaiFeng, 475001, China
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Luo D, Wang L, Zhang M, Martinez L, Chen S, Zhang Y, Wang W, Wu Q, Wu Y, Liu K, Xie B, Chen B. Spatial spillover effect of environmental factors on the tuberculosis occurrence among the elderly: a surveillance analysis for nearly a dozen years in eastern China. BMC Public Health 2024; 24:209. [PMID: 38233763 PMCID: PMC10795419 DOI: 10.1186/s12889-024-17644-5] [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: 08/17/2023] [Accepted: 01/02/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND In many areas of China, over 30% of tuberculosis cases occur among the elderly. We aimed to investigate the spatial distribution and environmental factors that predicted the occurence of tuberculosis in this group. METHODS Data were collected on notified pulmonary tuberculosis (PTB) cases aged ≥ 65 years in Zhejiang Province from 2010 to 2021. We performed spatial autocorrelation and spatial-temporal scan statistics to determine the clusters of epidemics. Spatial Durbin Model (SDM) analysis was used to identify significant environmental factors and their spatial spillover effects. RESULTS 77,405 cases of PTB among the elderly were notified, showing a decreasing trend in the notification rate. Spatial-temporal analysis showed clustering of epidemics in the western area of Zhejiang Province. The results of the SDM indicated that a one-unit increase in PM2.5 led to a 0.396% increase in the local notification rate. The annual mean temperature and precipitation had direct effects and spatial spillover effects on the rate, while complexity of the shape of the greenspace (SHAPE_AM) and SO2 had negative spatial spillover effects. CONCLUSION Targeted interventions among the elderly in Western Zhejiang may be more efficient than broad, province-wide interventions. Low annual mean temperature and high annual mean precipitation in local and neighboring areas tend to have higher PTB onset among the elderly.
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Affiliation(s)
- Dan Luo
- Department of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Luyu Wang
- School of Urban Design, Wuhan University, Hubei, Wuhan, China
| | - Mengdie Zhang
- Zhejiang University School of Public Health, Hangzhou, Zhejiang, China
| | - Leonardo Martinez
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA, USA
| | - Songhua Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yu Zhang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Wei Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Qian Wu
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yonghao Wu
- Department of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China, 310058
| | - Kui Liu
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
- National Centre for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Bo Xie
- School of Urban Design, Wuhan University, Hubei, Wuhan, China.
| | - Bin Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, 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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Zheng J, Shen G, Hu S, Han X, Zhu S, Liu J, He R, Zhang N, Hsieh CW, Xue H, Zhang B, Shen Y, Mao Y, Zhu B. Small-scale spatiotemporal epidemiology of notifiable infectious diseases in China: a systematic review. BMC Infect Dis 2022; 22:723. [PMID: 36064333 PMCID: PMC9442567 DOI: 10.1186/s12879-022-07669-9] [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: 05/26/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022] Open
Abstract
Background The prevalence of infectious diseases remains one of the major challenges faced by the Chinese health sector. Policymakers have a tremendous interest in investigating the spatiotemporal epidemiology of infectious diseases. We aimed to review the small-scale (city level, county level, or below) spatiotemporal epidemiology of notifiable infectious diseases in China through a systematic review, thus summarizing the evidence to facilitate more effective prevention and control of the diseases. Methods We searched four English language databases (PubMed, EMBASE, Cochrane Library, and Web of Science) and three Chinese databases (CNKI, WanFang, and SinoMed), for studies published between January 1, 2004 (the year in which China’s Internet-based disease reporting system was established) and December 31, 2021. Eligible works were small-scale spatial or spatiotemporal studies focusing on at least one notifiable infectious disease, with the entire territory of mainland China as the study area. Two independent reviewers completed the review process based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results A total of 18,195 articles were identified, with 71 eligible for inclusion, focusing on 22 diseases. Thirty-one studies (43.66%) were analyzed using city-level data, 34 (47.89%) were analyzed using county-level data, and six (8.45%) used community or individual data. Approximately four-fifths (80.28%) of the studies visualized incidence using rate maps. Of these, 76.06% employed various spatial clustering methods to explore the spatial variations in the burden, with Moran’s I statistic being the most common. Of the studies, 40.85% explored risk factors, in which the geographically weighted regression model was the most commonly used method. Climate, socioeconomic factors, and population density were the three most considered factors. Conclusions Small-scale spatiotemporal epidemiology has been applied in studies on notifiable infectious diseases in China, involving spatiotemporal distribution and risk factors. Health authorities should improve prevention strategies and clarify the direction of future work in the field of infectious disease research in China. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07669-9.
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Affiliation(s)
- Junyao Zheng
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China.,School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Guoquan Shen
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Siqi Hu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Xinxin Han
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China
| | - Siyu Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Jinlin Liu
- School of Public Policy and Administration, Northwestern Polytechnical University, Xi'an, China
| | - Rongxin He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.,MRC Centre for Global Infectious Disease Analysis and the Abdul Latif Jameel Institute for Disease and Emergency Analytics, School of Public Health, Imperial College, London, UK
| | - Chih-Wei Hsieh
- Department of Public Policy, City University of Hong Kong, Hong Kong, China
| | - Hao Xue
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA
| | - Bo Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yue Shen
- Laboratory for Urban Future, School of Urban Planning and Design, Peking University Shenzhen Graduate School, Shenzhen, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen, 518055, Guangdong, China.
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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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Yang SQ, Fang ZG, Lv CX, An SY, Guan P, Huang DS, Wu W. Spatiotemporal cluster analysis of COVID-19 and its relationship with environmental factors at the city level in mainland China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:13386-13395. [PMID: 34595708 PMCID: PMC8483427 DOI: 10.1007/s11356-021-16600-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/14/2021] [Indexed: 05/15/2023]
Abstract
This study sought to identify the spatial, temporal, and spatiotemporal clusters of COVID-19 cases in 366 cities in mainland China with the highest risks and to explore the possible influencing factors of imported risks and environmental factors on the spatiotemporal aggregation, which would be useful to the design and implementation of critical preventative measures. The retrospective analysis of temporal, spatial, and spatiotemporal clustering of COVID-19 during the period (January 15 to February 25, 2020) was based on Kulldorff's time-space scanning statistics using the discrete Poisson probability model, and then the logistic regression model was used to evaluate the impact of imported risk and environmental factors on spatiotemporal aggregation. We found that the spatial distribution of COVID-19 cases was nonrandom; the Moran's I value ranged from 0.017 to 0.453 (P < 0.001). One most likely cluster and three secondary likely clusters were discovered in spatial cluster analysis. The period from February 2 to February 9, 2020, was identified as the most likely cluster in the temporal cluster analysis. One most likely cluster and seven secondary likely clusters were discovered in spatiotemporal cluster analysis. Imported risk, humidity, and inhalable particulate matter PM2.5 had a significant impact on temporal and spatial accumulation, and temperature and PM10 had a low correlation with the spatiotemporal aggregation of COVID-19. The information is useful for health departments to develop a better prevention strategy and potentially increase the effectiveness of public health interventions.
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Affiliation(s)
- Shu-Qin Yang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Zheng-Gang Fang
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Cai-Xia Lv
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Shu-Yi An
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, Liaoning, China
| | - Peng Guan
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - De-Sheng Huang
- Department of Mathematics, School of Fundamental Sciences, China Medical University, Shenyang, Liaoning, China
| | - Wei Wu
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China.
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Liu K, Chen S, Zhang Y, Li T, Xie B, Wang W, Wang F, Peng Y, Ai L, Chen B, Wang X, Jiang J. Tuberculosis burden caused by migrant population in Eastern China: evidence from notification records in Zhejiang Province during 2013-2017. BMC Infect Dis 2022; 22:109. [PMID: 35100983 PMCID: PMC8805310 DOI: 10.1186/s12879-022-07071-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 01/17/2022] [Indexed: 01/04/2023] Open
Abstract
Background Internal migrants have an enormous impact on tuberculosis (TB) epidemic in China. Zhejiang Province, as one of the developed areas, also had a heavy burden caused by TB. Methods In this study, we collected all cases in Zhejiang Province through the TB Management Information System from 2013 to 2017. Description analysis and Spatio-temporal analysis using R software and ArcGIS were performed to identify the epidemiological characteristics and clusterings, respectively. Results 48,756 individuals in total were notified with TB among the migrant population (TBMP), accounting for one-third of all cases identified. The primary sources of TB from migrants outside the province were from Guizhou, Sichuan, and Anhui. Wenzhou, Taizhou, and Lishui were the three mainly outflowing cities among the intra-provincial TBMP and Hangzhou as the primarily inflowing city. Also, results implied that the inconsistency of the TBMP in spatial analysis and the border area of Quzhou and Lishui city had the highest risk of TB occurrence among the migrants. Additionally, one most likely cluster and four secondary clusters were identified by the spatial–temporal analysis. Conclusion The effective control of TB in extra-provincial MP was critical to lowering the TB burden of MP in Zhejiang Province. Also, it is suggested that active TB screening for migrant employees outflowed from high epidemic regions should be strengthened, and further traceability analysis needs to be investigated to clarify the mechanism of TB transmission in clustered areas. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07071-5.
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Affiliation(s)
- Kui Liu
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.,Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Songhua Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Yu Zhang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Tao Li
- National Center for Tuberculosis Control and Prevention, China CDC, Beijing, People's Republic of China
| | - Bo Xie
- School of Urban Design, Wuhan University, Wuhan, Hubei Province, People's Republic of China
| | - Wei Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Fei Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Ying Peng
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Liyun Ai
- Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China
| | - Bin Chen
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China. .,Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
| | - Xiaomeng Wang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
| | - Jianmin Jiang
- Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China. .,Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
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Prevalence and spatial distribution characteristics of human echinococcosis in China. PLoS Negl Trop Dis 2021; 15:e0009996. [PMID: 34962928 PMCID: PMC8789093 DOI: 10.1371/journal.pntd.0009996] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 01/25/2022] [Accepted: 11/15/2021] [Indexed: 11/27/2022] Open
Abstract
Background Echinococcosis is a zoonotic parasitic disease caused by larval stages of cestodes belonging to the genus Echinococcus. The infection affects people’s health and safety as well as agropastoral sector. In China, human echinococcosis is a major public health burden, especially in western China. Echinococcosis affects people health as well as agricultural and pastoral economy. Therefore, it is important to understand the prevalence status and spatial distribution of human echinococcosis in order to advance our knowledge of basic information for prevention and control measures reinforcement. Methods Report data on echinococcosis were collected in 370 counties in China in 2018 and were used to assess prevalence and spatial distribution. SPSS 21.0 was used to obtain the prevalence rate for CE and AE. For statistical analyses and mapping, all data were processed using SPSS 21.0 and ArcGIS 10.4, respectively. Chi-square test and Exact probability method were used to assess spatial autocorrelation and spatial clustering. Results A total of 47,278 cases of echinococcosis were recorded in 2018 in 370 endemic counties in China. The prevalence rate of human echinococcosis was 10.57 per 10,000. Analysis of the disease prevalence showed obvious spatial positive autocorrelation in globle spatial autocorrelation with two aggregation modes in local spatial autocorrelation, namely high-high and low-high aggregation areas. The high-high gathering areas were mainly concentrated in northern Tibet, western Qinghai, and Ganzi in the Tibetan Autonomous Region and in Sichuan. The low-high clusters were concentrated in Gamba, Kangma and Yadong counties of Tibet. In addition, spatial scanning analysis revealed two spatial clusters. One type of spatial clusters included 71 counties in Tibet Autonomous Region, 22 counties in Qinghai, 11 counties in Sichuan, three counties in Xinjiang Uygur Autonomous Region, two counties in Yunnan, and one county in Gansu. In the second category, six types of spatial clusters were observed in the counties of Xinjiang Uygur Autonomous Region, and the Qinghai, Gansu, and Sichuan Provinces. Conclusion This study showed a serious prevalence of human echinococcosis with obvious spatial aggregation of the disease prevalence in China. The Qinghai-Tibet Plateau is the "hot spot" area of human echinococcosis in China. Findings from this study indicate that there is an urgent need of joint strategies to strengthen efforts for the prevention and control of echinococcosis in China, especially in the Qinghai-Tibet Plateau. Echinococcosis is a zoonotic parasitic disease caused by larval stages of cestodes belonging to the genus Echinococcus. In China, human echinococcosis is a major public health burden, especially in western China. Therefore, it is important to understand the prevalence status and spatial distribution of human echinococcosis in order to provide basic information for prevention and control measures reinforcement. To describe the distribution and analyze the prevalence and spatial distribution characteristics of human echinococcosis in China, report data of echinococcosis were collected in 370 counties in 2018. For the year 2018, there were 47,278 cases of echinococcosis recorded in 370 endemic counties in China. Analysis of the disease prevalence showed obvious spatial positive autocorrelation in global spatial autocorrelation with two aggregation modes in local spatial autocorrelation, namely high-high and low-high aggregation areas. The high-high gathering areas were mainly concentrated in northern Tibet, western Qinghai, and Ganzi in the Tibetan Autonomous Region and in Sichuan. This study showed obvious spatial aggregation of human echinococcosis prevalence in China. The Qinghai-Tibet Plateau is the "hot spot" area of human echinococcosis in China. Such findings indicate that here is an urgent need of joint strategies to strengthen efforts for the prevention and control of echinococcosis in China, especially in the Qinghai-Tibet Plateau.
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Tripathy BR, Liu X, Songer M, Kumar L, Kaliraj S, Chatterjee ND, Wickramasinghe WMS, Mahanta KK. Descriptive Spatial Analysis of Human-Elephant Conflict (HEC) Distribution and Mapping HEC Hotspots in Keonjhar Forest Division, India. Front Ecol Evol 2021. [DOI: 10.3389/fevo.2021.640624] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Escalation of human-elephant conflict (HEC) in India threatens its Asian elephant (Elephas maximus) population and victimizes local communities. India supports 60% of the total Asian elephant population in the world. Understanding HEC spatial patterns will ensure targeted mitigation efforts and efficient resource allocation to high-risk regions. This study deals with the spatial aspects of HEC in Keonjhar forest division, where 345 people were killed and 5,145 hectares of croplands were destroyed by elephant attacks during 2001–2018. We classified the data into three temporal phases (HEC1: 2001–2006, HEC2: 2007–2012, and HEC3: 2013–2018), in order to (1) derive spatial patterns of HEC; (2) identify the hotspots of HEC and its different types along with the number of people living in the high-risk zones; and (3) assess the temporal change in the spatial risk of HEC. Significantly dense clusters of HEC were identified in Keonjhar and Ghatgaon forest ranges throughout the 18 years, whereas Champua forest range became a prominent hotspot since HEC2. The number of people under HEC risk escalated from 14,724 during HEC1 and 34,288 in HEC2, to 65,444 people during HEC3. Crop damage was the most frequent form of HEC in the study area followed by house damage and loss of human lives. Risk mapping of HEC types and high priority regions that are vulnerable to HEC, provides a contextual background for researchers, policy makers and managers.
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Differencing the Risk of Reiterative Spatial Incidence of COVID-19 Using Space–Time 3D Bins of Geocoded Daily Cases. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2021. [DOI: 10.3390/ijgi10040261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The space–time behaviour of COVID-19 needs to be analysed from microdata to understand the spread of the virus. Hence, 3D space–time bins and analysis of associated emerging hotspots are useful methods for revealing the areas most at risk from the pandemic. To implement these methods, we have developed the SITAR Fast Action Territorial Information System using ESRI technologies. We first modelled emerging hotspots of COVID-19 geocoded cases for the region of Cantabria (Spain), then tested the predictive potential of the method with the accumulated cases for two months ahead. The results reveal the difference in risk associated with areas with COVID-19 cases. The study not only distinguishes whether a bin is statistically significant, but also identifies temporal trends: a reiterative pattern is detected in 58.31% of statistically significant bins (most with oscillating behaviour over the period). In the testing method phase, with positive cases for two months ahead, we found that only 7.37% of cases were located outside the initial 3D bins. Furthermore, 83.02% of new cases were in statistically significant previous emerging hotspots. To our knowledge, this is the first study to show the usefulness of the 3D bins and GIS emerging hotspots model of COVID-19 microdata in revealing strategic patterns of the pandemic for geoprevention plans.
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Gwitira I, Karumazondo N, Shekede MD, Sandy C, Siziba N, Chirenda J. Spatial patterns of pulmonary tuberculosis (TB) cases in Zimbabwe from 2015 to 2018. PLoS One 2021; 16:e0249523. [PMID: 33831058 PMCID: PMC8031317 DOI: 10.1371/journal.pone.0249523] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 03/21/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Accurate mapping of spatial heterogeneity in tuberculosis (TB) cases is critical for achieving high impact control as well as guide resource allocation in most developing countries. The main aim of this study was to explore the spatial patterns of TB occurrence at district level in Zimbabwe from 2015 to 2018 using GIS and spatial statistics as a preamble to identifying areas with elevated risk for prioritisation of control and intervention measures. METHODS In this study Getis-Ord Gi* statistics together with SaTscan were used to characterise TB hotspots and clusters in Zimbabwe at district level from 2015 to 2018. GIS software was used to map and visualise the results of cluster analysis. RESULTS Results show that TB occurrence exhibits spatial heterogeneity across the country. The TB hotspots were detected in the central, western and southern part of the country. These areas are characterised by artisanal mining activities as well as high poverty levels. CONCLUSIONS AND RECOMMENDATIONS Results of this study are useful to guide TB control programs and design effective strategies which are important in achieving the United Nations Sustainable Development goals (UNSDGs).
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Affiliation(s)
- Isaiah Gwitira
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Norbert Karumazondo
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Munyaradzi Davis Shekede
- Department of Geography Geospatial Sciences and Earth Observation, Faculty of Science, University of Zimbabwe, Harare, Zimbabwe
| | - Charles Sandy
- National TB Control Program, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Nicolas Siziba
- National TB Control Program, Ministry of Health and Child Care, Harare, Zimbabwe
| | - Joconiah Chirenda
- Department of Community Medicine, Faculty of Medicine and Health Sciences, Parirenyatwa Hospital, University of Zimbabwe, Harare, Zimbabwe
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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: 13] [Impact Index Per Article: 4.3] [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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Leiva-Bianchi M, Mena C, Ormazábal Y, Serrano C, Rojas P. Changes in geographic clustering of post-traumatic stress disorder and post-traumatic growth seven years after an earthquake in Cauquenes, Chile. GEOSPATIAL HEALTH 2020; 15. [PMID: 33461268 DOI: 10.4081/gh.2020.886] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 09/06/2020] [Indexed: 06/12/2023]
Abstract
Recent findings indicate that both disruptive Post-Traumatic Stress Disorder (PTSD) and healthy Post-Traumatic Growth (PTG) responses have some spatial distribution depending on where they are measured and the different degrees of exposure that people may have to a critical event (e.g., earthquake). Less is known about how these responses change as a function of space and time after these events. The objective of this study was to enter deeper into this relationship analysing how PTSD and PTG responses vary in their spatial distribution 6 and 7 years after an earthquake (such as the one that occurred on 27 February, 2010 in Cauquenes City, Chile). Spatial analyses based on Geographic Information Systems (GIS) were performed to detect global and local geographic clustering. Investigating 171 (2016) and 106 (2017) randomly selected adults from Cauquenes, we demonstrated that 7 years after the event only 4 variables were spatially clustered, i.e. personal mental strength, interpersonal relations, new possibilities and appreciation of life), all of them PTG dimensions; This result contrasted with the situation the previous year (2016), when 7 variables were clustered (total PTG, spiritual change, new possibilities, appreciation of life, PTSD symptoms, PTSD reactions and PTSD in total). The spatial identifications found could facilitate the comparison of mental health conditions in populations and the impact of recovery programmes in communities exposed to disasters.
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Affiliation(s)
- Marcelo Leiva-Bianchi
- Faculty of Psychology, Laboratory of Methodology for Behaviour and Neurosciences, University of Talca.
| | - Carlos Mena
- Faculty of Forestry Sciences, Geomatics Center, University of Talca, Talca.
| | - Yony Ormazábal
- Faculty of Forestry Sciences, Geomatics Center, University of Talca, Talca.
| | - Carlos Serrano
- Faculty of Psychology, Laboratory of Methodology for Behaviour and Neurosciences, University of Talca.
| | - Pedro Rojas
- Faculty of Psychology, Laboratory of Methodology for Behaviour and Neurosciences, University of Talca.
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Omodior O. A Space-Time Permutation Scan Statistic for Evaluating County-Level Tickborne Disease Clusters in Indiana, 2009-2016. Health Secur 2020; 19:108-115. [PMID: 33156708 DOI: 10.1089/hs.2019.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The purpose of this study was to identify age group, gender, rural-urban differences, and spatiotemporal clusters of tickborne disease diagnoses in Indiana. We analyzed retrospective surveillance data for Lyme disease, ehrlichiosis, Rocky Mountain spotted fever, typhus/rickettsial diseases, and tularemia diagnosed in Indiana from 2009 to 2016. We used chi-square cross tabulation to test gender, age group, and county classification (rural, rural-mixed, urban) differences in tickborne disease. We used the Kruskal-Wallis test with a post hoc Conover test to identify differences in summated tickborne disease by county classification. Finally, we used retrospective space-time permutation models in SaTScan to test the hypothesis of complete spatiotemporal randomness of tickborne disease. We found more Lyme disease diagnoses among Indiana residents 44 years of age or younger compared with those over 44 years. Conversely, more ehrlichiosis, Rocky Mountain spotted fever, and tularemia were reported in Indiana residents aged over 44 years of age. An analysis of summated tickborne disease by county showed significantly higher diagnosis reported in urban counties, compared with rural and rural-mixed counties. Finally, 2 significant clusters of summated tickborne disease were observed in south-central Indiana in 2014 and in western Indiana from 2010 to 2011. The detection of tickborne disease clusters, coupled with the finding that significant differences exist in the diagnosis of tickborne diseases between urban, rural, and rural-mixed counties in Indiana, suggests a need for continued surveillance of the counties observed within these clusters.
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Affiliation(s)
- Oghenekaro Omodior
- Oghenekaro Omodior, PhD, is an Assistant Professor, School of Public Health, Indiana University, Bloomington, IN
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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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Mena C, Ormazabal Y, Fuentes E, Palomo I. Impacts of Physical Environment Perception on the Frailty Condition in Older People. GEOSPATIAL HEALTH 2020; 15. [PMID: 32575969 DOI: 10.4081/gh.2020.888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/16/2020] [Indexed: 05/10/2023]
Abstract
Frailty increases the vulnerability of older people who commonly develop a syndrome leading to growing dependence and finally often death. Physical environment conditions may affect the severity of the syndrome positive or negatively. The main objective of this study was to analyse the conditions of different urban physical environments and their relationship with the frailty syndrome in older people. Geographic Information Systems (GIS) analyses were performed to detect global and local geographic clustering. Investigating 284 adults with ages from 60 to 74 years old from Talca City, Chile, we found spatial clustering of frailty conditions registered for older people, with hotspots of high and low values associated with areas of different urban infrastructures and socioeconomic levels into the city. The spatial identifications found should facilitate exploring the impact of mental health programmes in communities exposed to disasters like earthquakes, thereby improving their quality of life as well as reducing overall costs. Spatial correlation has a great potential for studying frailty conditions in older people with regard to better understanding the impact of environmental conditions on health.
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Affiliation(s)
- Carlos Mena
- Centro de Geomática, Facultad de Ciencias Forestales, Universidad de Talca.
| | - Yony Ormazabal
- Centro de Geomática, Facultad de Ciencias Forestales, Universidad de Talca.
| | - Eduardo Fuentes
- Thrombosis Research Center, Medical Technology School, Department of Clinical Biochemistry and Immunohaematology, Faculty of Health Sciences, Universidad de Talca, Talca.
| | - Iván Palomo
- Thrombosis Research Center, Medical Technology School, Department of Clinical Biochemistry and Immunohaematology, Faculty of Health Sciences, Universidad de Talca, Talca.
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Ullah S, Daud H, Dass SC, Fanaee-T H, Kausarian H, Khalil A. Space-Time Clustering Characteristics of Tuberculosis in Khyber Pakhtunkhwa Province, Pakistan, 2015-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041413. [PMID: 32098247 PMCID: PMC7068355 DOI: 10.3390/ijerph17041413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/15/2020] [Accepted: 01/21/2020] [Indexed: 12/23/2022]
Abstract
The number of tuberculosis (TB) cases in Pakistan ranks fifth in the world. The National TB Control Program (NTP) has recently reported more than 462,920 TB patients in Khyber Pakhtunkhwa province, Pakistan from 2002 to 2017. This study aims to identify spatial and space-time clusters of TB cases in Khyber Pakhtunkhwa province Pakistan during 2015-2019 to design effective interventions. The spatial and space-time cluster analyses were conducted at the district-level based on the reported TB cases from January 2015 to April 2019 using space-time scan statistics (SaTScan). The most likely spatial and space-time clusters were detected in the northern rural part of the province. Additionally, two districts in the west were detected as the secondary space-time clusters. The most likely space-time cluster shows a tendency of spread toward the neighboring districts in the central part, and the most likely spatial cluster shows a tendency of spread toward the neighboring districts in the south. Most of the space-time clusters were detected at the start of the study period 2015-2016. The potential TB clusters in the remote rural part might be associated to the dry-cool climate and lack of access to the healthcare centers in the remote areas.
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Affiliation(s)
- Sami Ullah
- Department of Fundamental & Applied Sciences, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Perak, Malaysia;
- Correspondence:
| | - Hanita Daud
- Department of Fundamental & Applied Sciences, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Perak, Malaysia;
| | - Sarat C. Dass
- School of Mathematical and Computer Sciences, Heriot-Watt University Malaysia, Putrajaya 62200, Malaysia;
| | - Hadi Fanaee-T
- Center for Applied Intelligent Systems Research (CAISR), Halmstad University, SE-301 18 Halmstad, Sweden;
| | - Husnul Kausarian
- Department of Geological Engineering, Universitas Islam Riau, Pekanbaru 28284, Indonesia;
| | - Alamgir Khalil
- Department of Statistics, University of Peshawar, Peshawar 25120, Pakistan;
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The association between internal migration and pulmonary tuberculosis in China, 2005-2015: a spatial analysis. Infect Dis Poverty 2020; 9:5. [PMID: 32063228 PMCID: PMC7025414 DOI: 10.1186/s40249-020-0621-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/07/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Internal migration places individuals at high risk of contracting tuberculosis (TB). However, there is a scarcity of national-level spatial analyses regarding the association between TB and internal migration in China. In our research, we aimed to explore the spatial variation in cases of sputum smear-positive pulmonary TB (SS + PTB) in China; and the associations between SS + PTB, internal migration, socioeconomic factors, and demographic factors in the country between 2005 and 2015. METHODS Reported cases of SS + PTB were obtained from the national PTB surveillance system database; cases were obtained at the provincial level. Internal migration data were extracted from the national population sampling survey and the census. Spatial autocorrelations were explored using the global Moran's statistic and local indicators of spatial association. The spatial temporal analysis was performed using Kulldorff's scan statistic. Fixed effects regression was used to explore the association between SS + PTB and internal migration. RESULTS A total of 4 708 563 SS + PTB cases were reported in China between 2005 and 2015, of which 3 376 011 (71.7%) were male and 1 332 552 (28.3%) were female. There was a trend towards decreasing rates of SS + PTB notifications between 2005 and 2015. The result of global spatial autocorrelation indicated that there were significant spatial correlations between SS + PTB rate and internal migration each year (2005-2015). Spatial clustering of SS + PTB cases was mainly located in central and southern China and overlapped with the clusters of emigration. The proportions of emigrants and immigrants were significantly associated with SS + PTB. Per capita GDP and education level were negatively associated with SS + PTB. The internal migration flow maps indicated that migrants preferred neighboring provinces, with most migrating for work or business. CONCLUSIONS This study found a significant spatial autocorrelation between SS + PTB and internal migration. Both emigration and immigration were statistically associated with SS + PTB, and the association with emigration was stronger than that for immigration. Further, we found that SS + PTB clusters overlapped with emigration clusters, and the internal migration flow maps suggested that migrants from SS + PTB clusters may influence the TB epidemic characteristics of neighboring provinces. These findings can help stakeholders to implement effective PTB control strategies for areas at high risk of PTB and those with high rates of internal migrants.
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Li M, Roberts CA, Chen L, Zhao D. A male adult skeleton from the Han Dynasty in Shaanxi, China (202 BC-220 AD) with bone changes that possibly represent spinal tuberculosis. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 27:9-16. [PMID: 31494353 DOI: 10.1016/j.ijpp.2019.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 08/05/2019] [Accepted: 08/09/2019] [Indexed: 06/10/2023]
Abstract
Bioarchaeological data for tuberculosis (TB) have been published very sporadically in China or the rest of East Asia. To explore the history of TB in this area, 85 skeletons excavated from the Liuwei Cemetery in Shaanxi, China (202 BC-220 AD) were macroscopically examined to record TB related bone changes. These skeletons represented inhabitants of Maolingyi, an urban area that had a high population density during the Han Dynasty (202 BC-220 CE). Seventeen of the 85 skeletons had spines that were well enough preserved to observe evidence of spinal disease. Among them, a male skeleton aged around 30 years (M34-E) manifested multiple lytic lesions in the eleventh thoracic to second lumbar vertebral bodies (T11 to L2). TB was considered a possible diagnosis for the spinal lesions observed, with differential diagnoses of brucellosis and typhoid. The dense population and overcrowding in urban Maolingyi were considered the potential social risk factors for TB found at this site. The findings of this study contribute to limited knowledge about the history of TB in East Asia and suggest a relationship between population density and the spread of TB in Maolingyi at that time. However, the lack of published bioarchaeological data of TB in East Asia hinders understanding the transmission of TB within Asia and its link to the rest of the world. Further intensive review of archaeological skeletons in Asia is urgently needed. 。, 。85, 17, 。, 30、、。, 。, 。、, , 。, 。, 。.
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Affiliation(s)
- Mocen Li
- Department of Archaeology, Durham University, Durham, DH1 3LE, United Kingdom; School of Cultural Heritage, Northwest University, Xi'an, 710069, China.
| | - Charlotte A Roberts
- Department of Archaeology, Durham University, Durham, DH1 3LE, United Kingdom
| | - Liang Chen
- School of Cultural Heritage, Northwest University, Xi'an, 710069, China.
| | - Dongyue Zhao
- School of Cultural Heritage, Northwest University, Xi'an, 710069, China
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21
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O'Donnell MS, Edmunds DR, Aldridge CL, Heinrichs JA, Coates PS, Prochazka BG, Hanser SE. Designing multi‐scale hierarchical monitoring frameworks for wildlife to support management: a sage‐grouse case study. Ecosphere 2019. [DOI: 10.1002/ecs2.2872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Michael S. O'Donnell
- U.S. Geological Survey Fort Collins Science Center Fort Collins Colorado 80526 USA
| | - David R. Edmunds
- Natural Resource Ecology Laboratory Colorado State University, in cooperation with the Fort Collins Science Center, U.S. Geological Survey Fort Collins Colorado 80526 USA
| | - Cameron L. Aldridge
- Natural Resource Ecology Laboratory Department of Ecosystem Science and Sustainability Colorado State University, in cooperation with the Fort Collins Science Center, U.S. Geological Survey Fort Collins Colorado 80526 USA
| | - Julie A. Heinrichs
- Natural Resource Ecology Laboratory Colorado State University, in cooperation with the Fort Collins Science Center, U.S. Geological Survey Fort Collins Colorado 80526 USA
| | - Peter S. Coates
- U.S. Geological Survey Western Ecological Research Center Dixon California 95620 USA
| | - Brian G. Prochazka
- U.S. Geological Survey Western Ecological Research Center Dixon California 95620 USA
| | - Steve E. Hanser
- U.S. Geological Survey Ecosystems Mission Area Reston VA 20192 USA
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Zhang H, Yang L, Li L, Xu G, Zhang X. The epidemic characteristics and spatial autocorrelation analysis of hand, foot and mouth disease from 2010 to 2015 in Shantou, Guangdong, China. BMC Public Health 2019; 19:998. [PMID: 31340798 PMCID: PMC6657152 DOI: 10.1186/s12889-019-7329-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/16/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hand, foot and mouth disease (HFMD) is the highest incidence of infectious diseases in China. Shantou is one of the most infected cities. Therefore, it is necessary for us to understand the epidemic characteristics and distribution trend of HFMD in Shantou. The purpose of this study is to investigate the spatial epidemiological characteristics of HFMD and analyse its spatial autocorrelation. METHOD We collated and summarised the data of HFMD in Shantou from 2010 to 2015. SaTScan software and Moran's I were used to analyse the spatial correlation of HFMD, and the results were presented in ArcMap. RESULTS The distribution of HFMD in Shantou was of a seasonal trend, mainly concentrating during May and June. Children under 5-years-old were the main group of cases of HFMD, accounting for 92.46%. The proportion of infected children, especially those aged zero to 1, was the largest in each year, accounting for 45.62%, meaning that smaller children were more susceptible to HFMD. The number of male patients with HFMD was greater than that of females (1.78:1, male: female). With regard to the potential impact of patients' living style on the incidence rate of HFMD, this study revealed that scattered children were the dominant infected population, accounting for as much 84.49% of cases. The incidence of HFMD was unevenly distributed among streets. The incidence interval of streets was in a range of 13.76/100,000 to 1135.19/100,000. Spatial autocorrelation analysis showed that there was no global spatial correlation in Shantou, except in 2013. The results of local spatial autocorrelation analysis showed that H-H correlation existed in the high incidence local area of Shantou. CONCLUSIONS The incidence of HFMD across the various streets in Shantou not only varied widely but also represented local autocorrelation. Attention, as well as prevention and control measures, should be focused on those high-incidence areas, such as the Queshi street, Zhuchi street and Xinjin street.
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Affiliation(s)
- Haoyuan Zhang
- MPH Education Center and Injury Preventive Research Center, Shantou University Medical College, 22 Xinling Road, Shantou, 515041 China
| | - Lianpeng Yang
- MPH Education Center and Injury Preventive Research Center, Shantou University Medical College, 22 Xinling Road, Shantou, 515041 China
- Zhuhai Maternal and Child Health Care Hospital, 543 Ningxi road, Zhuhai, 519001 China
| | - Liping Li
- MPH Education Center and Injury Preventive Research Center, Shantou University Medical College, 22 Xinling Road, Shantou, 515041 China
| | - Guangxing Xu
- Shantou Center for Disease Control and Prevention, 58 Shanfen road, Shantou, 515041 China
| | - Xubin Zhang
- Shantou Center for Disease Control and Prevention, 58 Shanfen road, Shantou, 515041 China
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23
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Li T, Cheng Q, Li C, Stokes E, Collender P, Ohringer A, Li X, Li J, Zelner JL, Liang S, Yang C, Remais JV, He J. Evidence for heterogeneity in China's progress against pulmonary tuberculosis: uneven reductions in a major center of ongoing transmission, 2005-2017. BMC Infect Dis 2019; 19:615. [PMID: 31299911 PMCID: PMC6626433 DOI: 10.1186/s12879-019-4262-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 07/04/2019] [Indexed: 02/02/2023] Open
Abstract
Background China contributed 8.9% of all incident cases of tuberculosis globally in 2017, and understanding the spatiotemporal distribution of pulmonary tuberculosis (PTB) in major transmission foci in the country is critical to ongoing efforts to improve population health. Methods We estimated annual PTB notification rates and their spatiotemporal distributions in Sichuan province, a major center of ongoing transmission, from 2005 to 2017. Time series decomposition was used to obtain trend components from the monthly incidence rate time series. Spatiotemporal cluster analyses were conducted to detect spatiotemporal clusters of PTB at the county level. Results From 2005 to 2017, 976,873 cases of active PTB and 388,739 cases of smear-positive PTB were reported in Sichuan Province, China. During this period, the overall reported incidence rate of active PTB decreased steadily at a rate of decrease (3.77 cases per 100,000 per year, 95% confidence interval (CI): 3.28–4.31) that was slightly faster than the national average rate of decrease (3.14 cases per 100,000 per year, 95% CI: 2.61–3.67). Although reported PTB incidence decreased significantly in most regions of the province, incidence was observed to be increasing in some counties with high HIV incidence and ethnic minority populations. Active and smear-positive PTB case reports exhibited seasonality, peaking in March and April, with apparent links to social dynamics and climatological factors. Conclusions While PTB incidence rates decreased strikingly in the study area over the past decade, improvements have not been equally distributed. Additional surveillance and control efforts should be guided by the seasonal-trend and spatiotemporal cluster analyses presented here, focusing on areas with increasing incidence rates, and updated to reflect the latest information from real-time reporting. Electronic supplementary material The online version of this article (10.1186/s12879-019-4262-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ting Li
- Institute of Tuberculosis Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China
| | - Qu Cheng
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Charles Li
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Everleigh Stokes
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Philip Collender
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Alison Ohringer
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Xintong Li
- Department of Biostatistics Rollins School of Public Health, Emory University, Atlanta, 30322, USA
| | - Jing Li
- Institute of Tuberculosis Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China
| | - Jonathan L Zelner
- Department of Epidemiology and Center for Social Epidemiology and Population Health School of Public Health, University of Michigan, Ann Arbor, 48109, USA
| | - Song Liang
- Department of Environmental and Global Health College of Public Health and Health Professions, University of Florida, Gainesville, 32611, USA
| | - Changhong Yang
- Institute of Public Health Information, Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China
| | - Justin V Remais
- Division of Environmental Health Sciences School of Public Health, University of California, Berkeley, 94720, USA
| | - Jin'ge He
- Institute of Tuberculosis Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, 610041, China.
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24
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Cui Z, Lin D, Chongsuvivatwong V, Graviss EA, Chaiprasert A, Palittapongarnpim P, Lin M, Ou J, Zhao J. Hot and Cold Spot Areas of Household Tuberculosis Transmission in Southern China: Effects of Socio-Economic Status and Mycobacterium tuberculosis Genotypes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101863. [PMID: 31137811 PMCID: PMC6572207 DOI: 10.3390/ijerph16101863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 05/19/2019] [Accepted: 05/23/2019] [Indexed: 11/16/2022]
Abstract
The aims of the study were: (1) compare sociodemographic characteristics among active tuberculosis (TB) cases and their household contacts in cold and hot spot transmission areas, and (2) quantify the influence of locality, genotype and potential determinants on the rates of latent tuberculosis infection (LTBI) among household contacts of index TB cases. Parallel case-contact studies were conducted in two geographic areas classified as "cold" and "hot" spots based on TB notification and spatial clustering between January and June 2018 in Guangxi, China, using data from field contact investigations, whole genome sequencing, tuberculin skin tests (TSTs), and chest radiographs. Beijing family strains accounted for 64.6% of Mycobacterium tuberculosis (Mtb) strains transmitted in hot spots, and 50.7% in cold spots (p-value = 0.02). The positive TST rate in hot spot areas was significantly higher than that observed in cold spot areas (p-value < 0.01). Living in hot spots (adjusted odds ratio (aOR) = 1.75, 95%, confidence interval (CI): 1.22, 2.50), Beijing family genotype (aOR = 1.83, 95% CI: 1.19, 2.81), living in the same room with an index case (aOR = 2.29, 95% CI: 1.5, 3.49), travelling time from home to a medical facility (aOR = 4.78, 95% CI: 2.96, 7.72), history of Bacillus Calmette-Guérin vaccination (aOR = 2.02, 95% CI: 1.13 3.62), and delay in diagnosis (aOR = 2.56, 95% CI: 1.13, 5.80) were significantly associated with positive TST results among household contacts of TB cases. The findings of this study confirmed the strong transmissibility of the Beijing genotype family strains and this genotype's important role in household transmission. We found that an extended traveling time from home to the medical facility was an important socioeconomic factor for Mtb transmission in the family. It is still necessary to improve the medical facility infrastructure and management, especially in areas with a high TB prevalence.
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Affiliation(s)
- Zhezhe Cui
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.
| | - Dingwen Lin
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.
| | | | - Edward A Graviss
- Department of Pathology and Genomic Medicine, The Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX 77030, USA.
| | - Angkana Chaiprasert
- Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
| | | | - Mei Lin
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.
| | - Jing Ou
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.
| | - Jinming Zhao
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China.
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25
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Cui Z, Lin D, Chongsuvivatwong V, Zhao J, Lin M, Ou J, Zhao J. Spatiotemporal patterns and ecological factors of tuberculosis notification: A spatial panel data analysis in Guangxi, China. PLoS One 2019; 14:e0212051. [PMID: 31048894 PMCID: PMC6497253 DOI: 10.1371/journal.pone.0212051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 01/04/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Guangxi is one of the provinces having the highest notification rate of tuberculosis in China. However, spatial and temporal patterns and the association between environmental diversity and tuberculosis notification are still unclear. OBJECTIVE To detect the spatiotemporal pattern of tuberculosis notification rates from 2010 to 2016 and its potential association with ecological environmental factors in Guangxi Zhuang autonomous region, China. METHODS We performed a spatiotemporal analysis with prediction using time series analysis, Moran's I global and local spatial autocorrelation statistics, and space-time scan statistics to detect temporal and spatial clusters of tuberculosis notifications in Guangxi between 2010 and 2016. Spatial panel models were employed to identify potential associating factors. RESULTS The number of reported cases peaked in spring and summer and decreased in autumn and winter. The predicted number of reported cases was 49,946 in 2017. Moran's I global statistics were greater than 0 (0.363-0.536) during the study period. The most significant hot spots were mainly located in the central area. The eastern area exhibited a low-low relation. By the space-time scanning, the clusters identified were similar to those of the local autocorrelation statistics, and were clustered toward the early part of 2016. Duration of sunshine, per capita gross domestic product, the treatment success rate of tuberculosis and participation rate of the new cooperative medical care insurance scheme in rural areas had a significant negative association with tuberculosis notification rates. CONCLUSION The notification rate of tuberculosis in Guangxi remains high, with the highest notification cluster located in the central region. The notification rate is associated with economic level, treatment success rate and participation in the new cooperative medical care insurance scheme.
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Affiliation(s)
- Zhezhe Cui
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Dingwen Lin
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
| | | | - Jinming Zhao
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Mei Lin
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Jing Ou
- Department of Tuberculosis Control, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China
| | - Jinghua Zhao
- Institute for Communicable Disease Control and Prevention, Qinghai Center for Disease Control and Prevention, Xining, China
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26
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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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27
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Shaweno D, Karmakar M, Alene KA, Ragonnet R, Clements AC, Trauer JM, Denholm JT, McBryde ES. Methods used in the spatial analysis of tuberculosis epidemiology: a systematic review. BMC Med 2018; 16:193. [PMID: 30333043 PMCID: PMC6193308 DOI: 10.1186/s12916-018-1178-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 09/20/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) transmission often occurs within a household or community, leading to heterogeneous spatial patterns. However, apparent spatial clustering of TB could reflect ongoing transmission or co-location of risk factors and can vary considerably depending on the type of data available, the analysis methods employed and the dynamics of the underlying population. Thus, we aimed to review methodological approaches used in the spatial analysis of TB burden. METHODS We conducted a systematic literature search of spatial studies of TB published in English using Medline, Embase, PsycInfo, Scopus and Web of Science databases with no date restriction from inception to 15 February 2017. The protocol for this systematic review was prospectively registered with PROSPERO ( CRD42016036655 ). RESULTS We identified 168 eligible studies with spatial methods used to describe the spatial distribution (n = 154), spatial clusters (n = 73), predictors of spatial patterns (n = 64), the role of congregate settings (n = 3) and the household (n = 2) on TB transmission. Molecular techniques combined with geospatial methods were used by 25 studies to compare the role of transmission to reactivation as a driver of TB spatial distribution, finding that geospatial hotspots are not necessarily areas of recent transmission. Almost all studies used notification data for spatial analysis (161 of 168), although none accounted for undetected cases. The most common data visualisation technique was notification rate mapping, and the use of smoothing techniques was uncommon. Spatial clusters were identified using a range of methods, with the most commonly employed being Kulldorff's spatial scan statistic followed by local Moran's I and Getis and Ord's local Gi(d) tests. In the 11 papers that compared two such methods using a single dataset, the clustering patterns identified were often inconsistent. Classical regression models that did not account for spatial dependence were commonly used to predict spatial TB risk. In all included studies, TB showed a heterogeneous spatial pattern at each geographic resolution level examined. CONCLUSIONS A range of spatial analysis methodologies has been employed in divergent contexts, with all studies demonstrating significant heterogeneity in spatial TB distribution. Future studies are needed to define the optimal method for each context and should account for unreported cases when using notification data where possible. Future studies combining genotypic and geospatial techniques with epidemiologically linked cases have the potential to provide further insights and improve TB control.
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Affiliation(s)
- Debebe Shaweno
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
- Victorian Tuberculosis Program at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.
| | - Malancha Karmakar
- Victorian Tuberculosis Program at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia
| | - Kefyalew Addis Alene
- Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, Australia
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Romain Ragonnet
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Burnet Institute, Melbourne, Australia
| | | | - James M Trauer
- Victorian Tuberculosis Program at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Justin T Denholm
- Victorian Tuberculosis Program at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia
| | - Emma S McBryde
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
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28
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Tuberculosis among Full-Time Teachers in Southeast China, 2005⁻2016. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092024. [PMID: 30227616 PMCID: PMC6163467 DOI: 10.3390/ijerph15092024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/12/2018] [Accepted: 09/13/2018] [Indexed: 12/20/2022]
Abstract
Objective: To explore the incidence rate and characteristics of tuberculosis (TB) among full-time teachers from 2005 to 2016 in southeast China and to provide a basis for TB prevention and control measures in schools. Methods: Information about full-time teachers with TB was obtained from the National Tuberculosis Information Management System (NTIMS). Population data were collected from the Zhejiang Statistical Yearbook and the Zhejiang Education Yearbook. The TB incidence rates and epidemiological characteristics of full-time teachers were analyzed and the Chi-square test was used to analyze influencing factors of epidemiological characteristics and clinical characteristics, case-finding delay, and treatment outcomes. Results: A total of 1795 teachers with TB were reported from 2005 to 2016, and the annual incidence rate was 28.87 per 100,000. The average annual PTB (pulmonary TB) incidence rate among full-time teachers was 25.43/100,000 from 2005 to 2016 and the average annual PTB incidence rate among students was 15.40/100,000 from 2005 to 2016. The highest average incidence rates were observed in the QZ (Quzhou) and HZ (Hangzhou) districts. The male-to-female ratio of the patients was 0.95:1. Approximately half of the patients were 15–40 years old. The mean case-finding interval was 45.3 days. Multivariable logistic regression analysis of TB case-finding delay among full-time teachers revealed that the older (OR = 1.44, 95% CI = 1.18–1.76, p < 0.01), not local (OR = 1.81, 95% CI = 1.20–2.73, p < 0.01), retreatment (OR = 2.06, 95% CI = 1.39–3.08, p < 0.01) and extra-pulmonary tuberculosis (OR = 1.71, 95% CI = 1.13–2.61, p = 0.01) cases were at high risk of case-finding delay. Compared to physical examination, patients detected by referrals and tracking (OR = 2.26, 95% CI = 1.16–4.38, p = 0.02) and patients who directly visited the designated TB hospital (OR = 2.00, 95% CI = 1.03–3.88, p = 0.04) were more prone to case-finding delay. The cure rate of full-time teachers with TB was 77.10%. The cure rates differed significantly between groups classified based on age, case-finding patterns, diagnostic results, treatment classifications, and strategies of patient management. Conclusion: The TB incidence rate among full-time teachers decreased from 2005 to 2016, but teachers suffered a higher risk of TB than students. Western Zhejiang was a hotspot for TB incidence among full-time teachers. Female teacher and young and middle-aged teacher cases account for the majority of the reported patients. There was a case-finding delay among full-time teachers with TB. We should conduct regular physical examinations and strengthen full-course supervision to reduce the risk of TB patients with case-finding delay and increase the TB cure rate.
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29
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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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Mburu JW, Kingwara L, Esther M, Andrew N. Molecular clustering of patients with Mycobacterium tuberculosis strains cultured from the diabetic and non-diabetic newly diagnosed TB positive cases. J Clin Tuberc Other Mycobact Dis 2018; 12:21-26. [PMID: 31720394 PMCID: PMC6830120 DOI: 10.1016/j.jctube.2018.05.001] [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: 01/25/2018] [Revised: 05/08/2018] [Accepted: 05/21/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Social determinants of health, biological, and individual variants have been associated with Pulmonary TB (PTB) case clustering. None of the studies have focused on diabetes mellitus (DM) despite it being one of the co-morbidity affecting TB patients. Minimal data is available and it is not clear whether patients with DM and TB are more likely than TB patients without DM to be grouped into similar molecular clusters thus indicating a bias in transmission among TB/DM co-morbidity patients. OBJECTIVE To determine proportion of TB strains within TB and TB/DM cases that were clustered with their corresponding clinical outcomes and hence could be attributable to active TB transmission in the two urban counties of Nairobi, Kenya. METHODS We carried out a prospective cohort study of non-pregnant patients aged 15 years and above that tested positive for TB in two peri‑urban counties in Kenya between February 2014 and August 2015. Clinical and socio-demographic data were obtained from a questionnaire and medical records of the National TB program patient data base at two, three, five and six months. Spoligotyping data was then obtained and compared from previously identified strains in a data bank from the spolDB4. RESULTS We identified 7 different TB strains out of which East Asia Beijing, Euro America and Indo oceanic being the most dominant strain within the two counties accounting for 92.4% of the infections. DM was not a significant factor in increasing the likelihood of PTB patients to cluster according to the genotype of the infecting Mycobacterium tuberculosis bacillus. TB lineages, DM and County of the patient were found to be independent of the clinical outcomes that were observed in the study. CONCLUSION Diabetes mellitus is not a significant factor in increasing the molecular clustering among PTB patients.
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Affiliation(s)
- Josephine W. Mburu
- National Tuberculosis Reference Laboratory, MOH, Kenya
- Jomo Kenyatta University of Agriculture and Technology (JKUAT), Kenya
| | | | - Magiri Esther
- Jomo Kenyatta University of Agriculture and Technology (JKUAT), Kenya
| | - Nyerere Andrew
- Jomo Kenyatta University of Agriculture and Technology (JKUAT), Kenya
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Tadesse S, Enqueselassie F, Hagos S. Spatial and space-time clustering of tuberculosis in Gurage Zone, Southern Ethiopia. PLoS One 2018; 13:e0198353. [PMID: 29870539 PMCID: PMC5988276 DOI: 10.1371/journal.pone.0198353] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 05/17/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Spatial targeting is advocated as an effective method that contributes for achieving tuberculosis control in high-burden countries. However, there is a paucity of studies clarifying the spatial nature of the disease in these countries. This study aims to identify the location, size and risk of purely spatial and space-time clusters for high occurrence of tuberculosis in Gurage Zone, Southern Ethiopia during 2007 to 2016. MATERIALS AND METHODS A total of 15,805 patient data that were retrieved from unit TB registers were included in the final analyses. The spatial and space-time cluster analyses were performed using the global Moran's I, Getis-Ord [Formula: see text] and Kulldorff's scan statistics. RESULTS Eleven purely spatial and three space-time clusters were detected (P <0.001).The clusters were concentrated in border areas of the Gurage Zone. There were considerable spatial variations in the risk of tuberculosis by year during the study period. CONCLUSIONS This study showed that tuberculosis clusters were mainly concentrated at border areas of the Gurage Zone during the study period, suggesting that there has been sustained transmission of the disease within these locations. The findings may help intensify the implementation of tuberculosis control activities in these locations. Further study is warranted to explore the roles of various ecological factors on the observed spatial distribution of tuberculosis.
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Affiliation(s)
- Sebsibe Tadesse
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fikre Enqueselassie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Seifu Hagos
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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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: 35] [Impact Index Per Article: 5.0] [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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Huang L, Li XX, Abe EM, Xu L, Ruan Y, Cao CL, Li SZ. Spatial-temporal analysis of pulmonary tuberculosis in the northeast of the Yunnan province, People's Republic of China. Infect Dis Poverty 2017; 6:53. [PMID: 28335803 PMCID: PMC5364648 DOI: 10.1186/s40249-017-0268-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 02/17/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The number of pulmonary tuberculosis (PTB) cases in China ranks third in the world. A continuous increase in cases has recently been recorded in Zhaotong prefecture-level city, which is located in the northeastern part of Yunnan province. This study explored the space-time dynamics of PTB cases in Zhaotong to provide useful information that will help guide policymakers to formulate effective regional prevention and control strategies. METHODS The data on PTB cases were extracted from the nationwide tuberculosis online registration system. Time series and spatial cluster analyses were applied to detect PTB temporal trends and spatial patterns at the town level between 2011 and 2015 in Zhaotong. Three indicators of PTB treatment registration history were used: initial treatment registration rate, re-treatment registration rate, and total PTB registration rate. RESULTS Seasonal trends were detected with an apparent symptom onset peak during the winter season and a registration peak during the spring season. A most likely cluster and six secondary clusters were identified for the total PTB registration rate, one most likely cluster and five secondary clusters for the initial treatment registration rate, and one most likely cluster for the re-treatment registration rate. The most likely cluster of the three indicators had a similar spatial distribution and size in Zhenxiong County, which is characterised by a poor socio-economic level and the largest population in Yunnan. CONCLUSION This study identified temporal and spatial distribution of PTB in a high PTB burden area using existing health data. The results of the study provide useful information on the prevailing epidemiological situation of PTB in Zhaotong and could be used to develop strategies for more effective PTB control at the town level. The cluster that overlapped the three PTB indicators falls within the geographic areas where PTB control efforts should be prioritised.
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Affiliation(s)
- Li Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 People’s Republic of China
- Tuberculosis Program, Yunnan Center for Disease Control and Prevention, 158 Dongsi Road, Xishan District, Kunming, Yunnan 650022 People’s Republic of China
| | - Xin-Xu Li
- National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206 People’s Republic of China
| | - Eniola Michael Abe
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Lin Xu
- Tuberculosis Program, Yunnan Center for Disease Control and Prevention, 158 Dongsi Road, Xishan District, Kunming, Yunnan 650022 People’s Republic of China
| | - Yao Ruan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Chun-Li Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 People’s Republic of China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Center for Tropical Diseases, Shanghai, 200025 People’s Republic of China
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Worrell MC, Kramer M, Yamin A, Ray SM, Goswami ND. Use of Activity Space in a Tuberculosis Outbreak: Bringing Homeless Persons Into Spatial Analyses. Open Forum Infect Dis 2017; 4:ofw280. [PMID: 28480272 PMCID: PMC5414060 DOI: 10.1093/ofid/ofw280] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/03/2017] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) causes significant morbidity and mortality in US cities, particularly in poor, transient populations. During a TB outbreak in Fulton County, Atlanta, GA, we aimed to determine whether local maps created from multiple locations of personal activity per case would differ significantly from traditional maps created from single residential address. METHODS Data were abstracted for patients with TB disease diagnosed in 2008-2014 and receiving care at the Fulton County Health Department. Clinical and activity location data were abstracted from charts. Kernel density methods, activity space analysis, and overlay with homeless shelter locations were used to characterize case spatial distribution when using single versus multiple addresses. RESULTS Data were collected for 198 TB cases, with over 30% homeless US-born cases included. Greater spatial dispersion of cases was found when utilizing multiple versus single addresses per case. Activity spaces of homeless and isoniazid (INH)-resistant cases were more spatially congruent with one another than non-homeless and INH-susceptible cases (P < .0001 and P < .0001, respectively). CONCLUSIONS Innovative spatial methods allowed us to more comprehensively capture the geography of TB-infected homeless persons, who made up a large portion of the Fulton County outbreak. We demonstrate how activity space analysis, prominent in exposure science and chronic disease, supports that routine capture of multiple location TB data may facilitate spatially different public health interventions than traditional surveillance maps.
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Affiliation(s)
| | - Michael Kramer
- Department of Epidemiology, Rollins School of Public Health and
| | - Aliya Yamin
- Fulton County Health Department Tuberculosis Clinic, Atlanta, Georgia
| | - Susan M Ray
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Neela D Goswami
- Department of Epidemiology, Rollins School of Public Health and
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
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Yeboah-Manu D, Asare P, Asante-Poku A, Otchere ID, Osei-Wusu S, Danso E, Forson A, Koram KA, Gagneux S. Spatio-Temporal Distribution of Mycobacterium tuberculosis Complex Strains in Ghana. PLoS One 2016; 11:e0161892. [PMID: 27564240 PMCID: PMC5001706 DOI: 10.1371/journal.pone.0161892] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/12/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is a perception that genomic differences in the species/lineages of the nine species making the Mycobacterium tuberculosis complex (MTBC) may affect the efficacy of distinct control tools in certain geographical areas. We therefore analyzed the prevalence and spatial distribution of MTBC species and lineages among isolates from pulmonary TB cases over an 8-year period, 2007-2014. METHODOLOGY Mycobacterial species isolated by culture from consecutively recruited pulmonary tuberculosis patients presenting at selected district/sub-district health facilities were confirmed as MTBC by IS6110 and rpoß PCR and further assigned lineages and sub lineages by spoligotyping and large sequence polymorphism PCR (RDs 4, 9, 12, 702, 711) assays. Patient characteristics, residency, and risks were obtained with a structured questionnaire. We used SaTScan and ArcMap analyses to identify significantly clustered MTBC lineages within selected districts and spatial display, respectively. RESULTS Among 2,551 isolates, 2,019 (79.1%), 516 (20.2%) and 16 (0.6%) were identified as M. tuberculosis sensu stricto (MTBss), M. africanum (Maf), 15 M. bovis and 1 M. caprae, respectively. The proportions of MTBss and Maf were fairly constant within the study period. Maf spoligotypes were dominated by Spoligotype International Type (SIT) 331 (25.42%), SIT 326 (15.25%) and SIT 181 (14.12%). We found M. bovis to be significantly higher in Northern Ghana (1.9% of 212) than Southern Ghana (0.5% of 2339) (p = 0.020). Using the purely spatial and space-time analysis, seven significant MTBC lineage clusters (p< 0.05) were identified. Notable among the clusters were Ghana and Cameroon sub-lineages found to be associated with north and south, respectively. CONCLUSION This study demonstrated that overall, 79.1% of TB in Ghana is caused by MTBss and 20% by M. africanum. Unlike some West African Countries, we did not observe a decline of Maf prevalence in Ghana.
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Affiliation(s)
- Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
- * E-mail:
| | - P. Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - A. Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - I. D. Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - S. Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - E. Danso
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - A. Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-bu, Accra, Ghana
| | - K. A. Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Ge E, Zhang X, Wang X, Wei X. Spatial and temporal analysis of tuberculosis in Zhejiang Province, China, 2009-2012. Infect Dis Poverty 2016; 5:11. [PMID: 26906041 PMCID: PMC4763446 DOI: 10.1186/s40249-016-0104-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 01/25/2016] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Tuberculosis (TB) is an infectious disease of major public health concern. The disease has demonstrated large space-time variations. This study aims to explore the space-time dynamics of TB cases in an economically and geographically dynamic province in China with specific references of TB control for policy makers. METHODS Data on all reported TB cases from 2009 to 2012 were collected from the TB program at the Zhejiang Provincial Center for Disease Control and Prevention. We employed time series and exploratory spatial data analyses, including Moran's I, Local Getis's G i (*) , and Kulldorff's space-time scan statistics, to identify the temporal trends and spatial patterns of TB at a county level. RESULTS A total of 147,941 TB cases were reported during 2009-2012 in Zhejiang. A higher proportion of TB cases were younger, male, and registered permanent residents among all TB cases notified in the province. TB cases were reported most frequently in April with small peaks in June, July, and October. This disease was spatially clustering with Moran's I values ranged from 0.29 to 0.32 (p < 0.001). A most likely cluster and ten secondary clusters were identified, mainly concentrated in the southeast and west counties of the province. CONCLUSIONS This study identified seasonal patterns and significant space-time clusters of TB cases in Zhejiang, China. Poverty, migration, and seasonal effects may play important roles in potential clusters.
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Affiliation(s)
- Erjia Ge
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, S.A.R., China.
| | - Xin Zhang
- The Chinese University of Hong Kong, Shenzhen Research Institute, Shenzhen, China.
| | - Xiaomeng Wang
- TB Program, Zhejiang Centre for Disease Control and Prevention, No. 630 Xincheng Road, Binjiang District, Hangzhou, Zhejiang, 310051, China.
| | - Xiaolin Wei
- JC School of Public Health, The Chinese University of Hong Kong, 2/F, School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong, China. .,Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3 M7, Canada.
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Wubuli A, Xue F, Jiang D, Yao X, Upur H, Wushouer Q. Socio-Demographic Predictors and Distribution of Pulmonary Tuberculosis (TB) in Xinjiang, China: A Spatial Analysis. PLoS One 2015; 10:e0144010. [PMID: 26641642 PMCID: PMC4671667 DOI: 10.1371/journal.pone.0144010] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 11/12/2015] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Xinjiang is one of the high TB burden provinces of China. A spatial analysis was conducted using geographical information system (GIS) technology to improve the understanding of geographic variation of the pulmonary TB occurrence in Xinjiang, its predictors, and to search for targeted interventions. METHODS Numbers of reported pulmonary TB cases were collected at county/district level from TB surveillance system database. Population data were extracted from Xinjiang Statistical Yearbook (2006~2014). Spatial autocorrelation (or dependency) was assessed using global Moran's I statistic. Anselin's local Moran's I and local Getis-Ord statistics were used to detect local spatial clusters. Ordinary least squares (OLS) regression, spatial lag model (SLM) and geographically-weighted regression (GWR) models were used to explore the socio-demographic predictors of pulmonary TB incidence from global and local perspectives. SPSS17.0, ArcGIS10.2.2, and GeoDA software were used for data analysis. RESULTS Incidence of sputum smear positive (SS+) TB and new SS+TB showed a declining trend from 2005 to 2013. Pulmonary TB incidence showed a declining trend from 2005 to 2010 and a rising trend since 2011 mainly caused by the rising trend of sputum smear negative (SS-) TB incidence (p<0.0001). Spatial autocorrelation analysis showed the presence of positive spatial autocorrelation for pulmonary TB incidence, SS+TB incidence and SS-TB incidence from 2005 to 2013 (P <0.0001). The Anselin's Local Moran's I identified the "hotspots" which were consistently located in the southwest regions composed of 20 to 28 districts, and the "coldspots" which were consistently located in the north central regions consisting of 21 to 27 districts. Analysis with the Getis-Ord Gi* statistic expanded the scope of "hotspots" and "coldspots" with different intensity; 30 county/districts clustered as "hotspots", while 47 county/districts clustered as "coldspots". OLS regression model included the "proportion of minorities" and the "per capita GDP" as explanatory variables that explained 64% the variation in pulmonary TB incidence (adjR2 = 0.64). The SLM model improved the fit of the OLS model with a decrease in AIC value from 883 to 864, suggesting "proportion of minorities" to be the only statistically significant predictor. GWR model also improved the fitness of regression (adj R2 = 0.68, AIC = 871), which revealed that "proportion of minorities" was a strong predictor in the south central regions while "per capita GDP" was a strong predictor for the southwest regions. CONCLUSION The SS+TB incidence of Xinjiang had a decreasing trend during 2005-2013, but it still remained higher than the national average in China. Spatial analysis showed significant spatial autocorrelation in pulmonary TB incidence. Cluster analysis detected two clusters-the "hotspots", which were consistently located in the southwest regions, and the "coldspots", which were consistently located in the north central regions. The exploration of socio-demographic predictors identified the "proportion of minorities" and the "per capita GDP" as predictors and may help to guide TB control programs and targeting intervention.
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Affiliation(s)
- Atikaimu Wubuli
- Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
- Research Institution of Health Affairs Development and Reform, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Feng Xue
- Center for Tuberculosis Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang, China
| | - Daobin Jiang
- Department of Respiratory Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xuemei Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Halmurat Upur
- Department of Traditional Uygur Medicine, Xinjiang Medical University, Urumqi, Xinjiang, China
- * E-mail: (HU); (QW)
| | - Qimanguli Wushouer
- Department of Respiratory Medicine, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
- * E-mail: (HU); (QW)
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