Abstract
BackgroundTuberculosis (TB) is an important public health issue worldwide. However, evidence concerning the impact of environmental factors on TB is sparse. We performed a retrospective analysis to determine the spatiotemporal trends and geographic variations of, and the factors associated with, the TB prevalence in Inner Mongolia.MethodsWe performed a retrospective analysis of the epidemiology of TB. A Bayesian spatiotemporal model was used to investigate the spatiotemporal distribution and trends of the TB prevalence. A spatial panel data model was used to identify factors associated with the TB prevalence in the 101 counties of Inner Mongolia, using county-level aggregated data collected by the Inner Mongolia Center for Disease Control and Prevention.ResultsFrom January 2010 to December 2014, 79,466 (6.36‱) incident TB cases were recorded. The TB prevalence ranged from 4.97‱ (12,515/25,167,547) in 2014 to 7.49‱ (18,406/ 24,578,678) in 2010; the majority of TB cases were in males, and in those aged 46–60 years; by occupation, farmers and herdsmen were the most frequently affected. The Bayesian spatiotemporal model showed that the overall TB prevalence decreased linearly from 2010 to 2014 and occupation-stratified analyses yielded similar results, corroborating the reliability of the findings. The decrease of TB prevalence in the central-western and eastern regions was more rapid than that in the overall TB prevalence. A spatial correlation analysis showed spatial clustering of the TB prevalence from 2011 to 2014 (Moran’s index > 0, P < 0.05); in the spatial panel data model, rural residence, birth rate, number of beds, population density, precipitation, air pressure, and sunshine duration were associated with the TB prevalence.ConclusionsThe overall TB prevalence in Inner Mongolia decreased from 2010 to 2014; however, the incidence of TB was high throughout this period. The TB prevalence was influenced by a spatiotemporal interaction effect and was associated with epidemiological, healthcare, and environmental factors.
Highlights
Tuberculosis (TB) is an important public health issue worldwide
Descriptive Analysis Trends of the TB Prevalence According to Sex and Age From 2010 to 2014, the TB prevalence among males and females decreased markedly in Inner Mongolia
Our findings suggest that several often‐overlooked meteorological factors are associated with a high TB prevalence
Summary
Tuberculosis (TB) is an important public health issue worldwide. Evidence concerning the impact of environmental factors on TB is sparse. We performed a retrospective analysis to determine the spatiotemporal trends and geographic variations of, and the factors associated with, the TB prevalence in Inner Mongolia. According to the World Health Organization, approximately 1.7 billion (23%) people have latent TB infections and an estimated 10.0 million (range, 9.0–11.1 million) new cases of TB are reported annually. TB caused an estimated 1.3 million (range, 1.2–1.4 million) deaths in 2017. China has the fourth highest number of incident TB cases, and second number of multidrug resistant TB cases in 30 high‐burden countries worldwide [2]. TB is a critical public health challenge worldwide, in low- and middle-income countries
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