Abstract
ObjectiveThis study was aimed to find out epidemiologic characteristic of tuberculosis (TB) cases, and Human Immunodeficiency Virus (HIV) positive cases among TB patients (TB/HIV co-infection) through demographic, temporal, and spatial study in Urumqi.MethodsDescriptive statistics and multivariate logistic regression were applied to identify the epidemiologic characteristics and risk factors of TB epidemic and TB/HIV co-infection epidemic. All addresses of each TB case, TB/HIV co-infection case, and administrative street were transformed into geographical coordinate. Subsequently, the geocoded address for 82 streets was transformed into a dot map used as the basis of spatial datasets. In addition, the paper also used quantile map and the spatial scan statistic in order to identify the spatial distribution and spatial clusters of TB epidemic and TB/HIV co-infection epidemic.ResultThere was a declining trend of the notification rates of TB epidemic from 2007 to 2009, as well as a rising trend from 2010 to 2013. However, the notification rates of TB/HIV co-infection epidemic showed a rising trend from 2007 to 2010, and a declining trend from 2011 to 2013. Moreover, a significant share of TB epidemic and TB/HIV co-infection epidemic happened between the age of 15 to 45 years old, indicating an increase in risk of TB and TB/HIV infection. It is worth noting that the risk of HIV infection for male TB patients was 2.947 times (95% CI [2.178, 3.988]) than that of female patients. Han ethnicity and Uygur ethnicity in urban region accounted for a large proportion of total TB and TB/HIV co-infection cases. Most of the TB cases of minorities in Urumqi showed a statistically significant increase in risk of HIV infection than Han ethnicity in Urumqi. In addition, the spatial distribution of TB epidemic and TB/HIV co-infection epidemic was highly skewed. Most of the local clusters were located in urban area and rural-urban continuum where showed an increase in risk of TB and TB/HIV infection.ConclusionThe epidemiologic and spatial-temporal analysis of TB epidemic and TB/HIV co-infection epidemic demonstrates a potential connection between TB and HIV in Urumqi. Demographic, temporal, geographic factors are the reasons of causing TB and TB/HIV co-infection epidemic.
Highlights
Tuberculosis (TB) is contagious and airborne, ranking as a leading cause of death worldwide alongside Human Immunodeficiency Virus (HIV) infection [1]
With the increase of HIV positive TB patients and the decrease of treatment success rate among HIV positive TB patients [2], there is no positive trend for TB epidemic and TB/HIV co-infection epidemic, which has galvanized consensus over growing TB/HIV case
Urumqi is the capital of Xinjiang, with a population of 2,493,519 in 14,200 km2, which accounted for a large proportion of total TB and HIV cases reported in Xinjiang
Summary
Tuberculosis (TB) is contagious and airborne, ranking as a leading cause of death worldwide alongside Human Immunodeficiency Virus (HIV) infection [1]. Despite being preventable and treatable, TB remains the most common life-threatening opportunistic infection and a leading cause of deaths among people living with HIV/AIDS (PLWHA) [2]. Urumqi is the capital of Xinjiang, with a population of 2,493,519 in 14,200 km, which accounted for a large proportion of total TB and HIV cases reported in Xinjiang. HIV patients in Urumqi accounted 34.6% of total HIV cases reported in Xinjiang [4]. The infected ration of TB/HIV co-infection in Urumqi region is estimated at 142 cases per 1,000 TB patients from September 2007 to December 2009 [5]. The epidemic of TB and TB/HIV co-infection is not optimistic in Urumqi in recent years
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