The Environmental and Socioeconomic Effects and Prediction of Tuberculosis Patients in different age groups in the Southwest of China: a population based study.

Abstract

While the End Tuberculosis (TB) Strategy has been implemented worldwide, the cause of TB epidemic is multifactorial and has been not fully understood. To investigate the risk factors of TB and incorporate these factors to forecast the incidence of TB infection across different age groups in Sichuan, China. Correlation and linear regression analyses were conducted to assess the relationships between TB cases and ecological factors, including environmental, economic, and social factors in Sichuan Province from 2006 to 2017. The transfer function-noise (TFN) model was used to forecast trends, considering both time and multi-factors effects. From 2006 to 2017, Sichuan Province had a reported cumulative incidence rate of 1321.08 cases/100,000 in males and 583.04 cases/100,000 in females. There were significant sex differences in the distribution of cases among age groups (trend χ2=12,544.416, P<.001). Ganzi Tibetan Autonomous Prefecture had the highest incidence rates of TB in both males and females in Sichuan. Correlation and regression analyses shown that the total illiteracy rate and averagepressure ateachmeasuring station (for individuals aged 15-24) were risk factors for TB. The protective factors follows: the number of families with the minimum living standard guarantee in urban areas, average wind speed, number of discharged patients with invasive TB, number of people with the minimum living standard guarantee in rural areas, total health expenditure as a percentage of regional GDP, being a single male (for individuals aged 0-14), number of hospitals, number of health workers in infectious disease hospitals (for individuals aged 25-64), amount of daily morning and evening exercise, number of people with the urban minimum living standard guarantee, and being married (for females aged >64 years). The TFN model indicated that the incidence of TB in males aged 0-14 and 15-24 will continue to rise, and the incidence of TB in females aged 0-14 and >64 will continue to increase rapidly in Sichuan, by 2035. The End TB Strategy in Sichuan should take into account environmental, educational, medical, social, personal and other conditions, and further substantial efforts are needed especially in aged 0-24 males, aged 0-14 females, and 64 years elder females. Data collection of TB was required by the Law of the People's Republic of China on Prevention and Treatment of Infectious Diseases. The ethical approval in this study was granted by the Ethics Committee of Sichuan CDC (SCCDCIRB2022-001).