Tuberculosis burden caused by migrant population in Eastern China: evidence from notification records in Zhejiang Province during 2013\u20132017

Kui Liu,Yu Zhang,Ying Peng,Bo Xie,Jianmin Jiang,Tao Li,Liyun Ai,Xiaomeng Wang,Fei Wang,Songhua Chen,Bin Chen,Wei Wang

doi:10.1186/s12879-022-07071-5

Abstract

BackgroundInternal 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.MethodsIn 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.Results48,756 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.ConclusionThe 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.

Highlights

Tuberculosis (TB) had aroused a considerable disease burden globally, which caused 10 million people falling ill only in 2018 [1]
This study aimed to explore the potential influence of migrant population (MP) on the control and prevention of TB in Zhejiang Province
All notified TB cases consisted of confirmed pulmonary TB (PTB), clinical diagnostic PTB, and extrapulmonary TB (EPTB) as well, which referred to National Diagnostic Criteria for Pulmonary Tuberculosis (WS288–2008 and WS 288-2017) and Classification of Tuberculosis (WS196-2017) [16, 17]

Summary

Introduction

Tuberculosis (TB) had aroused a considerable disease burden globally, which caused 10 million people falling ill only in 2018 [1]. In China, people from underdeveloped areas commonly moved to the developed mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. The migrant population (MP) brought significant economic development to the inflow area and simultaneously created unprecedented challenges and issues such as transportation system, education resources, and health accessibility [6, 7]. For these specific groups, adverse factors for TB occurrence like limited living conditions and low economic levels were still existing [8, 9]. Zhejiang Province, as one of the developed areas, had a heavy burden caused by TB

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