Spatial and temporal clustering analysis of pulmonary tuberculosis and its associated risk factors in southwest China

Submitted: 7 November 2022
Accepted: 30 January 2023
Published: 25 May 2023
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Pulmonary tuberculosis (PTB) remains a serious public health problem, especially in areas of developing countries. This study aimed to explore the spatial-temporal clusters and associated risk factors of PTB in south-western China. Space-time scan statistics were used to explore the spatial and temporal distribution characteristics of PTB. We collected data on PTB, population, geographic information and possible influencing factors (average temperature, average rainfall, average altitude, planting area of crops and population density) from 11 towns in Mengzi, a prefecture-level city in China, between 1 January 2015 and 31 December 2019. A total of 901 reported PTB cases were collected in the study area and a spatial lag model was conducted to analyse the association between these variables and the PTB incidence. Kulldorff’s scan results identified two significant space-time clusters, with the most likely cluster (RR = 2.24, p < 0.001) mainly located in northeastern Mengzi involving five towns in the time frame June 2017 - November 2019. A secondary cluster (RR = 2.09, p < 0.05) was located in southern Mengzi, covering two towns and persisting from July 2017 to December 2019. The results of the spatial lag model showed that average rainfall was associated with PTB incidence. Precautions and protective measures should be strengthened in high-risk areas to avoid spread of the disease.

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Anselin L, 1988. Spatial econometrics: Methods and models. Kluwer Academic Publishers, Dordrecht, Netherlands, pp. 22-55. DOI: https://doi.org/10.1007/978-94-015-7799-1
Bloom BR, Atun R, Cohen T, Dye C, Fraser H, Gomez GB, Knight G, Murray M, Nardell E, Rubin E, Salomon J, Vassall A, Volchenkov G, White R, Wilson D, Yadav P, 2017. Tuberculosis. Chapter 11. In Major Infectious Diseases, Holmes KK, Bertozzi S, Bloom BR, Jha P, eds. 3rd ed. Washington (DC): The International Bank for Reconstruction and Development/The World Bank. DOI: https://doi.org/10.1596/978-1-4648-0524-0_ch11
Cao K, Yang K, Wang C, Guo J, Tao L, Liu Q, Gehendra M, Zhang Y, Guo X, 2016. Spatial-temporal epidemiology of tuberculosis in mainland China: An analysis based on Bayesian theory. Int J Environ Res Public Health 13:469. DOI: https://doi.org/10.3390/ijerph13050469
Chen J, Qiu Y, Yang R, Li L, Hou J, Lu K, Xu L, 2019. The characteristics of spatial-temporal distribution and cluster of tuberculosis in Yunnan Province, China, 2005-2018. BMC Public Health 19:1715. DOI: https://doi.org/10.1186/s12889-019-7993-5
Chen Q, 2014. Advanced econometrics and stata application. Beijing: Higher Education Press, pp 575-598.
Chinese Ministry of Health, 2019. The national overview of notifiable infectious disease in 2019. Accessed: May 15, 2022. Available from: http://www.nhc.gov.cn/jkj/s3578/202004/b1519e1bc1a944fc8ec176db600f68d1.shtml
Furin J, Cox H, Pai M, 2019. Tuberculosis. Lancet 393:1642-56. DOI: https://doi.org/10.1016/S0140-6736(19)30308-3
Gelaw YA, Yu W, Magalhães RJS, Assefa Y, Williams G, 2019. Effect of temperature and altitude difference on tuberculosis notification: a systematic review. J Glob Infect Dis 11:63-8. DOI: https://doi.org/10.4103/jgid.jgid_95_18
Glaziou P, Floyd K, Raviglione MC, 2018. Global epidemiology of tuberculosis. Semin Respir Crit Care Med 39:271-85. DOI: https://doi.org/10.1055/s-0038-1651492
Huang L, Abe EM, Li XX, Bergquist R, Xu L, Xue JB, Ruan Y, Cao CL, Li SZ, 2018. Space-time clustering and associated risk factors of pulmonary tuberculosis in southwest China. Infect Dis Poverty 7:91. DOI: https://doi.org/10.1186/s40249-018-0470-z
Huang L, Li XX, Abe EM, Xu L, Ruan Y, Cao CL, Li SZ, 2017. Spatial-temporal analysis of pulmonary tuberculosis in the northeast of the Yunnan province, People's Republic of China. Infect Dis Poverty 6:53. DOI: https://doi.org/10.1186/s40249-017-0268-4
Huang L, Xu L, Li SZ, 2017. Application progress of scanning statistics method in the distribution of pulmonary tuberculosis. Pract Prev Med 24:766-9.
Huang QL, Tang XY, Zhou HX, Li Q, Qiu XQ, 2013. Comparative study of four spatial regression models in screening influencing factors of disease spatial data. China Health Statistics 30:334-8.
Jiang L, 2016. Reflection on the choice of spatial regression model. Stats Info Forum 31:10-6.
Kammerer JS, Shang N, Althomsons SP, Haddad MB, Grant J, Navin TR, 2013. Using statistical methods and genotyping to detect tuberculosis outbreaks. Int J Health Geogr 12:5. DOI: https://doi.org/10.1186/1476-072X-12-15
Kulldorff M, 1997. A spatial scan statistic. Commun Statistics — Theory Meth 26:1481–96. DOI: https://doi.org/10.1080/03610929708831995
Li G, Zhang XP, Xu YP, Song S, Wang YF, Ji XM, Xiang J, Yang J, 2016. Stable isotope characteristics of precipitation and water vapor source in Mengzi area, southern Yunnan. Environ Sci 37:1313-20. [Chinese]
Li Q, Liu M, Zhang Y, Wu S, Yang Y, Liu Y, Amsalu E, Tao L, Liu X, Zhang F, Luo Y, Yang X, Li W, Li X, Wang W, Wang X, Guo X, 2019. The spatio-temporal analysis of the incidence of tuberculosis and the associated factors in mainland China, 2009-2015. Infect Genet Evol 75:103949. DOI: https://doi.org/10.1016/j.meegid.2019.103949
Li X, Li T, Tan S, 2013. Males, ages ≥ 45 years, businessperson, floating population, and rural residents may be considered high-risk groups for tuberculosis infection in Guangzhou, China: a review of 136,394 TB confirmed cases. Rev Inst Med Trop Sao Paulo 55:366-8. DOI: https://doi.org/10.1590/S0036-46652013000500013
Li XX, Wang LX, Zhang J, Liu YX, Zhang H, Jiang SW, Chen JX, Zhou XN, 2014. Exploration of ecological factors related to the spatial heterogeneity of tuberculosis prevalence in P. R. China. Glob Health Action 7:23620. DOI: https://doi.org/10.3402/gha.v7.23620
Li YS, Yuan Wei H, Sun JH, Ma WQ, Chen XH, Lian Y, 2021. Analysis of the temporal and spatial characteristics of hourly precipitation in rainy and dry seasons in Yunnan. Plateau Mountain Meteorol Res 41:24-32.
Liu LL, Song L, Dong LQ, Lu HZ, Yang B, 2020. Temporal and spatial pattern and cause analysis of precipitation in Yunnan province in recent 50 years. J Ecol 39:3463-70.
Liu MY, Li QH, Zhang YJ, Ma Y, Liu Y, Feng W, Hou CB, Amsalu E, Li X, Wang W, Li WM, Guo XH, 2018. Spatial and temporal clustering analysis of tuberculosis in the mainland of China at the prefecture level, 2005-2015. Infect Dis Poverty 7:106. DOI: https://doi.org/10.1186/s40249-018-0490-8
Nnoaham KE, Clarke A, 2008. Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis. Int J Epidemiol 37:113-9. DOI: https://doi.org/10.1093/ije/dym247
Qiu YB, Xu L, Li LL, 2014. Analysis of epidemic characteristics of tuberculosis in Yunnan province from 2002 to 2011. Mod Prev Med 41:975-7.
Selmane S, L'hadj M, 2021. Spatiotemporal analysis and seasonality of tuberculosis in Algeria. Int J Mycobacteriol 10:234-42. DOI: https://doi.org/10.4103/ijmy.ijmy_111_21
Sun W, Gong J, Zhou J, Zhao Y, Tan J, Ibrahim AN, Zhou Y, 2015. A spatial, social and environmental study of tuberculosis in China using statistical and GIS technology. Int J Environ Res Public Health 12:1425-48. DOI: https://doi.org/10.3390/ijerph120201425
Sun YH, Tian MZ, Nie YW, Yang Z, Zhang LP, 2022. Spatial-temporal distribution characteristics and influencing factors of pulmonary tuberculosis in China from 2015 to 2019. Chin J Prev Med 23:436-41.
Tadesse S, Enqueselassie F, Hagos S, 2018. Spatial and space-time clustering of tuberculosis in Gurage Zone, Southern Ethiopia. PLoS One 13:e0198353. DOI: https://doi.org/10.1371/journal.pone.0198353
Tang N, 2015. Study on the geographical distribution and spatial clustering of tuberculosis cases in Yunnan Province. Master’s Thesis. Kunming Medical University.
Tanrikulu AC, Acemoglu H, Palanci Y, Dagli CE, 2008. Tuberculosis in Turkey: high altitude and other socio-economic risk factors. Public Health 122:613-9. DOI: https://doi.org/10.1016/j.puhe.2007.09.005
United Nations, 2015. Transforming our world: the 2030 Agenda for Sustainable Development. Accessed: May 15, 2022. Available from: https://sdgs.un.org/zh/2030agenda
Vargas MH, Furuya ME, Pérez-Guzmán C, 2004. Effect of altitude on the frequency of pulmonary tuberculosis. Int J Tuberc Lung Dis 8:1321-4.
Wang JJ, Liu XN, Yang JW, Jing ZC, 2022. Epidemic characteristics and spatial distribution characteristics of pulmonary tuberculosis in Mengzi city, Yunnan from 2015 to 2019. Chin J Prev Med 23:224-30.
WHO, 2020. Global tuberculosis report 2020. Available from:https://www.who.int/teams/global-tuberculosis-programme/tb-reports Accessed: May 15, 2022.
Wubuli A, Xue F, Jiang D, Yao X, Upur H, Wushouer Q, 2015. Socio-demographic predictors and distribution of pulmonary tuberculosis (TB) in Xinjiang, China: A spatial analysis. PLoS One 10:e0144010. DOI: https://doi.org/10.1371/journal.pone.0144010
Xiao Y, He L, Chen Y, Wang Q, Meng Q, Chang W, Xiong L, Yu Z, 2018. The influence of meteorological factors on tuberculosis incidence in Southwest China from 2006 to 2015. Sci Rep 8:10053. DOI: https://doi.org/10.1038/s41598-018-28426-6
Ying Q, Chen K, 2012. Application progress of spatial analysis technology in tuberculosis research. Dis Surveill 27:330-4.
Zhang MH, 2019. Study on the achievement of tuberculosis control target and influencing factors in China. Chinese Center for Disease Control and Prevention.
Zhang Y, Liu M, Wu SS, Jiang H, Zhang J, Wang S, Ma W, Li Q, Ma Y, Liu Y, Feng W, Amsalu E, Li X, Wang W, Li W, Guo X, 2019. Spatial distribution of tuberculosis and its association with meteorological factors in mainland China. BMC Infect Dis 19:379. DOI: https://doi.org/10.1186/s12879-019-4008-1
Zhao YJ, 2019. Study on the current situation and influencing factors of direct economic burden of pulmonary tuberculosis patients in three counties of Yunnan. Kunming Medical University.

How to Cite

Wang, J., Liu, X., Jing, Z., & Yang, J. (2023). Spatial and temporal clustering analysis of pulmonary tuberculosis and its associated risk factors in southwest China. Geospatial Health, 18(1). https://doi.org/10.4081/gh.2023.1169