Spatio-temporal analysis of socio-economic characteristics for pulmonary tuberculosis in Sichuan province of China, 2006
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RESEARCH ARTICLE
Open Access
Spatio-temporal analysis of socio-economic characteristics for pulmonary tuberculosis in Sichuan province of China, 2006–2015 Lan Xia1†, Sui Zhu2†, Chuang Chen1, Zheng-Yuan Rao1, Yong Xia1, Dan-Xia Wang1, Pei-Ru Zhang1, Jinge He1, Ju-Ying Zhang3* and Jian-Lin Wu1*
Abstract Background: The disease burden caused by pulmonary tuberculosis (TB) in Sichuan province still persisted at a high level, and large spatial variances were presented across regional distribution disparities. The socio-economic factors were suspected to affect the population of TB notification, we aimed to describe TB case notification rate (CNR) and identify which factors influence TB epidemic are necessary for the prevention and control of the disease in Sichuan province. Methods: A retrospective cross-sectional study and an ecological spatial analysis was conducted to quantify the presence and location of spatial clusters of TB by the Moran’s I index and examined these patterns with socioeconomic risk factors by hierarchical Bayesian spatio-temporal model. Results: A total of 630,009 pulmonary TB cases were notified from 2006 to 2015 in 181 counties of Sichuan province. The CNR decreased year by year since 2007, from 88.70 to 61.37 per 100,000 persons. The spatial heterogeneities of CNR were observed during the study periods. Global Moran’s I index varied from 0.23 to 0.44 with all P-value < 0.001. The Bayesian spatio-temporal model with parametric spatio-temporal interactions was chosen as the best model according to the minimum of Deviance Information Criterion (DIC)(19,379.01), and in which the quadratic form of time was taken. The proportion of age group and education year were all associated with CNR after adjusting the spatial effect, temporal effect and spatio-temporal interactions. TB CNR increased by 10.2% [95% credible interval (CI): 6.7–13.7%] for every 1-standard-deviation increase in proportion of age group and decreased by 23% (95% CI: 13.7–32.7%) for every 1-standard-deviation increase in education year. (Continued on next page)
* Correspondence: [email protected]; [email protected] † Lan Xia and Sui Zhu contributed equally to this work. 3 Department of Epidemiology and Biostatistics, School of Public Health, Sichuan University, No.17 Section 3, Renmin South Road, Chengdu 610044, Sichuan Province, China 1 Department of Tuberculosis, Sichuan Provincial Center for Disease Control and Prevention, No.6 middle school road, Wuhou district, Chengdu 610041, Sichuan Province, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the articl
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