Hailong Zhou1, Xiaoyan Yang2, Sheng Zhao3, Xiaoping Pan1,4, Junhong Xu5. 1. West China School of Public Health, Sichuan University, Chengdu, China. 2. West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China. 3. School of Finance and Statistics, Hunan University, Changsha, China. 4. National Center for Women and Children's Health, China CDC, Beijing, China. 5. Sichuan Provincial Center for Disease Prevention and Control, Chengdu, China.
Abstract
OBJECTIVE: China is a country that experiences frequent earthquakes and has a high pulmonary tuberculosis burden. In this study, we aimed to explore the spatial clustering and risk factors of the reported incidence of pulmonary tuberculosis burden before and after the Wenchuan earthquake. METHODS: Data on the location and the demographic, socioeconomic, and health service characteristics of the 181 counties of Sichuan province from 2004 to 2012 were collected. Global and local spatial autocorrelation analyses were performed to explore spatial clustering. The associated factors were screened using stepwise multiple linear regression, and a spatial lag model was fitted to explore the influence factors. RESULTS: The incidence of pulmonary tuberculosis burden showed a global and local spatial autocorrelation relationship. The high-incidence counties shifted gradually over time from east to west and finally clustered in the "Aba-Ganzi" region. Factors influencing the incidence of pulmonary tuberculosis burden included minority areas, the proportion of the working population, county latitude, and the severity of the earthquake. The influence factors varied over time; the impact of minority regions, occupation, and health resources allocation weakened, whereas the economic development and mobility of the population became more significant. CONCLUSION: The spatial structural relationship is an important factor related to pulmonary tuberculosis burden incidence. More attention should be paid to high-incidence areas and populations susceptible to pulmonary tuberculosis burden.
OBJECTIVE: China is a country that experiences frequent earthquakes and has a high pulmonary tuberculosis burden. In this study, we aimed to explore the spatial clustering and risk factors of the reported incidence of pulmonary tuberculosis burden before and after the Wenchuan earthquake. METHODS: Data on the location and the demographic, socioeconomic, and health service characteristics of the 181 counties of Sichuan province from 2004 to 2012 were collected. Global and local spatial autocorrelation analyses were performed to explore spatial clustering. The associated factors were screened using stepwise multiple linear regression, and a spatial lag model was fitted to explore the influence factors. RESULTS: The incidence of pulmonary tuberculosis burden showed a global and local spatial autocorrelation relationship. The high-incidence counties shifted gradually over time from east to west and finally clustered in the "Aba-Ganzi" region. Factors influencing the incidence of pulmonary tuberculosis burden included minority areas, the proportion of the working population, county latitude, and the severity of the earthquake. The influence factors varied over time; the impact of minority regions, occupation, and health resources allocation weakened, whereas the economic development and mobility of the population became more significant. CONCLUSION: The spatial structural relationship is an important factor related to pulmonary tuberculosis burden incidence. More attention should be paid to high-incidence areas and populations susceptible to pulmonary tuberculosis burden.
Authors: Debebe Shaweno; Malancha Karmakar; Kefyalew Addis Alene; Romain Ragonnet; Archie Ca Clements; James M Trauer; Justin T Denholm; Emma S McBryde Journal: BMC Med Date: 2018-10-18 Impact factor: 8.775