| Background:Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis infection.It can involve multiple organs and mainly cause pulmonary tuberculosis.In the world,tuberculosis is still a major public health problem endangering human health,and the death caused by tuberculosis infection always ranks among the top 10 causes of death in the world.China is a country with high burden of tuberculosis.In China,tuberculosis belongs to class B infectious diseases.For a long time,China has issued various policies to strengthen the control of tuberculosis.Ji’nan is a low prevalence area of tuberculosis,with a low incidence rate.Ji’nan is an area with low prevalence of tuberculosis,the incidence rate is lower than the national average level,and the mortality rate is lower than the level of the action plan for containment tuberculosis（2019-2022）.Nevertheless,in the order of notifiable infectious disease mortality in Jinan City in 2020,tuberculosis mortality is still in the first place.There is still a long way to go for the goal of ending TB epidemic in 2035.In this paper,through the analysis of the incidence of tuberculosis in Jinan from 2011 to 2020,we aim to understand the epidemic pattern and trend of tuberculosis in Jinan,and to provide scientific reference for the relevant departments to formulate targeted prevention and control strategies,which is of great significance to the prevention and control of tuberculosis in Jinan.Objectives:To analyze the incidence of tuberculosis in Jinan City from 2011 to 2020,and to understand the general epidemiological distribution of tuberculosis in Jinan City;The spatial epidemic characteristics of tuberculosis in Jinan were analyzed;To establish prediction model of tuberculosis incidence rate in order to predict the trend of tuberculosis incidence in the future.It provides a scientific basis for the relevant departments in Ji’nan to take the early warning of tuberculosis epidemic situation and formulate targeted prevention and control strategies.Methods:1.The data of tuberculosis cases in Jinan City from 2011 to 2020 were collected through the infectious disease surveillance information system of China Center for Disease Control and prevention,and the distribution of new tuberculosis cases in Jinan City from 2011 to 2020 was analyzed by descriptive epidemiological method;The periodicity and seasonality of tuberculosis were analyzed by HP filtration and seasonal index method;The natural discontinuity method was used to draw the thematic map and the excess hazard ratio map of tuberculosis incidence rate,and to analyze the distribution characteristics and development trend of the tuberculosis area in Ji’nan.2.The global spatial autocorrelation and local spatial autocorrelation analysis of incidence rate of pulmonary tuberculosis in Ji’nan were conducted using Moran’s I index and local Gi*coefficient.Based on Poisson distribution,spatio-temporal scanning was carried out to detect the high-risk areas and time of pulmonary tuberculosis in Jinan.3.We constructed the ARIMA optimal model by using the incidence rate of TB in Ji’nan in 2011-2020 years,and speculated the incidence rate of tuberculosis in Ji’nan in 2021-2022.Results:1.General epidemiological characteristics:In 2011-2020,the cumulative number of reported tuberculosis cases in Ji’nan was 24497,the ratio of male to female was 1.90:1,the annual average incidence rate was 34.33/100 000（27.36-39.97/100000）,the annual reported incidence rate was decreasing year by year;The total death cases were 116,the ratio of male to female was 4.04:1,and the annual reported mortality was0.16/100 000（0.10-0.23/100 000）.There was obvious periodicity and seasonality;January to May were the peak season,June to December were the low season.The peak incidence rate of age distribution was mainly in the 80-84 years old group（incidence rate 82.85/100 000）and 25-29 years old group（incidence rate was 43.82/100 000）;There was no death case of pulmonary tuberculosis under 15 years old,and the mortality rate was relatively high after 75 years old.In terms of occupation distribution,farmers,housework and unemployed,retired personnel,students and workers were the main groups,and the proportion were 41.44%,18.26%,10.41%,8.52%and 8.47%respectively,total accounting for 87.1%.In terms of regional distribution,It is mainly concentrated in the urban area of Jinan and some suburban counties.In the distribution of diagnosis,pathogen negative accounted for 69.53%,followed by pathogen positive（25.06%）,no pathogen result（5.00%）and rifampicin resistance（0.41%）.2.Spatial epidemiological characteristics:The autocorrelation coefficients of tuberculosis incidence in Jinan City from 2011 to 2013 and 2015 to 2020 were statistically significant and showed significant spatial positive correlation,that is,obvious spatial aggregation.From 2011 to 2020,the global Moran’s I index of pulmonary tuberculosis in Jinan City showed a double peak trend,the first peak was in 2013,and reached the peak in 2019.From 2011 to 2015,the hot spot areas of tuberculosis in Jinan City were concentrated in the central and western regions.From 2016 to 2020,the hot spot areas of tuberculosis in Jinan city gradually expanded from the central and western regions to the west,while the cold spot areas were less.In 2011-2020,the incidence rate of pulmonary tuberculosis in Ji’nan was analyzed by spatiotemporal scanning.A total of 6 congregated areas were detected.The most likely area was the Wuligou area in Huaiyin District.The aggregation time was January 2014 to January 2016,the relative risk was 9.56,and the logarithmic likelihood ratio was 227.113086.The cluster areas of tuberculosis in Jinan City were mainly located in Huaiyin District,Tianqiao District,Lixia District,Shanghe county and Licheng District,which were consistent with the hot spots of local spatial autocorrelation analysis.3.Prediction:The optimal model of ARIMA model is ARIMA（2,0,2）（1,1,2）12.The prediction results showed that the incidence rate of tuberculosis in Ji’nan continued to show a downward trend in 2021-2022 years,and the peak season was in January to May.Conclusions:1.The incidence of tuberculosis in male was more than that in female,mostly in young and middle-aged people,and the mortality of the elderly is higher.Farmers,housework,unemployed,retired,students and workers were the high-risk occupational groups of tuberculosis in Jinan.The incidence rate was decreasing year by year,and January to May was the peak season of Ji’nan.The incidence of tuberculosis was higher in Tianqiao District,Lixia District,Shanghe County,Huaiyin District and Licheng District.The number of laboratory diagnosed pulmonary tuberculosis was higher than that of clinical diagnosis,and the positive detection rate of etiology needs to be further improved.2.The incidence rate of tuberculosis in Ji’nan has significant spatial clustering.The gathering time mainly concentrated in January,and the gathering areas mainly appeared in the streets where the floating population gathered and the rural areas with backward economic development.3.ARIMA（2,0,2）（1,1,2）12 model can better match the monthly incidence rate of tuberculosis in Ji’nan,and can be used for short-term incidence rate prediction in the future.The incidence rate of tuberculosis in Ji’nan will continue to decrease in 2021-2022,and January to May will be the peak season. |
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