| Objective To collect data on tuberculosis cases in Qinghai Province and to analyze its epidemiological characteristics and spatial epidemiological characteristics,and have a clear understanding of the regions and populations featuring high incidence,clustering,and high-risk;further combine sociological and environmental meteorological data to analyze macro factors contributing to prevalence of TB in Qinghai Province,in order to provide scientific guidance for TB prevention and control in Qinghai Province.Methods(1)Data on registered cases of TB(type I-V),social indicators,and environmental meteorological data in Qinghai from 2011 to 2020 were collected,Excel database was established.(2)The epidemiological characteristics of TB were analyzed by Arc GIS software to establish the databases of TB cases,social indicators and environmental meteorological data in Qinghai,the spatial correlation and spatial trend of TB were analyzed by Arc Map10.8,and Poisson model was built by Sa TScan to analyze the aggregation characteristics of TB cases.(3)Social indicators and environmental meteorological data were incorporated into the spatial regression model to select the significant factors affecting the prevalence of TB.(4)Based on the time series method,the time series data of TB in Qinghai was decomposed and an exponential smoothing model was constructed to study the epidemic trend of TB.Results 39013 cases of type I-V TB were cumulatively reported in Qinghai Province from 2011 to 2020,with an average annual incidence rate of 64.52/100,000.(1)Epidemiological characteristics of TB in Qinghai: the paper showed a decreasing trend in 2011-2014,increasing in 2014-2019 and downward in 2019-2020;March,April and May were the prevalent months with the highest number of TB cases each year;the incidence rate was highest among men,farmers and herdsmen,Tibetans,and the elderly,and the base number of patients aged 15-25 was the largest;Yushu and Guoluo were two regions with the severe epidemic of TB.(2)Spatial epidemiological characteristics of TB in Qinghai: TB epidemic was spatially correlated in Qinghai every year,and had multiple clustering patterns;the overall trend of epidemic was worse in the west than east,and in the south than north as well;The space-time scan showed that there was a total of 4 TB high-risk clustered areas in Qinghai from 2011 to 2020,including a primary clustered area and 3secondary clustered areas.The primary clustered area was mainly located in Yushu and Guoluo,secondary clustered areaⅠmainly in Huangnan Prefecture,secondary clustered area Ⅱ mainly in Hainan Prefecture,secondary clustered area Ⅲ mainly in Haixi and Haibei Prefecture.(3)Analysis of influencing factors TB in Qinghai: the prevalence of TB in Qinghai is significantly influenced by altitude,average air pressure,GDP per capita,and day length.The regression equation is.(4)Study on epidemiological trends of TB in Qinghai: the data of TB cases in Qinghai were non-stationary and seasonal time series,and the Winters’ additive model based on the three-parameter exponential smoothing method had the best fit(0.61),which could be used for the trend study of TB epidemic.Conclusions TB seriously impacts the life quality and health of Qinghai people,especially men,Tibetans,farmers and herdsmen,and the elderly.Local clustered areas of TB have been existed for many years,with the harshest TB epidemic in the southern region.The prevalence of TB in Qinghai is significantly influenced by many macro factors,including altitude,average air pressure,per capita GDP,and day length,making TB prevention and control more struggling.In order to achieve the goal of "Eliminating TB",a series of measures such as multi-sectoral jointed measures of prevention and control,special funding,and enhanced population surveillance in key areas need to be carried out urgently.The exponential smoothing model can be applied to the study of TB epidemic trends,which is expected to provide a reference for TB prevention and control in Qinghai Province. |
PDF Full Text Request