Epidemiological Characteristics Of Pulmonary Tuberculosis In Inner Mongolia From 2016 To 2018 And Its Relationship With Air Pollution

Objective To reveal the temporal and spatial distribution of pulmonary tuberculosis and air pollution in Inner Mongolia from 2016 to 2018.To analyze the effect of air pollution on the risk of pulmonary tuberculosis.Methods The data of pulmonary tuberculosis and air pollutants,socio-demographic data,economic data and meteorological data in 2016-2018 were collected.The temporal and spatial distribution of pulmonary tuberculosis and air pollutants were described.Based on Bayesian spatiotemporal model,the temporal and spatial distribution model of pulmonary tuberculosis was constructed to analyze the variation of temporal and spatial pattern of pulmonary tuberculosis.The principal components of air pollutants were extracted by principal components analysis,and the effects of air pollutants on the risk of pulmonary tuberculosis were evaluated by generalized additive model.Results There were 10458 cases,11163 cases and 14066 cases of pulmonary tuberculosis in Inner Mongolia from 2016 to 2018.And the incidence rates were 41per 100000,44 per 100000 and 55 per 100000 from 2016 to 2018,the average annual incidence was 52 per 100000.Among them,the number of new cases of pulmonary tuberculosis in males of all three years were higher than that in females;the group of51 to 60 years old accounted for the highest proportion of new cases of all three years;and agriculture,animal husbandry and fishermen accounted for the highest proportion of new cases of all three years.The incidence of pulmonary tuberculosis in Inner Mongolia was seasonal and mainly concentrated in spring and winter.Its high-risk areas included Xin Barag Left Banner in Hulunbeir City,Xin Barag Right Banner in Hulunbeir City,Naiman Banner in Tongliao City,Alashan Right Banner in Alashan League and Horqin Right Wing Middle Banner in Hinggan League.The incidences of pulmonary tuberculosis were increasing rapidly in Qingshan District in Baotou City and Wulanhaote City in Hinggan League.Air pollution in Inner Mongolia had obvious seasonality.The peaks of PM_2.5、NO₂、SO₂and CO concentrations were concentrated in winter,peaks of PM10 concentration in spring,and peaks of O₃concentration in summer.The serious air pollution areas included Kundulun District in Baotou City,Jining District in Wulanchabu City and Haibo Bay District in Wuhai City.The principal components of air pollutants extracted by principal components analysis were primary pollutants(PM_2.5、PM₁₀、NO₂、SO₂and CO)and secondary pollutants（O₃）.The results of generalized additive model showed that the exposure of primary pollutants(PM_2.5、PM₁₀、NO₂、SO₂and CO)and secondary pollutants（O₃）at different lag time increased the risk of pulmonary tuberculosis（P<0.05）.The effects of air pollutants exposed on the risk of pulmonary tuberculosis in different sex groups were statistically different（P<0.05）,and the effects of air pollutants exposed on the risk of pulmonary tuberculosis in different age groups were statistically different（P<0.05）,which had a more significant effect on the risk of pulmonary tuberculosis in people aged 19-64 years.Conclusions During the period of 2016 to 2018,the incidence of pulmonary tuberculosis in Inner Mongolia was on the rise.The incidences of pulmonary tuberculosis and the distribution of air pollutants concentration showed the seasonal and regional differences.The exposure of air pollutants was a risk factor for the risk of pulmonary tuberculosis,and the influences of pollutants exposed on pulmonary tuberculosis were lagging behind.The effect of air pollutants on the risk of tuberculosis in women aged 19-64 years were more significant.