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Spatiotemporal characteristics and the epidemiology of tuberculosis in China from 2004 to 2017 by the nationwide surveillance system.
BMC Public Health. 2020 Aug 26; 20(1):1284.BP

Abstract

BACKGROUND

China has always been one of the countries with the most serious Tuberculosis epidemic in the world. Our study was to observe the Spatial-temporal characteristics and the epidemiology of Tuberculosis in China from 2004 to 2017 with Joinpoint regression analysis, Seasonal Autoregressive integrated moving average (SARIMA) model, geographic cluster, and multivariate time series model.

METHODS

The data of TB from January 2004 to December 2017 were obtained from the notifiable infectious disease reporting system supplied by the Chinese Center for Disease Control and Prevention. The incidence trend of TB was observed by the Joinpoint regression analysis. The Seasonal autoregressive integrated moving average (SARIMA) model was used to predict the monthly incidence. Geographic clusters was employed to analyze the spatial autocorrelation. The relative importance component of TB was detected by the multivariate time series model.

RESULTS

We included 13,991,850 TB cases from January 2004 to December 2017, with a yearly average morbidity of 999,417 cases. The final selected model was the 0 Joinpoint model (P = 0.0001) with an annual average percent change (AAPC) of - 3.3 (95% CI: - 4.3 to - 2.2, P < 0.001). A seasonality was observed across the 14 years, and the seasonal peaks were in January and March every year. The best SARIMA model was (0, 1, 1) X (0, 1, 1)12 which can be written as (1-B) (1-B12) Xt = (1-0.42349B) (1-0.43338B12) εt, with a minimum AIC (880.5) and SBC (886.4). The predicted value and the original incidence data of 2017 were well matched. The MSE, RMSE, MAE, and MAPE of the modelling performance were 201.76, 14.2, 8.4 and 0.06, respectively. The provinces with a high incidence were located in the northwest (Xinjiang, Tibet) and south (Guangxi, Guizhou, Hainan) of China. The hotspot of TB transmission was mainly located at southern region of China from 2004 to 2008, including Hainan, Guangxi, Guizhou, and Chongqing, which disappeared in the later years. The autoregressive component had a leading role in the incidence of TB which accounted for 81.5-84.5% of the patients on average. The endemic component was about twice as large in the western provinces as the average while the spatial-temporal component was less important there. Most of the high incidences (> 70 cases per 100,000) were influenced by the autoregressive component for the past 14 years.

CONCLUSION

In a word, China still has a high TB incidence. However, the incidence rate of TB was significantly decreasing from 2004 to 2017 in China. Seasonal peaks were in January and March every year. Obvious geographical clusters were observed in Tibet and Xinjiang Province. The relative importance component of TB driving transmission was distinguished from the multivariate time series model. For every provinces over the past 14 years, the autoregressive component played a leading role in the incidence of TB which need us to enhance the early protective implementation.

Authors+Show Affiliations

Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China.Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China.Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China.Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China.Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China.Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China.Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China.Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China.Department of General Courses, Weifang Medical University, Weifang, 261053, Shandong Province, China.Department of Clinical Laboratory, Hangzhou Xixi Hospital, 2 Hengbu Road, Xihu District, Hangzhou, 310023, Zhejiang Province, China. 13616500869@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32843011

Citation

Zuo, Zhongbao, et al. "Spatiotemporal Characteristics and the Epidemiology of Tuberculosis in China From 2004 to 2017 By the Nationwide Surveillance System." BMC Public Health, vol. 20, no. 1, 2020, p. 1284.
Zuo Z, Wang M, Cui H, et al. Spatiotemporal characteristics and the epidemiology of tuberculosis in China from 2004 to 2017 by the nationwide surveillance system. BMC Public Health. 2020;20(1):1284.
Zuo, Z., Wang, M., Cui, H., Wang, Y., Wu, J., Qi, J., Pan, K., Sui, D., Liu, P., & Xu, A. (2020). Spatiotemporal characteristics and the epidemiology of tuberculosis in China from 2004 to 2017 by the nationwide surveillance system. BMC Public Health, 20(1), 1284. https://doi.org/10.1186/s12889-020-09331-y
Zuo Z, et al. Spatiotemporal Characteristics and the Epidemiology of Tuberculosis in China From 2004 to 2017 By the Nationwide Surveillance System. BMC Public Health. 2020 Aug 26;20(1):1284. PubMed PMID: 32843011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spatiotemporal characteristics and the epidemiology of tuberculosis in China from 2004 to 2017 by the nationwide surveillance system. AU - Zuo,Zhongbao, AU - Wang,Miaochan, AU - Cui,Huaizhong, AU - Wang,Ying, AU - Wu,Jing, AU - Qi,Jianjiang, AU - Pan,Kenv, AU - Sui,Dongming, AU - Liu,Pengtao, AU - Xu,Aifang, Y1 - 2020/08/26/ PY - 2020/01/28/received PY - 2020/08/03/accepted PY - 2020/8/27/entrez PY - 2020/8/28/pubmed PY - 2020/12/1/medline KW - Epidemiology KW - Multivariate time series model KW - Spatial-temporal KW - Tuberculosis SP - 1284 EP - 1284 JF - BMC public health JO - BMC Public Health VL - 20 IS - 1 N2 - BACKGROUND: China has always been one of the countries with the most serious Tuberculosis epidemic in the world. Our study was to observe the Spatial-temporal characteristics and the epidemiology of Tuberculosis in China from 2004 to 2017 with Joinpoint regression analysis, Seasonal Autoregressive integrated moving average (SARIMA) model, geographic cluster, and multivariate time series model. METHODS: The data of TB from January 2004 to December 2017 were obtained from the notifiable infectious disease reporting system supplied by the Chinese Center for Disease Control and Prevention. The incidence trend of TB was observed by the Joinpoint regression analysis. The Seasonal autoregressive integrated moving average (SARIMA) model was used to predict the monthly incidence. Geographic clusters was employed to analyze the spatial autocorrelation. The relative importance component of TB was detected by the multivariate time series model. RESULTS: We included 13,991,850 TB cases from January 2004 to December 2017, with a yearly average morbidity of 999,417 cases. The final selected model was the 0 Joinpoint model (P = 0.0001) with an annual average percent change (AAPC) of - 3.3 (95% CI: - 4.3 to - 2.2, P < 0.001). A seasonality was observed across the 14 years, and the seasonal peaks were in January and March every year. The best SARIMA model was (0, 1, 1) X (0, 1, 1)12 which can be written as (1-B) (1-B12) Xt = (1-0.42349B) (1-0.43338B12) εt, with a minimum AIC (880.5) and SBC (886.4). The predicted value and the original incidence data of 2017 were well matched. The MSE, RMSE, MAE, and MAPE of the modelling performance were 201.76, 14.2, 8.4 and 0.06, respectively. The provinces with a high incidence were located in the northwest (Xinjiang, Tibet) and south (Guangxi, Guizhou, Hainan) of China. The hotspot of TB transmission was mainly located at southern region of China from 2004 to 2008, including Hainan, Guangxi, Guizhou, and Chongqing, which disappeared in the later years. The autoregressive component had a leading role in the incidence of TB which accounted for 81.5-84.5% of the patients on average. The endemic component was about twice as large in the western provinces as the average while the spatial-temporal component was less important there. Most of the high incidences (> 70 cases per 100,000) were influenced by the autoregressive component for the past 14 years. CONCLUSION: In a word, China still has a high TB incidence. However, the incidence rate of TB was significantly decreasing from 2004 to 2017 in China. Seasonal peaks were in January and March every year. Obvious geographical clusters were observed in Tibet and Xinjiang Province. The relative importance component of TB driving transmission was distinguished from the multivariate time series model. For every provinces over the past 14 years, the autoregressive component played a leading role in the incidence of TB which need us to enhance the early protective implementation. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/32843011/Spatiotemporal_characteristics_and_the_epidemiology_of_tuberculosis_in_China_from_2004_to_2017_by_the_nationwide_surveillance_system_ L2 - https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09331-y DB - PRIME DP - Unbound Medicine ER -