| [Objectives]To compare the geographic distribution changes between initial implementation (2005) of TB control strategy in Yunnan (DOTS) and after 10 years of the implementation (2014); to analysis influencing factors of geographical features of TB cases in Yunnan, to compare changes of spatial aggregation of TB cases in Yunnan; to determine the important areas of tuberculosis prevention and cure in Yunnan, to provide technical basis for developing control strategies in the province.[Methods]1. Using GIS as a technical support, Cross-sectional study was used. The case information of registration and reporting in Yunnan from 2005 to 2014 were collected by using infectious disease reporting information management system, according to different zoning methods (Administrative areas, per capita GDP areas).2.described TB incidence in Yunnan from 2005 to 2014, to observe parallel coordinate plot line relationship trends and judge relevance with population density, altitude and per capita GDP as the analysis data parallel coordinates, then obtained the slope and correlation coefficient by using the scatter diagram, finally analyzed TB influencing factors by using spatial regression analysis method.3. Analyzed global spatial autocorrelation was done on dataset of registration rate of active pulmonary tuberculosis and registration rate of smear positive pulmonary tuberculosis between 2005 and 2014 in Yunnan was analyzed with methods of spatial autocorrelation,analyzed global spatial autocorrelation was done on dataset of registration rate of active TB cases between 2005 and 2014 in Yunnan with local spatial autocorrelation, using Moran’s I index to judge aggregation. Gathering areas in different years were explored with Lisa local clustering map.[Results]1.The incidence area of active tuberculosis was widely distributed in yunnan province,The discrepancy of active TB incidence between the region is more and more larger, the high incidence area showed a higher incidence now.2. Infectious tuberculosis disease characterized by downward trend,the incidence of Yuxi district showed the largest decline, fell 49.5%, the smear-positive pulmonary tuberculosis incidence decline in more than 30%, clustering is not increased.3. The state of the economy (GDP per capita) is one of the important factors affect tuberculosis incidence in yunnan province, population density and altitude are not influencing factors of tuberculosis incidence in yunnan province. GDP per capita was correlated with the onset of pulmonary tuberculosis, correlation coefficient 0.3470.4.The areas with better economic conditions showed a lower incidence of both active tuberculosis and Smear positive tuberculosis, whereas the incidence of the poor economic situation in the region is higher.5. The key counties for prevention in Yunnan in the future will be Fugong county in western Yunnan, Weixin county and Yiliang county in northeastern Yunnan and the surrounding areas of these regions.[Conclusions]1. TB spatial distribution was balanced, with TB attacking every areas in our province and there was aggregation in global scope. TB incidence showed an aggregation distribution in Yunnan, TB cases got stronger through governance often years.2. The influencing factor was per capita GDP, TB had no correlation with altitude, population density; the influence of social environmental factors for TB was higher than the influence of natural environment factors.3. The areas with a high TB incidence mainly locates in the border areas of our province, especially west of Yunnan and northeast of Yunnan. The possibly because of these areas were influenced from outside, the superposition of its social environment, economic status, health resources allocation etc.4. The key counties for prevention in Yunnan in the future were Nujiang in western Yunnan, Weixin county and Yiliang county in northeastern Yunnan, and the surrounding areas of those areas. |
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