Epidemiological Characteristics And Spatial Aggregation Of Smear Positive Pulmonary Tuberculosis In Jilin Province During 2015～2019

Objective:Tuberculosis is a chronic respiratory infectious disease that seriously endangers human health,and smear-positive pulmonary tuberculosis patients are the main source of infection of tuberculosis.This study uses epidemiological and spatial analysis methods to explore the epidemiological characteristics and spatial aggregation of smear-positive tuberculosis in Jilin Province from 2015 to 2019,and provide a basis for formulating targeted prevention and control strategies,with a view to improving the level of public health surveillance and making it more reasonable and effective.Allocation of health resources.Methods:The data of this study comes from the tuberculosis report system of the Jilin Provincial Academy of Tuberculosis Prevention and Control.The Excel2016 software was used to summarize and organize the data of smear-positive pulmonary tuberculosis patients in Jilin Province from 2015 to 2019,and describe the epidemiological characteristics of smear-positive pulmonary tuberculosis.Arc GIS 10.2 was used to map the registration rate of smear-positive pulmonary tuberculosis in all counties and districts of Jilin Province,global spatial autocorrelation was analyzed by Global Moran’s I index,and local spatial autocorrelation was analyzed by hot spot analysis(Getis-Ord Gi*),clustering and outlier analysis(Local Moran’s I).Sa TSCAN9.6software is used for spatio-temporal scanning analysis,including pure time scanning,pure space scanning and spatiotemporal scanning,and the scanning results are visualized with Arc GIS 10.2.Results:1.From 2015 to 2019,a total of 19,834 smear-positive pulmonary tuberculosis patients were registered in Jilin Province.The average annual number of registrations was 3967,and the annual average registration rate was 14.50 per 100,000.Smearpositive pulmonary tuberculosis cases are registered and reported every month,mainly in March to June.Among them,there were 14,793 male cases and 5041 female cases,with a sex ratio of 2.93:1.The cases were mainly from the age group of 45 to 64 years old,accounting for 50.32% of all cases.Farmers are the occupation with the largest number of cases,accounting for 55.78% of all cases.The average annual registration rate of smear-positive tuberculosis varies greatly among counties and districts in Jilin Province.The counties with high registration rates are mainly located in Siping City and Jilin City.2.The results of global spatial autocorrelation analysis showed that the Moran’s I index of global autocorrelation of smear-positive pulmonary tuberculosis from 2015 to2017 was 0.2883,0.4532,and 0.4172,respectively,and the difference was statistically significant(P<0.05),indicating the registration rate of smear-positive pulmonary tuberculosis in Jilin Province There is obvious spatial aggregation.3.The hot spot analysis results show that the hot spots are mainly Lishu County,Tiedong District,Tiexi District,Hunchun City,and Fengman District;the cold spots are mainly Economic and Technological Development Zone,Jingyue High-tech Development Zone,Lvyuan District,Shuangyang District,Yongji County,Kuancheng District,Shulan City.The clustering and outlier analysis results show that the high-high agglomeration areas are Lishu County,Tiedong District,Tiexi District,Tongyu County,Hunchun City,and Tumen City;the low-low agglomeration areas are Economic and Technological Development Zone and Jingyue High-tech Development Zone,Shuangyang District,Erdao District,Jiutai District,Yushu City;high-low concentration areas are Jiaohe City and Chuanying District;low-high concentration areas are Fengman District and Shulan City.4.From the results of time scan analysis,the gathering time in 2015 is March to June,the gathering time in 2016 is March,the gathering time in 2017 is March to August,and the gathering time in 2018 is 3 In June,the gathering time in 2019 is from March to May.5.From the results of pure spatial scanning,it can be seen that the first-level gathering areas in 2015～2017 are located in Shuangliao City,Lishu County,Tiexi District,and Tiedong District;the first-level gathering areas in 2018～2019 are all located in Jiao River city.6.From the results of time-space scanning,we can see that the first-level clusters in 2015 are located in Tongyu County and Taonan City;the first-level clusters in 2016 are located in Shuangliao City,Lishu County,Tiexi District,and Tiedong District;The first-level gathering areas in 2017 are located in Lishu County,Shuangliao City,Tiedong District,Tiexi District,Yitong Manchu Autonomous County,Gongzhuling City,Dongliao County,Longshan District,and Xi’an District;the first-level gathering areas in 2018～2019 They are all located in Jiaohe City.Conclusions:1.The registration rate of smear-positive pulmonary tuberculosis in Jilin Province from 2015 to 2019 showed a fluctuating trend.2.From 2015 to 2019,the high incidence of smear-positive tuberculosis in Jilin Province was March to June.Men,middle-aged adults,and farmers will be the focus groups for future tuberculosis prevention and control work.3.The high incidence areas of smear-positive tuberculosis in Jilin Province from2015 to 2019 are located in parts of the southwest and central parts of Jilin Province.Among them,Siping City and Jilin City’s counties(districts)have more high incidence areas.These areas should be strengthened to prevent tuberculosis.