| Objectives:To understand the distribution characteristics and changing trend of tuberculosis in Xishuangbanna from 2009 to 2018.Using GIS to explore the spatial and temporal distribution characteristics and visual display of tuberculosis patients in each township of Xishuangbanna.To find out the cold/hot spots of tuberculosis in this region,and further explore the correlation between the spatial and temporal distribution characteristics of tuberculosis and the local climate factors.It provides a scientific theoretical basis for identifying key tuberculosis prevention areas,making tuberculosis control plans and evaluating the control effects.Methods:The basic information of tuberculosis patients registered in Xishuangbanna from 2009 to 2018 were collected from the tuberculosis epidemic network report system.Demography data of Xishuangbanna were collected from Health Commission and health statistical yearbook.Meteorological data including mean temperature,extreme maximum temperature,extreme minimum temperature and total sunshine hours were collected from Xishuangbanna Meteorological Bureau.(1)Using descriptive epidemiology to describe the characteristics of tuberculosis patients in three distribution.(2)The seasonal distribution of tuberculosis was explored by using the circular distribution method to calculate the peak days and peaks of the incidence of tuberculosis.(3)Moran’s I value was calculated and Moran’s scatter plot was drawn to verify whether the incidence of tuberculosis had global spatial autocorrelation in each study area.(4)The Getis-Ord General G statistic was calculated to measure the degree of clustering of high or low values in areas with pulmonary tuberculosis.(5)By calculating Anselin’s Local Moran’s 1 statistics for Local spatial autocorrelation analysis,the study area was divided into four clustering types.Getis-Ord Gi*can detect hot and cold spots of incidence of tuberculosis.(6)Nonparametric Spearman correlation analysis was used to find out the meteorological factors related to the incidence of tuberculosis.Results:(1)From 2009 to 2018,Xishuangbanna has reported 8304 cases of TB,and the incidence increased from 46.69/100,000 in 2009 to 141.07/100,000 in 2018,with an average reported incidence of 85.40/100,000 in 10 years.Jinghong reported the most tuberculosis cases with 4,184 cases(50.39%),while Menghai reported the least tuberculosis cases with 1,984 cases(23.89%).The highest incidence was in Jinghong,with an average of 101.41/100,000,while the lowest was in Menghai,with an average of 60.95/100,000.(2)The number of cases of tuberculosis has been reported throughout the year.The cases showed a double peak distribution,fewer cases were reported from January to February,a peak appeared from May to June,a gradual decline from July to October,and a small peak appeared from November to December.(3)According to the analysis of circular distribution method,the incidence time of the number of tuberculosis cases in Xishuangbanna showed a central trend from 2009 to 2018(r=0.0707,Z=41.4823,P<0.05).The peak day of tuberculosis was calculated as July 27,and the epidemic peak was from March 16 to December 8.(4)The incidence of tuberculosis in males(115.33/100,000)was higher than that in females(55.40/100,000).There are more cases in people between 30 and 60 years old(48.54%),and elderly people had the highest incidence(133.22/100,000).The incidence rate of ethnic minorities(75.22/100,000)was lower than that of Han(120.63/100,000).Among ethnic minorities,the Hani ethnic was reported the most cases(2352 cases,28.32%),followed by the Dai ethnic(1397 cases,16.82%).Farmers accounted for the largest proportion of TB patients(65.86%).(5)Global autocorrelation analysis showed that Moran’s I index ranged from-0.096 to 0.213 from 2009 to 2018,and there was statistical significance in 2015(P=0.021<0.05),but no statistical significance in other years(P>0.05).It is suggested that the incidence of tuberculosis in Xishuangbanna in 2015 has a positive spatial correlation and with spatial clustering characteristics,while the other years have a random distribution and without spatial clustering characteristics.(6)High/low clustering analysis showed that the values of General G were statistically significant in 2012(P=0.017<0.05)and 2015(P=0.006<0.05).It is suggested that the incidence of tuberculosis in Xishuangbanna in 2012 and 2015 was positively correlated in the 32 areas,showing a high value aggregation,and the other years showed a random distribution.(7)Local spatial analysis found that the hot spots from 2009 to 2012 were concentrated in Guanlei of Mengla,Jinuo,Menghan and Mengyang of Jinghong.From 2013 to 2016,it mainly focuses on Jinuo,Menghan,Mengyang and Gasa in Jinghong.In 2017 and 2018,there are no hot spots.From 2009 to 2015,the cold spots were mainly concentrated in Menghun,Menghai,Mengman and Dalluo of Menghai,while there was no cold spots from 2016 to 2018.(8)Non-parameter Spearman correlation analysis showed that there was no correlation between the incidence of tuberculosis and average temperature,extreme maximum temperature,extreme minimum temperature and total sunshine hours in Jinhong(P>0.05).There was a negative correlation between tuberculosis incidence and average temperature in Menghai and Mengla(rs<0,P<0.05),but no correlation with extreme maximum temperature,extreme minimum temperature and total sunshine hours(P>0.05).Conclusions:(1)From 2009 to 2018,the incidence of tuberculosis in Xishuangbanna showed an overall upward trend.The number of tuberculosis cases showed seasonal fluctuations,and the incidence showed a double peak distribution.Jinghong has the highest number of TB cases and the highest incidence of TB.(2)The incidence of pulmonary tuberculosis in Xishuangbanna is high in males,mostly in young and middle-aged patients,mostly in the elderly,and in farmers.Although the incidence rate of Han is higher than that of ethnic minorities,the number of cases reported by ethnic minorities is more than that of Han,and the number of cases by Hani ethnic is the largest.(3)In 2015,the incidence of tuberculosis in Xishuangbanna showed spatial clustering characteristics,and the other years showed random distribution.In 2012 and 2015,the incidence of tuberculosis in Xishuangbanna showed a high value of aggregation,while the other years showed a random distribution.(4)From 2009 to 2016,the hot spots of tuberculosis in Xishuangbanna were mainly concentrated in Guanlei of Mengla,Jinuo,Menghan and Mengyang of Jinghong.From 2009 to 2015,the cold spots of tuberculosis in Xishuangbanna were mainly concentrated in Menghun,Menghai,Mengman and Dalluo of Menghai.There would be no hot spots in 2017 and 2018,and no cold spots in 2016 to 2018.(5)The incidence of tuberculosis in Menghai and Mengla was negatively correlated with the average temperature,that is,the incidence of tuberculosis decreased with the increase of the average temperature.(6)In recent years,the health management of tuberculosis patients in Xishuangbanna has been standardized.In the future,the prevention and control work should be carried out according to specific conditions and focus on the classified prevention and treatment. |
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