Effect Of Meteorological Factors On The Incidence Of Pulmonary Tuberculosis In A County And City Located In Southern Xinjiang

Objective: Analyze the prevalence trends and epidemiological characteristics of pulmonary tuberculosis(PTB)in Bachu County and Hotan City,southern Xinjiang from2015-2019,and assess the impact of meteorological factors,extreme weather processes and weather events on the risk of TB incidence in different populations.To provide scientific recommendations and methodological basis for the adoption of reasonable and effective PTB prevention and control programs based on local conditions.Methods: Based on the daily reported numbers of PTB in Bachu County and Hotan City from January 1,2015 to December 31,2019,as well as meteorological data on temperature,relative humidity,wind speed,atmospheric pressure,rain and snow during the same period,the M-K test and Joinpoint regression model were used to analyze the trend characteristics of PTB incidence.The seasonal characteristics and peak incidence of PTB were explored based on the seasonal index method and circular distribution method;the effect of meteorological factors on the risk of PTB was analyzed by constructing a set of distribution lag nonlinear models and stratified by gender and age;the exposure-lag-effect of extreme weather processes and weather events on PTB incidence was assessed by specifying a set of generalized summation models;the incidence time series were divided into training and testing groups,ARIMA,ARIMAX,Prophet,and Holt-Winters time series prediction models were constructed based on the training data,and the prediction performance of the above time series models was compared using the prediction data as the criterion.Results: 1.The male population composition was higher and trended upward year by year in both areas,with males having the highest rate of increase during the study period.2.The number of reported PTB cases in both areas had a partially rapid upward phase during 2016-2018 due to large-scale TB screening,followed by a rapid fall back.3.The high incidence season is October,November and December each year in Bachu County,with October 12-13 presumed to be the peak of disease.June,August and November are the high incidence months in Hotan,and the peak incidence is presumed to be around June 9-10.4.In Bachu the low temperature(-11.30°C,lag=11d,RR=1.17,95%CI: 1.10-1.24),long lag of high temperature(26.10°C,lag=21d,RR=1.06,95%CI: 1.01-1.12),low relative humidity(6.16%,lag=21d,RR=1.11,95%CI:1.01-1.22),high relative humidity short lag(84.55%,lag=0d,RR=1.39,95%CI: 1.29-1.50),low wind speed(0.5 m/s,lag=7d,RR=1.06,95%CI: 1.01-1.11),high atmospheric pressure conditions(914.7 Kpa,lag=11d,RR=1.91,95%CI: 1.11-2.59).in Hotan,low temperature(-8.80°C,lag=3d,RR=1.12,95%CI: 1.05-1.20),low relative humidity long lag(15.5%,lag=21d,RR=30,95% CI: 1.19-1.43),high relative humidity(82.00%,lag=11d,RR=1.20,95% CI: 1.15-1.25),low wind speed(1.9 m/s,lag=15d,RR=1.04,95% CI: 1.01-1.07),low atmospheric pressure long lag(814.7 Kpa,lag= 21 d,RR=1.27,95% CI: 1.14-1.42)all contribute to the incidence of PTB.5.Subgroup analysis showed that in Bachu County the male,elderly subgroup was more sensitive to low temperature,low relative humidity,and low wind speed;the female,non-elderly subgroup was more sensitive to high relative humidity;and the male,non-elderly subgroup was more sensitive to high pressure conditions.In Hotan The female,elderly subgroup was more sensitive to low temperature and low wind speed;the female,non-elderly subgroup was more sensitive to high relative humidity.6.Heat wave and cold wave significantly increased the risk of PTB in Bachu County: cold wave > heat wave > minimum temperature > high temperature,and heat wave >cold wave > minimum temperature > high temperature in Hotan.Rain and snow also adversely affect PTB.7.After comparison,the ARIMAX model with meteorological factors has good predictive performance for the characteristics of tuberculosis incidence in southern Xinjiang and can be appropriately promoted.Conclusions: Special meteorological conditions and weather events have an impact on the incidence of PTB in Bachu County and Hotan City,South Xinjiang,especially low temperature,high and low relative humidity,and low wind speed showed a promoting effect in both places.When unfavorable meteorological conditions,especially heat waves and cold waves,are approaching,the ARIMAX model can be used to predict in advance,take early initiatives to prevent the disease,coordinate medical resources,etc.,and reduce the risk of PTB in high-risk groups.