Analysis of spatial heterogeneity and risk factors of tuberculosis in schools in Xuhui District, Shanghai from 2011 to 2024

doi:10.19983/j.issn.2096-8493.20250117

Abstract

Abstract:

Objective: To determine the high-risk hotspots and spatial risk factors of pulmonary tuberculosis (PTB) incidence in schools in Xuhui District of Shanghai, to provide scientific evidence for implementing regional and location-based precise prevention and control, rationally allocating health resources, and improving the PTB prevention and control strategy in schools. Methods: To collect data regarding the reported incidence of schools in Xuhui District of Shanghai from 2011 to 2024 from the “Tuberculosis Surveillance Report Information Management System”, a subsystem of the “China Disease Prevention and Control Information System”, and combine it with the real-time school PTB data registered by staff of Xuhui District Center for Disease Control and Prevention from 2018 to 2024. We adopted spatial auto-correlation and kernel density analysis and Bayesian methods to analyze the epidemiological characteristics of school PTB incidence in Xuhui District, and to depict hot spots of PTB incidence, as well as spatial distributions. Results: A total of 344 PTB cases were reported in Xuhui District from 2011 to 2024, aged mainly 16-26 years old. The annural average reported incidence rate was 13.43 per 100000. 88.95% (306/344) were college students, 37.50% (129/344) had patient delay. Kernel density and local spatial autocorrelation analysis found that Lingyun, Fenglin, Kangjian, and Changqiao Streets were high-incidence areas of tuberculosis. The number of reported cases were 107 cases (31.10%, 107/344), 61 cases (17.73%, 61/344), 38 cases (11.05%, 38/344), and 23 cases (6.69%, 23/344) respectively. The hot-spot areas of incidence were the southwestern part of Xuhui District (Lingyun, Changqiao, and Kangjian Streets, with annual average incidence rates of 31.79 per 100000, 31.51 per 100000, and 30.45 per 100000, respectively), and no cold-spot areas were detected. The density of population of college students (OR=1.357, 95%CI:1.179-1.538) was risk factor for the incidence of PTB in schools in Xuhui District. Conclusion: There is spatial heterogeneity in the incidence of PTB in schools in Xuhui District. The areas with a high incidence of PTB are Lingyun, Fenglin, Kangjian, and Changqiao Streets, and the hotspots are mainly distributed in Lingyun, Changqiao and Huajing Streets. The density of population of college students is spatial influencing factors of PTB incidence in schools.

Key words: Students, Tuberculosis, pulmonary/prevention and control, Factor analysis, statistical, Small-area analysis

CLC Number:

R521
R183.3

Su Qing, Zhang Sainan, Zhan He, Cai Xiaofeng, Zhang Shuang, Zhang Boshu, Yang Meixia. Analysis of spatial heterogeneity and risk factors of tuberculosis in schools in Xuhui District, Shanghai from 2011 to 2024[J]. Journal of Tuberculosis and Lung Disease , 2026, 7(2): 162-170. doi: 10.19983/j.issn.2096-8493.20250117

Figures/Tables 9

References 30

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街道/镇	小学	中学	大学	特殊学校
漕河泾街道	4	6	0	0
枫林路街道	3	5	1	1
虹梅路街道	2	0	0	0
湖南路街道	3	3	1	0
华泾镇	4	6	0	0
康健新村街道	7	6	2	1
凌云路街道	3	2	2	0
龙华街道	3	4	1	0
天平路街道	7	5	1	0
田林街道	6	6	2	0
斜土路街道	4	2	0	0
徐家汇街道	6	8	3	0
长桥街道	9	8	0	1
合计	61	61	13	3

特征	患者例数(构成比,%)	特征	患者例数(构成比,%)
性别		培训机构	20(5.80)
男性	177(51.45)	病原学结果^a
女性	167(48.55)	阳性	164(47.67)
职业		阴性	144(41.86)
学生	306(88.95)	无病原学结果	36(10.47)
教职工	38(11.05)	街道
学校类型		漕河泾街道	9(2.62)
大学院校	240(69.77)	枫林路街道	38(11.05)
高中/中职	53(15.41)	虹梅路街道	1(0.29)
初中学校	10(2.91)	湖南路街道	8(2.33)
小学学校	12(3.49)	华泾镇	9(2.62)
幼托机构	9(2.62)	康健新村街道	61(17.73)
凌云路街道	107(31.10)	就诊延迟(d)
龙华街道	22(6.40)	0~14	202(62.50)
天平路街道	16(4.65)	15~29	55(15.99)
田林街道	16(4.65)	30~44	32(9.30)
斜土路街道	4(1.16)	45~59	14(4.07)
徐家汇街道	30(8.72)	≥60	28(8.14)
长桥街道	23(6.69)	合计	344(100.00)

年份	Moran’s I值	方差	Z值	P值
2011—2014	0.188	0.016	2.080	0.037
2015—2019	0.149	0.006	2.844	0.004
2020—2024	0.405	0.029	3.014	0.003

空间因素	OR值	P值	95%CI值
大学生人口密度(人/km²)
<466.43	1.000
466.43~1211.63	1.106	0.067	0.900~1.385
>1211.63	1.357	0.028	1.179~1.538
中学生人口密度(人/km²)
<570.42	1.000
570.42~1590.70	1.226	1.138	0.981~1.404
>1590.70	1.143	0.816	0.901~1.265
小学生人口密度(人/km²)
<488.09	1.000
488.09~881.47	0.881	0.557	0.627~1.102
>881.47	0.926	0.991	0.706~1.211