Abstract:

Objective: To analyze the spatiotemporal of pulmonary tuberculosis (PTB) in the Xizang Autonomous Region (Xizang) and provide references for formulating PTB prevention and control policies. Methods: The cases of PTB with onset dates between January 1, 2010 and December 31, 2022, and current residence in Xizang were extracted from “Infectious Disease Surveillance System of the National Health Security Information Project-Disease Prevention and Control Information System”. Joinpoint regression was used to analyze the time trend of the incidence rate of PTB, and the annual percentage change (APC) was used to evaluate the change trend. Global autocorrelation and spatiotemporal scan statistic were used to analyze the overall and space-time clusters of PTB in Xizang. The log likelihood ratio (LLR) was used to evaluate the risk within the clustered area relative to outside the area. Results: A total of 60391 PTB cases were reported in Xizang from 2010 to 2022, with an average reported incidence rate of 141.97 per 100000 population. The reported incidence rate increased from 118.34 per 100000 population in 2010 to 182.38 per 100000 population in 2019 (APC=4.56%, 95%CI: 2.98%-6.18%), and then decreased to 95.96 per 100000 population in 2022 (APC=-16.50%, 95%CI: -23.22--9.20%). The increase in female incidence rate from 2010 to 2020 (APC=5.45%, 95%CI: 3.93%-6.99%) was higher than that in male incidence from 2010 to 2019 (APC=3.32%, 95%CI: 2.27%-4.38%). Spatiotemporal scan statistic analysis revealed that the most likely cluster area was identified in Changdu City (LLR=2105.41, P<0.001), with a clustering period from January 2016 to June 2022. The secondary cluster area was mainly identified in the eastern part of Naqu City (LLR=434.55, P<0.001) with its clustering period spawning from January 2018 to April 2022. Conclusion: The reported incidence rate of PTB in Xizang from 2010 to 2022 exhibited a trend of initial increase followed by a subsequent decline. The PTB incidence showed significant spatiotemporal aggregation, particularly clustered in Changdu and eastern Nagqu. Future efforts should prioritize strengthening health education and enhancing screening measures for populations in these high-risk regions.

Key words: Tuberculosis, pulmonary, Space-time clustering, Incidence, Xizang autonomous region