ORIGINAL RESEARCH article

Front. Public Health

Sec. Infectious Diseases: Epidemiology and Prevention

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1599274

This article is part of the Research TopicGeographic Epidemiology of Microbial Diseases: New Insights and ConsiderationsView all articles

Spatiotemporal Analysis of Pulmonary Tuberculosis in the Central Region of the Zhejiang Province, China (2016-2024)

Provisionally accepted
Kaixuan  ZhangKaixuan Zhang1Zuokai  YangZuokai Yang1Jiamei  SunJiamei Sun1Kui  LiuKui Liu2*Qiaolin  LuQiaolin Lu1*
  • 1Shaoxing Center for Disease Control and Prevention, Shaoxing, China
  • 2Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, Zhejiang Province, China

The final, formatted version of the article will be published soon.

In recent years, Shaoxing City, located in central Zhejiang Province, has experienced a slow decline in the incidence of pulmonary tuberculosis (PTB). Therefore, there is an urgent need to elucidate the potential causes for this decline through spatiotemporal analyses to provide a scientific basis for targeted prevention and control. We aimed to explore the spatiotemporal distribution of PTB notification rates in Shaoxing City from 2016 to 2024 and identify high-incidence clusters, thereby offering data-driven insights to optimize regional PTB control strategies. Methods: Statistical analyses were conducted using R and Excel on all reported active PTB cases in Shaoxing City. Spatiotemporal analysis of case distribution and regional clustering was conducted using ArcGIS and SatScan. Results and Discussion: In total, 17,298 active PTB cases were registered between 2016 and 2024, including 9,749 laboratoryconfirmed and 7,549 clinically diagnosed cases. The male-to-female ratio was 2.34:1. Farmers represented 68.2% of all cases. The PTB notification incidence showed a gradual decline. Spatial autocorrelation results revealed 52 sub-districts with high-high clusters over the nine-year period, primarily in Shengzhou and Xinchang counties. Spatiotemporal scan analysis identified one primary cluster area (RR = 1.62, LLR = 170.87, P < 0.001) and two secondary clusters between 2016-2024. The incidence of PTB in Shaoxing City showed a downward trend, though the decline was relatively slow. The southeastern region should be prioritized in efforts to accelerate the End TB initiative. Overall, comprehensive and intensive interventions, such as large-scale chest X-ray screening and health education programs, should be enhanced to effectively curb PTB transmission, especially among males and farmers.

Keywords: pulmonary tuberculosis, Mycobacterium tuberculosis, Epidemiological characteristics, spatial autocorrelation, spatiotemporal clustering

Received: 24 Mar 2025; Accepted: 29 May 2025.

Copyright: © 2025 Zhang, Yang, Sun, Liu and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Kui Liu, Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, Zhejiang Province, China
Qiaolin Lu, Shaoxing Center for Disease Control and Prevention, Shaoxing, China

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