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. 2016 Feb 23:5:11.
doi: 10.1186/s40249-016-0104-2.

Spatial and temporal analysis of tuberculosis in Zhejiang Province, China, 2009-2012

Erjia Ge  1 , Xin Zhang  2 , Xiaomeng Wang  3 , Xiaolin Wei  4   5
Affiliations

Spatial and temporal analysis of tuberculosis in Zhejiang Province, China, 2009-2012

Erjia Ge et al. Infect Dis Poverty. .

Abstract

Background: Tuberculosis (TB) is an infectious disease of major public health concern. The disease has demonstrated large space-time variations. This study aims to explore the space-time dynamics of TB cases in an economically and geographically dynamic province in China with specific references of TB control for policy makers.

Methods: Data on all reported TB cases from 2009 to 2012 were collected from the TB program at the Zhejiang Provincial Center for Disease Control and Prevention. We employed time series and exploratory spatial data analyses, including Moran's I, Local Getis's G i (*) , and Kulldorff's space-time scan statistics, to identify the temporal trends and spatial patterns of TB at a county level.

Results: A total of 147,941 TB cases were reported during 2009-2012 in Zhejiang. A higher proportion of TB cases were younger, male, and registered permanent residents among all TB cases notified in the province. TB cases were reported most frequently in April with small peaks in June, July, and October. This disease was spatially clustering with Moran's I values ranged from 0.29 to 0.32 (p < 0.001). A most likely cluster and ten secondary clusters were identified, mainly concentrated in the southeast and west counties of the province.

Conclusions: This study identified seasonal patterns and significant space-time clusters of TB cases in Zhejiang, China. Poverty, migration, and seasonal effects may play important roles in potential clusters.

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Figures

Fig. 1
Fig. 1
The monthly fluctuation of TB cases in Zhejiang province, China from 2009 to 2012
Fig. 2
Fig. 2
The notification rates of TB (the number of TB cases per 100,000 population) at a county level in Zhejiang province, 2009–2012
Fig. 3
Fig. 3
The spatial clusters (i.e., hot spots and cold spots) of the TB cases at the county level using the Local G i * statistic
Fig. 4
Fig. 4
The space-time clusters of TB cases at the county level in Zhejiang province, 2009–2011
See this image and copyright information in PMC

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