Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 17;24(1):209.
doi: 10.1186/s12889-024-17644-5.

Spatial spillover effect of environmental factors on the tuberculosis occurrence among the elderly: a surveillance analysis for nearly a dozen years in eastern China

Dan Luo #  1 , Luyu Wang #  2 , Mengdie Zhang  3 , Leonardo Martinez  4 , Songhua Chen  5 , Yu Zhang  5 , Wei Wang  5 , Qian Wu  5 , Yonghao Wu  6 , Kui Liu  7   8 , Bo Xie  9 , Bin Chen  10
Affiliations

Spatial spillover effect of environmental factors on the tuberculosis occurrence among the elderly: a surveillance analysis for nearly a dozen years in eastern China

Dan Luo et al. BMC Public Health. .

Abstract

Background: In many areas of China, over 30% of tuberculosis cases occur among the elderly. We aimed to investigate the spatial distribution and environmental factors that predicted the occurence of tuberculosis in this group.

Methods: Data were collected on notified pulmonary tuberculosis (PTB) cases aged ≥ 65 years in Zhejiang Province from 2010 to 2021. We performed spatial autocorrelation and spatial-temporal scan statistics to determine the clusters of epidemics. Spatial Durbin Model (SDM) analysis was used to identify significant environmental factors and their spatial spillover effects.

Results: 77,405 cases of PTB among the elderly were notified, showing a decreasing trend in the notification rate. Spatial-temporal analysis showed clustering of epidemics in the western area of Zhejiang Province. The results of the SDM indicated that a one-unit increase in PM2.5 led to a 0.396% increase in the local notification rate. The annual mean temperature and precipitation had direct effects and spatial spillover effects on the rate, while complexity of the shape of the greenspace (SHAPE_AM) and SO2 had negative spatial spillover effects.

Conclusion: Targeted interventions among the elderly in Western Zhejiang may be more efficient than broad, province-wide interventions. Low annual mean temperature and high annual mean precipitation in local and neighboring areas tend to have higher PTB onset among the elderly.

Keywords: Environmental exposure; Pulmonary tuberculosis; Spatial Durbin Model; Spatial-temporal analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Location of the Zhejiang Province in China
Fig. 2
Fig. 2
General epidemiological characteristics of PTB among the elderly in Zhejiang Province, 2010–2021. Notes: (A) Number of cases by sex each year; (B) The monthly fluctuation of PTB cases; (C) Changes in notification rate in 11 cities; (D) Proportion of pathogenic results per year
Fig. 3
Fig. 3
Local spatial autocorrelation of notification rate of PTB among the elderly population in Zhejiang, 2010–2021
Fig. 4
Fig. 4
Spatial–temporal clustering results of PTB among elderly people in Zhejiang Province, 2010–2021
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Global Tuberculosis Report. 2023. Geneva: World Health Organization [https://www.who.int/publications/i/item/9789240083851].
    1. Yew WW, Yoshiyama T, Leung CC, Chan DP. Epidemiological, clinical and mechanistic perspectives of tuberculosis in older people. Respirology. 2018;23(6):567–75. doi: 10.1111/resp.13303. - DOI - PubMed
    1. Hochberg NS, Horsburgh CR., Jr Prevention of Tuberculosis in older adults in the United States: obstacles and opportunities. Clin Infect Dis. 2013;56(9):1240–7. doi: 10.1093/cid/cit027. - DOI - PMC - PubMed
    1. Huynh GH, Klein DJ, Chin DP, Wagner BG, Eckhoff PA, Liu R, Wang L. Tuberculosis control strategies to reach the 2035 global targets in China: the role of changing demographics and reactivation disease. BMC Med. 2015;13:88. doi: 10.1186/s12916-015-0341-4. - DOI - PMC - PubMed
    1. Davis JL, Checkley W. Characterization of Air Pollution exposures as Risk factors for tuberculosis infection. Am J Respir Crit Care Med. 2021;204(10):1130–1. doi: 10.1164/rccm.202107-1795ED. - DOI - PMC - PubMed

Publication types