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Spatial epidemiology and risk factors of pulmonary tuberculosis morbidity in Wenchuan earthquake‐stricken area
Author(s) -
Zhou Hailong,
Yang Xiaoyan,
Zhao Sheng,
Pan Xiaoping,
Xu Junhong
Publication year - 2016
Publication title -
journal of evidence‐based medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.885
H-Index - 22
ISSN - 1756-5391
DOI - 10.1111/jebm.12196
Subject(s) - incidence (geometry) , tuberculosis , medicine , environmental health , population , epidemiology , demography , socioeconomic status , pulmonary tuberculosis , geography , pathology , sociology , optics , physics
Objective China is a country that experiences frequent earthquakes and has a high pulmonary tuberculosis burden. In this study, we aimed to explore the spatial clustering and risk factors of the reported incidence of pulmonary tuberculosis burden before and after the Wenchuan earthquake. Methods Data on the location and the demographic, socioeconomic, and health service characteristics of the 181 counties of Sichuan province from 2004 to 2012 were collected. Global and local spatial autocorrelation analyses were performed to explore spatial clustering. The associated factors were screened using stepwise multiple linear regression, and a spatial lag model was fitted to explore the influence factors. Results The incidence of pulmonary tuberculosis burden showed a global and local spatial autocorrelation relationship. The high‐incidence counties shifted gradually over time from east to west and finally clustered in the “Aba‐Ganzi” region. Factors influencing the incidence of pulmonary tuberculosis burden included minority areas, the proportion of the working population, county latitude, and the severity of the earthquake. The influence factors varied over time; the impact of minority regions, occupation, and health resources allocation weakened, whereas the economic development and mobility of the population became more significant. Conclusion The spatial structural relationship is an important factor related to pulmonary tuberculosis burden incidence. More attention should be paid to high‐incidence areas and populations susceptible to pulmonary tuberculosis burden.