Spatial clustering of drug-resistant tuberculosis in Hunan province, China: An ecological study
Objective: This study aimed to investigate the spatial distribution of drug-resistant tuberculosis (DR-TB) in Hunan province, China. Methods: An ecological study was conducted using DR-TB data collected from the Tuberculosis Control Institute of Hunan Province between 2012 and 2018. Spatial clus...
| Main Authors: | , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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BMJ PUBLISHING GROUP
2021
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| Subjects: | |
| Online Access: | http://hdl.handle.net/20.500.11937/86475 |
| _version_ | 1848764832794279936 |
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| author | Alene, Kefyalew Xu, Z. Bai, L. Yi, H. Tan, Y. Gray, D. Viney, K. Clements, A.C.A. |
| author_facet | Alene, Kefyalew Xu, Z. Bai, L. Yi, H. Tan, Y. Gray, D. Viney, K. Clements, A.C.A. |
| author_sort | Alene, Kefyalew |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: This study aimed to investigate the spatial distribution of drug-resistant tuberculosis (DR-TB) in Hunan province, China.
Methods: An ecological study was conducted using DR-TB data collected from the Tuberculosis Control Institute of Hunan Province between 2012 and 2018. Spatial clustering of DR-TB was explored using the Getis-Ord statistic. A Poisson regression model was fitted with a conditional autoregressive prior structure, and with posterior parameters estimated using a Bayesian Markov chain Monte Carlo simulation, to quantify associations with possible risk factors and identify clusters of high DR-TB risk.
Results: A total of 2649 DR-TB patients were reported to Hunan TB Control Institute between 2012 and 2018. The majority of the patients were male (74.8%, n=1983) and had a history of TB treatment (88.53%, n=2345). The proportion of extensively DR-TB among all DR-TB was 3.3% (95% CI 2.7% to 4.1%), which increased from 2.8% in 2012 to 4.4% in 2018. Of 1287 DR-TB patients with registered treatment outcomes, 434 (33.8%) were cured, 198 (15.3%) completed treatment, 92 (7.1%) died, 108 (8.3%) had treatment failure and 455 (35.3%) were lost to follow-up. Half (50.9%, n=655) had poor treatment outcomes. The annual cumulative incidence rate of notified DR-TB increased over time from 0.25 per 100 000 people in 2012 to 0.83 per 100 000 people in 2018. Substantial spatial heterogeneity was observed, and hotspots were detected in counties located in the North and East parts of Hunan province. The cumulative incidence of notified DR-TB was significantly associated with urban communities.
Conclusion: The annual incidence of notified DR-TB increased over time in Hunan province. Spatial clustering of DR-TB was detected and significantly associated with urbanisation. This finding suggests that targeting interventions to the highest risk areas and population groups would be effective in reducing the burden and ongoing transmission of DR-TB. |
| first_indexed | 2025-11-14T11:25:38Z |
| format | Journal Article |
| id | curtin-20.500.11937-86475 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:25:38Z |
| publishDate | 2021 |
| publisher | BMJ PUBLISHING GROUP |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-864752021-11-25T05:14:57Z Spatial clustering of drug-resistant tuberculosis in Hunan province, China: An ecological study Alene, Kefyalew Xu, Z. Bai, L. Yi, H. Tan, Y. Gray, D. Viney, K. Clements, A.C.A. Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine public health epidemiology tuberculosis Objective: This study aimed to investigate the spatial distribution of drug-resistant tuberculosis (DR-TB) in Hunan province, China. Methods: An ecological study was conducted using DR-TB data collected from the Tuberculosis Control Institute of Hunan Province between 2012 and 2018. Spatial clustering of DR-TB was explored using the Getis-Ord statistic. A Poisson regression model was fitted with a conditional autoregressive prior structure, and with posterior parameters estimated using a Bayesian Markov chain Monte Carlo simulation, to quantify associations with possible risk factors and identify clusters of high DR-TB risk. Results: A total of 2649 DR-TB patients were reported to Hunan TB Control Institute between 2012 and 2018. The majority of the patients were male (74.8%, n=1983) and had a history of TB treatment (88.53%, n=2345). The proportion of extensively DR-TB among all DR-TB was 3.3% (95% CI 2.7% to 4.1%), which increased from 2.8% in 2012 to 4.4% in 2018. Of 1287 DR-TB patients with registered treatment outcomes, 434 (33.8%) were cured, 198 (15.3%) completed treatment, 92 (7.1%) died, 108 (8.3%) had treatment failure and 455 (35.3%) were lost to follow-up. Half (50.9%, n=655) had poor treatment outcomes. The annual cumulative incidence rate of notified DR-TB increased over time from 0.25 per 100 000 people in 2012 to 0.83 per 100 000 people in 2018. Substantial spatial heterogeneity was observed, and hotspots were detected in counties located in the North and East parts of Hunan province. The cumulative incidence of notified DR-TB was significantly associated with urban communities. Conclusion: The annual incidence of notified DR-TB increased over time in Hunan province. Spatial clustering of DR-TB was detected and significantly associated with urbanisation. This finding suggests that targeting interventions to the highest risk areas and population groups would be effective in reducing the burden and ongoing transmission of DR-TB. 2021 Journal Article http://hdl.handle.net/20.500.11937/86475 10.1136/bmjopen-2020-043685 English http://creativecommons.org/licenses/by-nc/4.0/ BMJ PUBLISHING GROUP fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine public health epidemiology tuberculosis Alene, Kefyalew Xu, Z. Bai, L. Yi, H. Tan, Y. Gray, D. Viney, K. Clements, A.C.A. Spatial clustering of drug-resistant tuberculosis in Hunan province, China: An ecological study |
| title | Spatial clustering of drug-resistant tuberculosis in Hunan province, China: An ecological study |
| title_full | Spatial clustering of drug-resistant tuberculosis in Hunan province, China: An ecological study |
| title_fullStr | Spatial clustering of drug-resistant tuberculosis in Hunan province, China: An ecological study |
| title_full_unstemmed | Spatial clustering of drug-resistant tuberculosis in Hunan province, China: An ecological study |
| title_short | Spatial clustering of drug-resistant tuberculosis in Hunan province, China: An ecological study |
| title_sort | spatial clustering of drug-resistant tuberculosis in hunan province, china: an ecological study |
| topic | Science & Technology Life Sciences & Biomedicine Medicine, General & Internal General & Internal Medicine public health epidemiology tuberculosis |
| url | http://hdl.handle.net/20.500.11937/86475 |