Assessing the hotspot analysis and spatial clustering for pulmonary tuberculosis from 2019 to 2023 in Mysuru district, India

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2026-01-01 Epub Date: 2025-12-29 DOI:10.1016/j.cegh.2025.102272

Suhail Azam Khan , M.C. Manjunatha , B.S. Jayaraj , S.K. Chaya , K.S. Lokesh , Mohammad Shiraz Ahmed , P.A. Mahesh

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引用次数: 0

Abstract

Background

Pulmonary Tuberculosis (PTB) remains a major cause of morbidity in India despite progress in TB elimination, accounting for roughly 25 % of global TB cases. Ongoing spatial and demographic disparities hinder further reduction. The study aims to assess PTB syndemic profiles, spatial distribution, and persistent hotspots in a high-burden Indian district from 2019 to 2023 using geospatial analytics to inform precision public health policies.

Methods

A retrospective cross-section analysis of 10,201 PTB cases in Mysuru district used ArcGIS and Google Earth Pro to examine point density by age, gender, HIV status, and diabetes. Spatial autocorrelation (Moran's I, Getis-Ord Gi∗) identified hotspot clusters, while chi-square tests evaluated demographics and comorbidity trends.

Results

Between 2019 and 2023, PTB cases declined by 7.7 % (from 2245 to 2029). Cases among individuals aged 0–18 and 19–44 fell by 22 % and 22.3 %, respectively. Both male and female cases dropped by about 9.5 %, while diabetes cases rose by 10 % and non-diabetes cases fell by 6.5 %. HIV-positive cases declined by 52.6 %. A Moran's Index of 0.381799, z-score of 31.45, and p-value <0.001 indicate strong, statistically significant spatial clustering.

Conclusion

Despite the overall decline in disease burden, persistent urban PTB clusters continue to affect the elderly and individuals with diabetes. While TB-HIV comorbidity has significantly decreased, the enduring Diabetes-TB overlap highlights the need for integrated, geospatially targeted interventions and continuous GIS-based surveillance to address high-risk clusters and advance TB elimination in urban areas.

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2019 - 2023年印度迈苏尔地区肺结核热点分析及空间聚类分析

背景：尽管在消除结核病方面取得了进展，但肺结核仍然是印度发病的主要原因，约占全球结核病病例的25%。目前的空间和人口差距阻碍了进一步减少。该研究旨在利用地理空间分析，评估2019年至2023年印度高负担地区肺结核的症状概况、空间分布和持续热点，为精确的公共卫生政策提供信息。方法采用ArcGIS和谷歌Earth Pro软件对Mysuru地区10201例PTB病例进行回顾性横断面分析，按年龄、性别、HIV感染状况和糖尿病进行点密度分析。空间自相关（Moran's I, Getis-Ord Gi *）确定了热点集群，而卡方检验评估了人口统计学和合并症趋势。结果2019 - 2023年，肺结核病例下降7.7%（从2245例下降到2029例）。0-18岁和19-44岁的病例分别下降了22%和22.3%。男性和女性病例均下降了约9.5%，而糖尿病病例上升了10%，非糖尿病病例下降了6.5%。艾滋病毒阳性病例下降了52.6%。Moran's Index为0.381799，z-score为31.45，p值<；0.001表明空间聚类性很强，具有统计学意义。结论尽管疾病负担总体下降，但持续存在的城市肺结核集群继续影响老年人和糖尿病患者。虽然结核病-艾滋病毒合并症已显著减少，但长期存在的糖尿病-结核病重叠突出表明，需要采取综合的、有地理空间针对性的干预措施和基于地理信息系统的持续监测，以解决高风险群集问题，并推动城市地区消除结核病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.