2005 - 2019年中国1992个县城市化相关因素与结核病发病率的关系:一项全国性的观察性研究

IF 5.5 1区 医学
Yaping Wang, Xiaoqiu Liu, Yuhong Li, Min Liu, Yiheng Wang, Hongliang Zhang, Jue Liu, Yanlin Zhao
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引用次数: 0

摘要

背景:大多数结核病高负担国家位于快速城市化的低收入和中等收入地区。我们的目的是评估城市化因素与中国结核病发病率之间的关系。方法:采用综合人口密度、人均国内生产总值(GDP)、每千人医院床位、夜间光照(NTL)和归一化植被指数(NDVI)的综合指数,对2005 - 2019年中国县级城镇化进行了评价。年结核病发病率和病例数来源于中国疾病预防控制中心的国家结核病信息管理系统。采用固定效应模型检验城市化因素与结核病发病率之间的关系。通过将县划分为东北、东部、中部和西部四个区域进行亚群分析。结果:本研究共纳入中国1992个县。总体而言,城市化得分与结核病发病率降低相关(β = - 0.0114, P < 0.001),对应于每单位得分的结核病发病率降低1.1%。城市化与结核病发病率呈u型关系,在52.94个城市化单位处出现拐点。在城市化各指标中,人口密度和医院床位数与结核病发病率呈正相关,其发病率比分别为11.384(95%可信区间(CI): 9.337 ~ 13.881)和1.015 (95% CI: 1.011 ~ 1.019),而GDP、NTL和NDVI具有保护作用。中部地区呈上升趋势,城市化得分与结核病发病率上升1.8%相关。结论:城市化相关因素,包括GDP、NTL和NDVI,与结核病发病率呈负相关。中部地区对比鲜明的结果凸显了地区特有的挑战。因此,发展中国家政府应采取综合措施,在城市化过程中促进经济增长和环境可持续发展,优化结核病控制工作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Association of urbanization-related factors with tuberculosis incidence among 1992 counties in China from 2005 to 2019: a nationwide observational study.

Association of urbanization-related factors with tuberculosis incidence among 1992 counties in China from 2005 to 2019: a nationwide observational study.

Association of urbanization-related factors with tuberculosis incidence among 1992 counties in China from 2005 to 2019: a nationwide observational study.

Background: Most high tuberculosis (TB) burden countries are in low- and middle-income regions undergoing rapid urbanization. We aimed to assess the association between urbanization factors and TB incidence in China.

Methods: We evaluated urbanization at the county level in China from 2005 to 2019 using a composite index integrating population density, gross domestic product (GDP, per capita), hospital beds per 1000 population, nighttime light (NTL), and normalized difference vegetation index (NDVI). The annual incidence rate and number of TB cases were obtained from the national Tuberculosis Information Management System, maintained by the Chinese Center for Disease Control and Prevention. Fixed-effects models were used to examine the association between urbanization factors and TB incidence. A subgroup analysis was performed by dividing counties into four regions: northeast, eastern, central, and western.

Results: A total of 1992 counties in China were included in this study. Overall, urbanization scores were associated with reduced TB incidence (β = - 0.0114, P < 0.001), corresponding to a 1.1% reduction in TB incidence per unit score. Quadratic models presented a U-shaped relationship between urbanization and TB incidence with an inflection point at 52.94 urbanization units. For each indicator of urbanization, population density and the number of hospital beds were positively associated with TB incidence, with incidence rate ratios of 11.384 [95% confidence interval (CI): 9.337 to 13.881], and 1.015 (95% CI: 1.011 to 1.019), respectively, while GDP, NTL, and NDVI exhibited protective effects. Central China displayed an increase trend that urbanization score was linked to a 1.8% rise in TB incidence.

Conclusions: Urbanization-related factors, including GDP, NTL and NDVI, were inversely associated with TB incidence. Central China's contrasting results highlighted region-specific challenges. Therefore, governments in developing countries should adopt integrated approaches that promote both economic growth and sustainable development of environment during urbanization to optimize TB control efforts.

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来源期刊
Infectious Diseases of Poverty
Infectious Diseases of Poverty INFECTIOUS DISEASES-
自引率
1.20%
发文量
368
期刊介绍: Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.
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