Spatiotemporal analysis of regional and age differences in tuberculosis prevalence in mainland China

Globally, tuberculosis is a leading cause of infectious disease deaths. China ranks third among the 30 high-burden countries for tuberculosis and accounts for approximately 7.4% of the cases reported worldwide. Since very few studies have investigated the age difference in tuberculosis prevalence in mainland China, therefore, the preliminary characterisation of age differences in tuberculosis patients is not well understood. The data of reported sputum smear-positive, tuberculosis and sputum smear-negative cases in 340 prefectures from mainland China were extracted from the China Information System for Disease Control and Prevention from January 2009 to December 2018. Multiple statistical analysis and GIS techniques were used to investigate the temporal trend and identify the spatial distribution of sputum smear-positive, tuberculosis and sputum smear-negative cases in the study area. The results showed that the incidence of sputum smear-positive and tuberculosis has dropped to a stable level, while sputum smear-negative exhibited a rising trend. Additionally, sputum smear-positive, tuberculosis and sputum smear-negative are still highly prevalent in northwestern and southwestern regions of China. Interestingly, the young adult group (20-50 age) and elder group (>50 age) are more susceptible to being infected with tuberculosis, while lower infection levels were recorded in the juvenile group (<20 age). The present study investigated the temporal-spatial distribution of sputum smear-positive, tuberculosis and sputum smear-negative cases in mainland China before the COVID-19 pandemic breakout, which would help the government agency establish an effective mechanism of tuberculosis prevention in high-risk periods and high-risk areas in the study region.