Air pollution and tuberculosis incidence in Vietnam: short- and long-term effects from a provincial-level study

Tuberculosis (TB) remains a major public health challenge in many low- and middle-income countries, where environmental pollution and uneven policy implementation may further exacerbate disease transmission. This study aims to assesss the short and long-term impacts of environmental factors, particularly fine particulate matter (PM_2.5), and TB prevention policies on new TB incidence in Vietnam.

Panel data from 63 provinces from 2005 to 2023 were analyzed using the SYS-GMM model to estimate the effects of PM_2.5, temperature, per capita income, provincial government health expenditure, and the government's National Strategy for TB Prevention of 2014 on TB incidence. Long-term effects were also analyzed using long-term multipliers.

PM_2.5 had a statistically significant positive effect on TB incidence, consistent with prior findings that fine particulate matter damages respiratory defenses and increases infection risk. The long-term multiplier of PM_2.5 was even higher, indicating cumulative effects over time. Temperature was also positively correlated with the incidence of TB, while per capita income and health expenditure were negatively associated with TB incidence. The long-term impact of income was stronger than the short-term effect, highlighting the growing health benefits of economic development. The government's National Strategy for TB Prevention of 2014 was found to be statistically insignificant.

Air pollution significantly increases TB incidence in Vietnam in the short and long term. In the context of climate change and persistent pollution, combining environmental and TB prevention strategies is essential to achieving the goal of TB elimination.