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      Time-series analysis of tuberculosis from 2005 to 2017 in China

      Author(s): , , ,
      Publication date (Electronic):
      Journal: Epidemiology and Infection
      Publisher: Cambridge University Press (CUP)

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          Abstract

          Seasonal autoregressive integrated moving average (SARIMA) has been used to model nationwide tuberculosis (TB) incidence in other countries. This study aimed to characterise monthly TB notification rate in China. Monthly TB notification rate from 2005 to 2017 was used. Time-series analysis was based on a SARIMA model and a hybrid model of SARIMA-generalised regression neural network (GRNN) model. A decreasing trend (3.17% per years, P < 0.01) and seasonal variation of TB notification rate were found from 2005 to 2016 in China, with a predominant peak in spring. A SARIMA model of ARIMA (0,1,1) (0,1,1) 12 was identified. The mean error rate of the single SARIMA model and the SARIMA–GRNN combination model was 6.07% and 2.56%, and the determination coefficient was 0.73 and 0.94, respectively. The better performance of the SARIMA–GRNN combination model was further confirmed with the forecasting dataset (2017). TB is a seasonal disease in China, with a predominant peak in spring, and the trend of TB decreased by 3.17% per year. The SARIMA–GRNN model was more effective than the widely used SARIMA model at predicting TB incidence.

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          Tuberculosis prevalence in China, 1990-2010; a longitudinal analysis of national survey data.

          Lixia Wang, Hui Zhang, Yunzhou Ruan … (2014)
          China scaled up a tuberculosis control programme (based on the directly observed treatment, short-course [DOTS] strategy) to cover half the population during the 1990s, and to the entire population after 2000. We assessed the effect of the programme. In this longitudinal analysis, we compared data from three national tuberculosis prevalence surveys done in 1990, 2000, and 2010. The 2010 survey screened 252,940 eligible individuals aged 15 years and older at 176 investigation points, chosen by stratified random sampling from all 31 mainland provinces. All individuals had chest radiographs taken. Those with abnormal radiographs, persistent cough, or both, were classified as having suspected tuberculosis. Tuberculosis was diagnosed by chest radiograph, sputum-smear microscopy, and culture. Trained staff interviewed each patient with tuberculosis. The 1990 and 2000 surveys were reanalysed and compared with the 2010 survey. From 1990 to 2010, the prevalence of smear-positive tuberculosis decreased from 170 cases (95% CI 166-174) to 59 cases (49-72) per 100,000 population. During the 1990s, smear-positive prevalence fell only in the provinces with the DOTS programme; after 2000, prevalence decreased in all provinces. The percentage reduction in smear-positive prevalence was greater for the decade after 2000 than the decade before (57% vs 19%; p<0.0001). 70% of the total reduction in smear-positive prevalence (78 of 111 cases per 100,000 population) occurred after 2000. Of these cases, 68 (87%) were in known cases-ie, cases diagnosed with tuberculosis before the survey. Of the known cases, the proportion treated by the public health system (using the DOTS strategy) increased from 59 (15%) of 370 cases in 2000 to 79 (66%) of 123 cases in 2010, contributing to reduced proportions of treatment default (from 163 [43%] of 370 cases to 35 [22%] of 123 cases) and retreatment cases (from 312 [84%] of 374 cases to 48 [31%] of 137 cases; both p<0.0001). In 20 years, China more than halved its tuberculosis prevalence. Marked improvement in tuberculosis treatment, driven by a major shift in treatment from hospitals to the public health centres (that implemented the DOTS strategy) was largely responsible for this epidemiological effect. Chinese Ministry of Health. Copyright © 2014 Elsevier Ltd. All rights reserved.
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            Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis.

            Kelechi E Nnoaham, Aileen Clarke (2008)
            To explore the association between low serum vitamin D and risk of active tuberculosis in humans. Systematic review and meta-analysis. Observational studies published between 1980 and July 2006 (identified through Medline) that examined the association between low serum vitamin D and risk of active tuberculosis. For the review, seven papers were eligible from 151 identified in the search. The pooled effect size in random effects meta-analysis was 0.68 with 95% CI 0.43-0.93. This 'medium to large' effect represents a probability of 70% that a healthy individual would have higher serum vitamin D level than an individual with tuberculosis if both were chosen at random from a population. There was little heterogeneity between the studies. Low serum vitamin D levels are associated with higher risk of active tuberculosis. Although more prospectively designed studies are needed to firmly establish the direction of this association, it is more likely that low body vitamin D levels increase the risk of active tuberculosis. In view of this, the potential role of vitamin D supplementation in people with tuberculosis and hypovitaminosis D-associated conditions like chronic kidney disease should be evaluated.
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              Air pollution in China: Status and spatiotemporal variations.

              Congbo Song, Lin Di Wu, Yaochen Xie … (2017)
              In recent years, China has experienced severe and persistent air pollution associated with rapid urbanization and climate change. Three years' time series (January 2014 to December 2016) concentrations data of air pollutants including particulate matter (PM2.5 and PM10) and gaseous pollutants (SO2, NO2, CO, and O3) from over 1300 national air quality monitoring sites were studied to understand the severity of China's air pollution. In 2014 (2015, 2016), annual population-weighted-average (PWA) values in China were 65.8 (55.0, 50.7) μg m(-3) for PM2.5, 107.8 (91.1, 85.7) μg m(-3) for PM10, 54.8 (56.2, 57.2) μg m(-3) for O3_8 h, 39.6 (33.3, 33.4) μg m(-3) for NO2, 34.1 (26, 21.9) μg m(-3) for SO2, 1.2 (1.1, 1.1) mg m(-3) for CO, and 0.60 (0.59, 0.58) for PM2.5/PM10, respectively. In 2014 (2015, 2016), 7% (14%, 19%), 17% (27%, 34%), 51% (67%, 70%) and 88% (97%, 98%) of the population in China lived in areas that meet the level of annual PM2.5, PM10, NO2, and SO2 standard metrics from Chinese Ambient Air Quality Standards-Grade II. The annual PWA concentrations of PM2.5, PM10, O3_8 h, NO2, SO2, CO in the Northern China are about 40.4%, 58.9%, 5.9%, 24.6%, 96.7%, and 38.1% higher than those in Southern China, respectively. Though the air quality has been improving recent years, PM2.5 pollution in wintertime is worsening, especially in the Northern China. The complex air pollution caused by PM and O3 (the third frequent major pollutant) is an emerging problem that threatens the public health, especially in Chinese mega-city clusters. NOx controls were more beneficial than SO2 controls for improvement of annual PM air quality in the northern China, central, and southwest regions. Future epidemiologic studies are urgently required to estimate the health impacts associated with multi-pollutants exposure, and revise more scientific air quality index standards.
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                Author and article information

                Journal
                Title: Epidemiology and Infection
                Abbreviated Title: Epidemiol. Infect.
                Publisher: Cambridge University Press (CUP)
                ISSN (Print): 0950-2688
                ISSN (Electronic): 1469-4409
                Publication date Created: June 2018
                Publication date (Electronic): April 30 2018
                Publication date (Print): June 2018
                Volume: 146
                Issue: 8
                Pages: 935-939
                Article
                DOI: 10.1017/S0950268818001115
                PubMed ID: 29708082
                SO-VID: 78cf5f95-43b8-4146-99ad-801b25479ef6
                Copyright © © 2018
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