Incidence trend and spatial distribution characteristic of pulmonary tuber-culosis in China from 2004 to 2021
Aim:To explore incidence trend and spatial distribution characteristic of pulmonary tuberculosis in China from 2004 to 2021 and to provide evidence for formulating regional pulmonary tuberculosis prevention and control measures.Methods:Data on incidences of pulmonary tuberculosis from 2004 to 2021 were extracted from the Public Health Science Data Center and"Chinese Healthy Statistical Yearbook".Spatial auto-correlation analysis and hot-cold spots analysis were used to explore epidemic trend and spatial clustering characteristic of pulmonary tuberculosis in China.Results:The overall incidence rate of pulmonary tuberculosis in China presented a decreasing trend year by year.In space,the regional incidence rates showed a trend with higher rate in the western regions,lower rate in the eastern regions,higher rate in the southern re-gions and lower rate in the northern regions.Global Moran's I coefficient increased year by year from 0.262 in 2005 and reached the maximum value of 0.522 in 2020.Local spatial auto-correlation analysis results showed that"high-high"cluste-ring characteristic was identified in Sichuan,Guizhou,Hunan,Guangxi Zhuang Autonomous Region(Guangxi)and other re-gions from 2004 to 2008;"high-high"clustering characteristic was just found in Xizang Autonomous Region(Xizang)and Guangxi between 2009 and 2011;"high-high"clustering characteristic was recognized in Xizang and Xinjiang Uygur Auton-omous Region(Xinjiang)between 2012 and 2019;Except Xinjiang and Xizang,Yunnan and Guangxi appeared"high-high"clustering characteristic from 2020 to 2021;"low-low"clustering characteristic was concentrated in North and East China from 2004 to 2021.The hot spots for the average annual incidence of pulmonary tuberculosis were observed in Xinjiang,Xi-zang and Yunnan,whereas the cold spots were observed in 15 regions,mainly distributing in Beijing,Hebei,Shandong,Jian-gsu and other places.Conclusions:Though the incidence of pulmonary tuberculosis is continuously declining in China,spa-tial clustering characteristics become significantly obvious.Health resources allocation needs to be strengthened in hot areas such as Xinjiang,Xizang.