# Analysis of the epidemiological characteristics of pulmonary tuberculosis in Shijiazhuang, China 2010–2023

## TL;DR

This study examines how tuberculosis spread in Shijiazhuang, China, from 2010 to 2023, finding a decline in cases but persistent clusters in rural areas.

## Contribution

The study provides a detailed spatio-temporal analysis of PTB in Shijiazhuang, identifying key demographic and geographic patterns.

## Key findings

- PTB incidence declined significantly from 2010 to 2023, with a steeper drop between 2010 and 2013.
- High PTB clusters were found in rural counties like Lingshou and Pingshan, while urban areas showed low clusters.
- Males, older adults, and farmers were disproportionately affected by PTB.

## Abstract

Spatio-temporal analysis is a key epidemiological tool for monitoring disease transmission and identifying outbreak hotspots. However, the patterns of pulmonary tuberculosis (PTB) spread over time and space in Shijiazhuang remain poorly understood. This study aims to clarify the spatio-temporal dynamics of PTB transmission in this region.

We conducted a retrospective study using PTB surveillance data from 2010 to 2023, extracted from the national Tuberculosis Information Management System. Descriptive epidemiological analysis was conducted to assess the severity and distribution characteristics of PTB in Shijiazhuang. The Joinpoint regression model was employed to analyze the annual temporal trends. Spatial autocorrelation analysis and Space–time scan analysis were utilized to explore the spatio-temporal clustering characteristics.

From 2010 to 2023, a total of 54,855 PTB cases were reported, with an average annual incidence of 38.97 per 100,000 population. Males, older adults, and farmers were disproportionately affected. The overall incidence declined significantly (AAPC = −7.65%, p < 0.05), with a steeper drop between 2010 to 2013 and a more gradual decline thereafter. Spatial analysis revealed persistent high-high clusters in rural counties such as Lingshou county and Pingshan county, and low-low clusters in central urban districts. The phased space–time scan analysis results identified 19 clusters.

This study reveals a declining PTB incidence in Shijiazhuang, with a higher burden among males, older adults, and farmers, alongside persistent spatial clusters in rural areas, particularly in the north. These findings emphasize the need for targeted interventions and strengthened rural surveillance to achieve tuberculosis elimination goals.