Analysis of the china tuberculosis incidence study from 2004 to 2019 and association with GDP per capita: A Frontier Analysis

Abstract

Abstract Background: Tuberculosis (TB) continues to pose a considerable social and economic burden, with China currently ranking as the third highest in terms of TB burden globally. This study examined the variations in TB incidence across different provinces in China between 2004 and 2019, while analyzing its relationship with Gross Domestic Product (GDP) per capita. The objective is to provide more precise insights to aid the formulation of effective policies for TB prevention and control in China. Method: The TB data utilized in this study was obtained from the Data-centre of China Public Health Science. To analyze the temporal trends of TB incidence rate from 2004 to 2019, joinpoint regression analysis was employed. In order to estimate the overall level of spatial autocorrelation, global spatial autocorrelation was utilized, and local indicators of spatial association were employed to assess the impact of individual locations on the magnitude of the global statistic and to identify the location and types of clusters. Additionally, to assess the relationship between the incidence of TB and GDP per capita, Pearson's test and frontier analysis were adopted. Results: The analysis revealed a consistent decline in TB incidence from 2004 to 2019(APC = -3.2, P < 0.001), with the highest incidence occurring in spring and the lowest in December each year. Significant global spatial autocorrelation existed in the TB incidence rate from 2004 to 2019 (all P < 0.005) with the Moran’s I index ranging from 0.1926 to 0.5319. The western regions of China primarily exhibited a high incidence, forming the high-high cluster, whereas Beijing, Tianjin, Hebei, and Jiangsu consistently belonged to the low-low cluster throughout the study period. We discovered a correlation between TB incidence and per capita GDP, and some regions with inadequate TB control, such as Tibet, Xinjiang, Qinghai and Guizhou, etc provinces, exhibited higher incidence rates that given GDP per capita. Conclusion: Tibet, Xinjiang, Qinghai and Guizhou, etc show a larger TB burden compared to other regions with similar GDP per capita, which requires further exploring how to control TB in a satisfactory situation with limited capital investment and health resources.