Epidemiological characteristics of tuberculosis and effects of meteorological factors and air pollutants on tuberculosis in Shijiazhuang, China: A distribution lag non-linear analysis

Background: Tuberculosis (TB) is a serious public health problem in China. There is evidence to prove that meteorological factors and exposure to air pollutants have a certain impact on TB. But the evidence of this relationship is insufficient, and the conclusions are inconsistent. Methods: Descriptive epidemiological methods were used to describe the distribution characteristics of TB in Shijiazhuang in the past five years. Through the generalized linear regression model (GLM) and the generalized additive model (GAM), the risk factors that affect the incidence of TB are screened. A combination of GLM and distribution lag nonlinear model (DLNM) was used to evaluate the lag effect of environmental factors on the TB. Results were tested for robustness by sensitivity analysis. Results: The incidence of TB in Shijiazhuang showed a downward trend year by year, with seasonality and periodicity. Every 10 mu g/m(3) of PM10 changes, the RR distribution is bimodal. The first peak of RR occurs on the second day of lag (RR = 1.00166, 95% CI: 1.00023, 1.00390); the second risk period starts from 13th day of lag and peaks on 15th day (RR = 1.00209, 95% CI: 1.00076, 1.00341), both of which are statistically significant. The cumulative effect of increasing 10 mu g/m(3) showed a similar bimodal distribution. Time zones where the RR makes sense are days 4-6 and 13-20. RR peaked on the 18th day (RR = 1.02239, 95% CI: 1.00623, 1.03882). The RR has a linear relationship with the concentration. Under the same concentration, the RR peaks within 15-20 days. Conclusion: TB in Shijiazhuang City showed a downward trend year by year, with obvious seasonal fluctuations. The air pollutant PM10 increases the risk of TB. The development of TB has a short-term lag and cumulative lag effects. We should focus on protecting susceptible people from TB in spring and autumn, and strengthen the monitoring and emission management of PM10 in the atmosphere.

Automated summary

Tuberculosis (TB) is a serious public health issue in China, with evidence suggesting that meteorological factors and exposure to air pollutants impact TB. Descriptive epidemiological methods were used to analyze TB distribution characteristics in Shijiazhuang over the past five years, with results showing a downward trend in incidence along with seasonal fluctuations. The air pollutant PM10 was found to increase the risk of TB, with short-term and cumulative lag effects observed in TB development.