Epidemic trend and spatial-temporal analysis of pulmonary tuberculosis in Hotan prefecture, xinjiang, china, 2015–2021

Globally, tuberculosis remains a significant public health concern. The 2022 World Health Organization report indicates that approximately 10.6 million people are infected with tuberculosis annually worldwide, resulting in 1.6 million deaths. In 2021, China ranked as the third country with the highest tuberculosis burden globally, following India and Indonesia. Xinjiang, as the westernmost region of China, experiences the most severe tuberculosis incidence. This study focuses on the Hotan region of Xinjiang, utilizing spatio-temporal statistical methods to investigate the local tuberculosis incidence trends from 2015 to 2021 and analyze potential influencing factors. Spatial autocorrelation and spatiotemporal scanning techniques were employed to assess the tuberculosis incidence trend. Furthermore, geographically weighted regression was utilized to examine the impact of meteorological and air pollution factors on tuberculosis incidence in the Hotan area from a spatial perspective. The findings revealed spatial heterogeneity in the distribution of pulmonary tuberculosis (PTB) in the Hotan area, with the identification of four spatial clusters through local spatial autocorrelation analysis. Spatiotemporal scan analysis confirmed the presence of two cluster types. Geographically weighted regression analysis identified three influencing factors, with daily average temperature showing a negative correlation with tuberculosis incidence, while PM10 and SO₂ levels exhibited positive correlations. Given the dry climate, frequent sandstorms, and severe air pollution in the Hotan area, tuberculosis prevention and control efforts are under environmental pressure (it refers to the challenges posed by the region's dry, dusty climate and poor air quality for TB control efforts). Local authorities should prioritize environmental management and enhance tuberculosis prevention and control measures.