{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T02:03:01Z","timestamp":1791511381898,"version":"4.3.4"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>In recent years, Shaoxing City, located in central Zhejiang Province, has experienced a slow decline in the incidence of pulmonary tuberculosis (PTB). Therefore, there is an urgent need to elucidate the potential causes for this decline through spatiotemporal analyses to provide a scientific basis for targeted prevention and control. We aimed to explore the spatiotemporal distribution of PTB notification rates in Shaoxing City from 2016 to 2024 and identify high-incidence clusters, thereby offering data-driven insights to optimize regional PTB control strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Statistical analyses were conducted using R and Excel on all reported active PTB cases in Shaoxing City. Spatiotemporal analysis of case distribution and regional clustering was conducted using ArcGIS and SatScan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and discussion<\/jats:title><jats:p>In total, 17,298 active PTB cases were registered between 2016 and 2024, including 9,749 laboratory-confirmed and 7,549 clinically diagnosed cases. The male-to-female ratio was 2.34:1. Farmers represented 68.2% of all cases. The PTB notification incidence showed a gradual decline. Spatial autocorrelation results revealed 52 sub-districts with high-high clusters over the nine-year period, primarily in Shengzhou and Xinchang counties. Spatiotemporal scan analysis identified one primary cluster area (<jats:italic>RR<\/jats:italic>\u202f=\u202f1.62, <jats:italic>LLR<\/jats:italic>\u202f=\u202f170.87, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001) and two secondary clusters between 2016 and 2024. The incidence of PTB in Shaoxing City showed a downward trend, though the decline was relatively slow. The southeastern region should be prioritized in efforts to accelerate the End TB Strategy. Overall, comprehensive and intensive interventions, such as large-scale chest X-ray screening and health education programs, should be enhanced to effectively curb PTB transmission, especially among males and farmers.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1599274","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T05:29:12Z","timestamp":1750138152000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Spatiotemporal analysis of pulmonary tuberculosis in the central region of the Zhejiang Province, China (2016\u20132024)"],"prefix":"10.3389","volume":"13","author":[{"given":"Kaixuan","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuokai","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiamei","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaoling","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.3389\/fimmu.2018.01346","article-title":"Mycobacterium tuberculosis invasion of the human lung: first 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