{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T01:57:47Z","timestamp":1782957467152,"version":"3.54.5"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"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>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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\u2013time scan analysis were utilized to explore the spatio-temporal clustering characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u202f=\u202f\u22127.65%, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05), 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\u2013time scan analysis results identified 19 clusters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1621695","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T05:27:59Z","timestamp":1751520479000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Analysis of the epidemiological characteristics of pulmonary tuberculosis in Shijiazhuang, China 2010\u20132023"],"prefix":"10.3389","volume":"13","author":[{"given":"Xin","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lihua","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1642","DOI":"10.1016\/s0140-6736(19)30308-3","article-title":"Tuberculosis","volume":"393","author":"Furin","year":"2019","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"S629","DOI":"10.1093\/infdis\/jix362","article-title":"What we know about tuberculosis transmission: an overview","volume":"216","author":"Churchyard","year":"2017","journal-title":"J Infect Dis"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/S1473-3099(24)00007-0","article-title":"Global, regional, and national age-specific progress towards the 2020 milestones of the WHO end TB strategy: a systematic analysis for the global burden of disease study 2021","volume":"24","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/s12889-023-17495-6","article-title":"Global, regional and national trends in tuberculosis incidence and main risk factors: a study using data from 2000 to 2021","volume":"24","author":"Bai","year":"2024","journal-title":"BMC Public Health"},{"key":"ref5","article-title":"Global Tuberculosis Report 2024","year":"2024"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1506266","DOI":"10.3389\/fpubh.2024.1506266","article-title":"Disease burden of tuberculosis in China from 1990 to 2021 and its prediction to 2036","volume":"12","author":"Sun","year":"2024","journal-title":"Front Public Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1186\/s12916-018-1178-4","article-title":"Methods used in the spatial analysis of tuberculosis epidemiology: a systematic review","volume":"16","author":"Shaweno","year":"2018","journal-title":"BMC Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1186\/s12879-022-07539-4","article-title":"Spatio-temporal distribution of tuberculosis and the effects of environmental factors in China","volume":"22","author":"Li","year":"2022","journal-title":"BMC Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"940","DOI":"10.14236\/jhi.v24i2.940","article-title":"Understanding the use of geographical information systems (GIS) in health informatics research: a review","volume":"24","author":"Shaw","year":"2017","journal-title":"J Innov Health Inform"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4974","DOI":"10.1038\/s41598-023-31430-0","article-title":"Analysis of spatial-temporal dynamic distribution and related factors of tuberculosis in China from 2008 to 2018","volume":"13","author":"Xue","year":"2023","journal-title":"Sci Rep"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1186\/s12879-024-09645-x","article-title":"Spatiotemporal analysis and seasonality of tuberculosis in Pudong new area of Shanghai, China, 2014-2023","volume":"24","author":"Pan","year":"2024","journal-title":"BMC Infect Dis"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1586","DOI":"10.1186\/s12889-023-16493-y","article-title":"Geo-spatial high-risk clusters of tuberculosis in the global general population: a systematic review","volume":"23","author":"Teibo","year":"2023","journal-title":"BMC Public Health"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"437","DOI":"10.3390\/tropicalmed8090437","article-title":"Spatiotemporal distribution of tuberculosis in the Oromia region of Ethiopia: a hotspot analysis","volume":"8","author":"Bekele","year":"2023","journal-title":"Trop Med Infect Dis"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e65","DOI":"10.1017\/s0950268824000335","article-title":"Factors affecting the incidence of pulmonary tuberculosis based on the GTWR model in China, 2004-2021","volume":"152","author":"Yu","year":"2024","journal-title":"Epidemiol Infect"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1186\/s12879-025-10952-0","article-title":"Coinfection of hepatitis B, tuberculosis, and HIV\/AIDS in Beijing from 2016 to 2023: a surveillance data analysis","volume":"25","author":"Wang","year":"2025","journal-title":"BMC Infect Dis"},{"key":"ref16","article-title":"Let's work together to end the tuberculosis epidemic","year":""},{"key":"ref17","article-title":"Climate bulletin of Shijiazhuang City","year":"2023"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e64286","DOI":"10.2196\/64286","article-title":"Epidemiological characteristics and spatiotemporal clustering of pulmonary tuberculosis among students in Southwest China from 2016 to 2022: analysis of population-based surveillance data","volume":"10","author":"Kong","year":"2024","journal-title":"JMIR Public Health Surveill"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"7425","DOI":"10.1038\/s41598-020-64387-5","article-title":"Identification and prediction of tuberculosis in eastern China: analyses from 10-year population-based notification data in Zhejiang Province, China","volume":"10","author":"Liu","year":"2020","journal-title":"Sci Rep"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2504","DOI":"10.1186\/s12889-024-19994-6","article-title":"Spatial and temporal analysis and forecasting of TB reported incidence in western China","volume":"24","author":"Zhao","year":"2024","journal-title":"BMC Public Health"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1017\/s0950268804003528","article-title":"A model-adjusted space-time scan statistic with an application to syndromic surveillance","volume":"133","author":"Kleinman","year":"2005","journal-title":"Epidemiol Infect"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s40249-018-0490-8","article-title":"Spatial and temporal clustering analysis of tuberculosis in the mainland of China at the prefecture level, 2005-2015","volume":"7","author":"Liu","year":"2018","journal-title":"Infect Dis Poverty"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s41182-025-00718-4","article-title":"Geospatial analysis of cholera outbreak in Lusaka, Zambia, between 2023 and 2024","volume":"53","author":"Ngosa","year":"2025","journal-title":"Trop Med Health"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1186\/s12887-025-05550-7","article-title":"Spatial and temporal variation of pneumonia incidence among under-five children in Central Gondar zone, Northwest Ethiopia, 2013- 2022","volume":"25","author":"Degif","year":"2025","journal-title":"BMC Pediatr"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1111\/tmi.13901","article-title":"Temporal trend, high-risk spatial and spatiotemporal clustering of leprosy indicators in Brazil: a 20-year ecological and population-based study","volume":"28","author":"Paz","year":"2023","journal-title":"Trop Med Int Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"25407","DOI":"10.1038\/srep25407","article-title":"Identification of distribution characteristics and epidemic trends of hepatitis E in Zhejiang Province, China from 2007 to 2012","volume":"6","author":"Liu","year":"2016","journal-title":"Sci Rep"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1254579","DOI":"10.3389\/fpubh.2023.1254579","article-title":"Regional and epidemiological characteristics of tuberculosis and treatment outcomes in West China","volume":"11","author":"Wang","year":"2023","journal-title":"Front Public Health"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s40249-024-01203-6","article-title":"Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014-2021","volume":"13","author":"Deng","year":"2024","journal-title":"Infect Dis Poverty"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"997025","DOI":"10.3389\/fpubh.2022.997025","article-title":"Gender differences in tuberculosis incidence rates-a pooled analysis of data from seven high-income countries by age group and time period","volume":"10","author":"Peer","year":"2022","journal-title":"Front Public Health"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1590\/s1806-37562017000000443","article-title":"Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs","volume":"44","author":"Silva","year":"2018","journal-title":"J Bras Pneumol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1271","DOI":"10.2147\/ijgm.S502996","article-title":"Elderly patients with tuberculosis combined with diabetes mellitus: a comprehensive analysis of lymphocyte subpopulation dynamics, clinical features, drug resistance and disease regression","volume":"18","author":"Wang","year":"2025","journal-title":"Int J Gen Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1445857","DOI":"10.3389\/fpubh.2024.1445857","article-title":"Prevalence trends, population characteristics and treatment outcomes of tuberculosis combined with diabetes in Southwest China: a register-based retrospective study","volume":"12","author":"Kong","year":"2024","journal-title":"Front Public Health"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s40249-023-01147-3","article-title":"Epidemiological characteristics of seven notifiable respiratory infectious diseases in the mainland of China: an analysis of national surveillance data from 2017 to 2021","volume":"12","author":"Deng","year":"2023","journal-title":"Infect Dis Poverty"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"102209","DOI":"10.1016\/j.eclinm.2023.102209","article-title":"Comparative effectiveness of interventions for preventing tuberculosis: systematic review and network meta-analysis of interventional studies","volume":"64","author":"Liyew","year":"2023","journal-title":"EClinicalMedicine"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"e0312001","DOI":"10.1371\/journal.pone.0312001","article-title":"A meta-analysis of technology-based interventions on treatment adherence and treatment success among TBC patients","volume":"19","author":"Huda","year":"2024","journal-title":"PLoS One"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"e0311408","DOI":"10.1371\/journal.pone.0311408","article-title":"Assessing the impact of COVID-19 on tuberculosis detection and treatment in healthcare facilities across Addis Ababa, Ethiopia: a comprehensive mixed-method, multi-center study","volume":"19","author":"Nasir","year":"2024","journal-title":"PLoS One"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"436","DOI":"10.5588\/ijtld.21.0148","article-title":"The impact of COVID-19 on TB: a review of the data","volume":"25","author":"McQuaid","year":"2021","journal-title":"Int J Tuberc Lung Dis"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e1132","DOI":"10.1016\/S2214-109X(20)30288-6","article-title":"Potential impact of the COVID-19 pandemic on HIV, tuberculosis, and malaria in low-income and middle-income countries: a modelling study","volume":"8","author":"Hogan","year":"2020","journal-title":"Lancet Glob Health"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"110310","DOI":"10.1016\/j.envres.2020.110310","article-title":"Epidemiological characteristics of tuberculosis and effects of meteorological factors and air pollutants on tuberculosis in Shijiazhuang, China: a distribution lag non-linear analysis","volume":"195","author":"Wang","year":"2021","journal-title":"Environ Res"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1097\/ede.0000000000000877","article-title":"Drivers of seasonal variation in tuberculosis incidence: insights from a systematic review and mathematical model","volume":"29","author":"Tedijanto","year":"2018","journal-title":"Epidemiology"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e0214555","DOI":"10.1371\/journal.pone.0214555","article-title":"Seasonality of childhood tuberculosis cases in Kampala, Uganda, 2010-2015","volume":"14","author":"Jaganath","year":"2019","journal-title":"PLoS One"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"654","DOI":"10.2105\/ajph.2010.199505","article-title":"The social determinants of tuberculosis: from evidence to action","volume":"101","author":"Hargreaves","year":"2011","journal-title":"Am J Public Health"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.ijid.2021.12.344","article-title":"Risk factors for types of recurrent tuberculosis (reactivation versus reinfection): a global systematic review and meta-analysis","volume":"116","author":"Qiu","year":"2022","journal-title":"Int J Infect Dis"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e0281479","DOI":"10.1371\/journal.pone.0281479","article-title":"Spatial-temporal analysis of pulmonary tuberculosis in Hubei Province, China, 2011-2021","volume":"18","author":"Zhang","year":"2023","journal-title":"PLoS One"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1186\/s12879-020-05249-3","article-title":"Spatial-temporal analysis of tuberculosis in Chongqing, China 2011-2018","volume":"20","author":"Yu","year":"2020","journal-title":"BMC Infect Dis"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"4039","DOI":"10.2147\/IDR.S412870","article-title":"Spatiotemporally comparative analysis of HIV, pulmonary tuberculosis, HIV-pulmonary tuberculosis coinfection in Jiangsu Province, China","volume":"16","author":"Wu","year":"2023","journal-title":"Infect Drug Resist"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"e49123","DOI":"10.2196\/49123","article-title":"Analysis of tuberculosis epidemiological distribution characteristics in Fujian Province, China, 2005-2021: spatial-temporal analysis study","volume":"10","author":"Yu","year":"2024","journal-title":"JMIR Public Health Surveill"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1621695\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T05:28:00Z","timestamp":1751520480000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1621695\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,3]]},"references-count":47,"alternative-id":["10.3389\/fpubh.2025.1621695"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1621695","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,3]]},"article-number":"1621695"}}