JMIR Publications

ABSTRACT

Background:

Tuberculosis (TB) represents a major public health concern as a chronic infectious disease. With the rapidly growing aging population worldwide, the burden of TB among the elderly has become increasingly severe. However, few studies have characterized the spatial epidemiological features of TB in this age group.

Objective:

This study analyzed the spatiotemporal distribution characteristics of TB among individuals aged 65 and older in Chongqing, China, to understand the local TB epidemic profile and provide a scientific basis for guiding TB prevention and control efforts in the region.

Methods:

The study data were obtained from the Tuberculosis Information Management System (TBIMS) of China. Descriptive analysis and Chi-square test for trend were performed using Excel 2019 and SPSS 26 to characterize the epidemiology of TB in the elderly. Spatial analysis, including global and local autocorrelation, was conducted using ArcGIS 10.7 to analyze spatial trends and visualize the incidence rates. Hot spot analysis was also employed to identify areas of significantly high or low incidence. Furthermore, spatiotemporal scan statistics were performed using SaTScan 10.3.2 software to detect spatiotemporal clusters of TB cases among the elderly population.

Results:

A total of 20,265 TB cases among the elderly were reported in Chongqing from 2020 to 2024, with an average annual incidence rate of 69.59 per 100,000 population. The incidence of TB in this population decreased from 74.48 per 100,000 in 2020 to 68.68 per 100,000 in 2024, corresponding to an average annual percentage change of -1.61%. The incidence of TB peaked during the spring and summer months each year. Global spatial autocorrelation analysis revealed significant positive spatial clustering, with Global Moran's I statistics ranging from 0.618 to 0.756 (all P values < .001). Local spatial autocorrelation identified persistent hotspots located in the northeastern and southeastern parts of Chongqing. Spatiotemporal scan statistics detected one most likely cluster and three secondary clusters. The most likely cluster was situated in southeastern Chongqing (Relative Risk [RR] = 3.52, Log-Likelihood Ratio [LLR] = 1017.43, P < .001).

Conclusions:

The study confirmed a distinct seasonal pattern and significant spatiotemporal clustering of TB among the elderly in Chongqing. The high-risk areas were predominantly concentrated in the northeastern and southeastern regions of the municipality. Our findings underscore the necessity for sustained reinforcement of TB control measures in these high-risk regions and the adoption of more targeted public health interventions.