Spatial-temporal pattern of tuberculosis mortality in China and its relationship with long-term PM2.5 exposure based on a causal inference approach

Evidence on the spatial-temporal distribution of tuberculosis (TB) mortality across China and its relationship with long-term particulate matter (PM2.5) exposure is limited. We aimed to address significant gaps in our understanding of the spatial-temporal clustering patterns of TB mortality in China...

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Vydané v:	Environmental research letters Ročník 18; číslo 8; s. 084006 - 84016
Hlavní autori:	Wu, Gonghua, Wang, Shenghao, Jiang, Zini, Hopke, Philip K, Rich, David Q, Chen, Liang, Lin, Shao, Zhang, Kai, Romeiko, Xiaobo Xue, Qu, Yanji, Deng, Xinlei, Lin, Ziqiang, Xiao, Jianpeng, Zhang, Wangjian, Hao, Yuantao
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Bristol IOP Publishing 01.08.2023
Predmet:	causal inference Clustering DID Exposure Inference Low altitude Mortality Mortality risk Particulate matter PM2.5 pulmonary tuberculosis Sensitivity analysis Social factors Socioeconomic factors Socioeconomics Temporal distribution Tuberculosis China
ISSN:	1748-9326
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Abstract	Evidence on the spatial-temporal distribution of tuberculosis (TB) mortality across China and its relationship with long-term particulate matter (PM2.5) exposure is limited. We aimed to address significant gaps in our understanding of the spatial-temporal clustering patterns of TB mortality in China and provide evidence for its causal links with long-term PM2.5 exposure. Annual pulmonary TB mortality, PM2.5 concentrations, and socioeconomic factors for provinces in mainland China between 2004 and 2017 were obtained. Turning points in the temporal trend and spatial clustering patterns of pulmonary TB mortality were identified. A difference-in-differences causal inference approach was applied to estimate the long-term effect of PM2.5 exposure on the mortality. The average annual percent change of pulmonary TB mortality in China was −2.5% (95% CI: −5.6%, 0.7%), with an 11.1% annual increase in the Northwest since 2012 (P= 0.029). The hot and cold spots, determined by the local Moran’s I index, were all located in northern China, where Xinjiang in the Northwest had the highest mortality across the study period. We found a significant association between long-term PM2.5 exposure and pulmonary TB mortality, with percent increase risk of mortality (IR%) being 0.74% (95 CI%, 0.04%, 1.45%) for 1 µg/m3 increase in PM2.5 concentration. This association varied across multiple socioeconomic groups, with the highest IR% in provinces with lower level of latitude (IR% = 0.83%, 95% CI: 0.01%, 1.65%), lower quartile of gross domestic product (IR% = 1.01%, 95% CI: 0.23%, 1.80%) or higher proportion (⩾14%) of people >65 years of age (IR% = 1.24%, 95% CI: 0.44%, 2.04%). Comprehensive sensitivity analyses showed a robust adverse effect of long-term PM2.5 exposure on pulmonary TB mortality. Attention needs to be paid to the rising trend of pulmonary TB mortality in Northwest China. Our study provides the stable evidence to date of the causal association between long-term PM2.5 exposure and the risk of death from pulmonary TB, especially in low-altitude, underdeveloped, and aged provinces.
AbstractList	Evidence on the spatial-temporal distribution of tuberculosis (TB) mortality across China and its relationship with long-term particulate matter (PM2.5) exposure is limited. We aimed to address significant gaps in our understanding of the spatial-temporal clustering patterns of TB mortality in China and provide evidence for its causal links with long-term PM2.5 exposure. Annual pulmonary TB mortality, PM2.5 concentrations, and socioeconomic factors for provinces in mainland China between 2004 and 2017 were obtained. Turning points in the temporal trend and spatial clustering patterns of pulmonary TB mortality were identified. A difference-in-differences causal inference approach was applied to estimate the long-term effect of PM2.5 exposure on the mortality. The average annual percent change of pulmonary TB mortality in China was −2.5% (95% CI: −5.6%, 0.7%), with an 11.1% annual increase in the Northwest since 2012 (P= 0.029). The hot and cold spots, determined by the local Moran’s I index, were all located in northern China, where Xinjiang in the Northwest had the highest mortality across the study period. We found a significant association between long-term PM2.5 exposure and pulmonary TB mortality, with percent increase risk of mortality (IR%) being 0.74% (95 CI%, 0.04%, 1.45%) for 1 µg/m3 increase in PM2.5 concentration. This association varied across multiple socioeconomic groups, with the highest IR% in provinces with lower level of latitude (IR% = 0.83%, 95% CI: 0.01%, 1.65%), lower quartile of gross domestic product (IR% = 1.01%, 95% CI: 0.23%, 1.80%) or higher proportion (⩾14%) of people >65 years of age (IR% = 1.24%, 95% CI: 0.44%, 2.04%). Comprehensive sensitivity analyses showed a robust adverse effect of long-term PM2.5 exposure on pulmonary TB mortality. Attention needs to be paid to the rising trend of pulmonary TB mortality in Northwest China. Our study provides the stable evidence to date of the causal association between long-term PM2.5 exposure and the risk of death from pulmonary TB, especially in low-altitude, underdeveloped, and aged provinces. Evidence on the spatial-temporal distribution of tuberculosis (TB) mortality across China and its relationship with long-term particulate matter (PM _2.5 ) exposure is limited. We aimed to address significant gaps in our understanding of the spatial-temporal clustering patterns of TB mortality in China and provide evidence for its causal links with long-term PM _2.5 exposure. Annual pulmonary TB mortality, PM _2.5 concentrations, and socioeconomic factors for provinces in mainland China between 2004 and 2017 were obtained. Turning points in the temporal trend and spatial clustering patterns of pulmonary TB mortality were identified. A difference-in-differences causal inference approach was applied to estimate the long-term effect of PM _2.5 exposure on the mortality. The average annual percent change of pulmonary TB mortality in China was −2.5% (95% CI : −5.6%, 0.7%), with an 11.1% annual increase in the Northwest since 2012 ( P = 0.029). The hot and cold spots, determined by the local Moran’s I index, were all located in northern China, where Xinjiang in the Northwest had the highest mortality across the study period. We found a significant association between long-term PM _2.5 exposure and pulmonary TB mortality, with percent increase risk of mortality ( IR %) being 0.74% (95 CI %, 0.04%, 1.45%) for 1 µ g/m ^3 increase in PM _2.5 concentration. This association varied across multiple socioeconomic groups, with the highest IR % in provinces with lower level of latitude ( IR % = 0.83%, 95% CI : 0.01%, 1.65%), lower quartile of gross domestic product ( IR % = 1.01%, 95% CI: 0.23%, 1.80%) or higher proportion (⩾14%) of people >65 years of age ( IR % = 1.24%, 95% CI: 0.44%, 2.04%). Comprehensive sensitivity analyses showed a robust adverse effect of long-term PM _2.5 exposure on pulmonary TB mortality. Attention needs to be paid to the rising trend of pulmonary TB mortality in Northwest China. Our study provides the stable evidence to date of the causal association between long-term PM _2.5 exposure and the risk of death from pulmonary TB, especially in low-altitude, underdeveloped, and aged provinces.
Author	Xiao, Jianpeng Deng, Xinlei Chen, Liang Lin, Ziqiang Wang, Shenghao Zhang, Kai Lin, Shao Romeiko, Xiaobo Xue Zhang, Wangjian Hao, Yuantao Wu, Gonghua Hopke, Philip K Jiang, Zini Rich, David Q Qu, Yanji
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Snippet	Evidence on the spatial-temporal distribution of tuberculosis (TB) mortality across China and its relationship with long-term particulate matter (PM2.5)... Evidence on the spatial-temporal distribution of tuberculosis (TB) mortality across China and its relationship with long-term particulate matter (PM _2.5 )...
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SubjectTerms	causal inference Clustering DID Exposure Inference Low altitude Mortality Mortality risk Particulate matter PM2.5 pulmonary tuberculosis Sensitivity analysis Social factors Socioeconomic factors Socioeconomics Temporal distribution Tuberculosis
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Title	Spatial-temporal pattern of tuberculosis mortality in China and its relationship with long-term PM2.5 exposure based on a causal inference approach
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