2016-2024年广东省结核病共病住院患者时空分布与聚集特征分析OA

Objective:To analyze the characteristics of the comorbidity spectrum,spatio-temporal distribution pattern and spatial clustering mode of hospitalized tuberculosis patients in Guangdong Province from 2016 to 2024,so as to provide scientific evidence for regionalized and precise prevention and control.Methods:Based on the Guangdong Provincial Health Statistical Information Network Reporting System,the front page information of medical records of hospitalized tuberculosis patients(ICD-10:A15-A19)was extracted,and 20 common types of comorbidities were identified.Descriptive statistical analysis was adopted to analyze the epidemiological characteristics of comorbidities.Global and local Moran's I were applied to examine the spatial autocorrelation and clustering characteristics of the major comorbidity combinations,namely tuberculosis-hypertension,tuberculosis-diabetes mellitus,and tuberculosis-chronic obstructive pulmonary disease.Results:A total of 729 937 tuberculosis patients were enrolled,among whom 64.07％(467 645/729 937)had at least one comorbidity.The comorbidity rate of tuberculosis-hypertension increased from 13.71％(11 285/82 329)in 2016 to 21.00％(16 697/79 495)in 2024;that of tuberculosis-diabetes mellitus increased from 12.17％(10 020/82 329)to 19.53％(15 524/79 495);and the comorbidity rate of tuberculosis-chronic obstructive pulmonary disease fluctuated from 9.28％(7229/77 870)to 11.22％(9238/82 329),remaining at approximately 10.00％overall.Spatial analysis revealed that the tuberculosis-hypertension exhibited a distribution pattern of"high in peripheral areas and low in core areas",and the high-high clustering areas gradually shifted from multiple cities in the Pearl River Delta region(2016-2021,2023)to Jieyang City(2023-2024).Tuberculosis-diabetes mellitus remained highly prevalent in eastern Guangdong,with the strongest spatial autocorrelation(Moran's I＞0.34).Tuberculosis-chronic obstructive pulmonary disease showed a distribution pattern of"high in the north and low in the south",and the high-high clustering areas were stably concentrated in northern Guangdong(2016-2024)and parts of eastern Guangdong(2016-2024).Conclusion:The burden of tuberculosis comorbidities in Guangdong Province has continued to escalate with significant spatio-temporal heterogeneity and clustering characteristics.A regionalized and categorized precision prevention and control system should be established,and differentiated interventions should be implemented for the dominant comorbidity types in different regions,so as to enhance the overall prevention and control efficacy of tuberculosis comorbidities.