Survival Analysis and Associated Factors for Pulmonary Tuberculosis Death: Evidence from the Information System of Tuberculosis Disease and Mortality Surveillance in China.

Background: Pulmonary tuberculosis (PTB) is a severe infection, and its factors that influence survival have not been explored in some developed regions. Therefore, this study aimed to identify the factors that influence TB survival in China. Methods: We acquired data of PTB deaths through matching two manage systems of PTB and mortality surveillance. The Kaplan-Meier method and Cox regression model were used to identify the significant factors under various survival times. Results: A total of 283 deaths were caused by PTB, in which 53.4% occurred during the first year. In the Cox regression model, regular sputum smear test could reduce the risk of PTB death from the result of one-, three-, and five-year survival; and history of PTB treatment could decline the risk of PTB death in the first year. Additionally, age of "75-90 years" and positive result of sputum smear test significantly increased the risk of PTB death for the findings of three- and five-year survival, while age of "60-75 years" could increase the probability of PTB death for five-year survival. Conclusion: To reduce PTB deaths, more attention should be paid to the older group especially in the first year. Regular sputum smear test could effectively reduce the mortality of PTB cases. More evidence-based interventions should be implemented to enhance the survival of patients with PTB.

Tuberculosis burden caused by migrant population in Eastern China: evidence from notification records in Zhejiang Province during 2013-2017.

BACKGROUND: Internal migrants have an enormous impact on tuberculosis (TB) epidemic in China. Zhejiang Province, as one of the developed areas, also had a heavy burden caused by TB. METHODS: In this study, we collected all cases in Zhejiang Province through the TB Management Information System from 2013 to 2017. Description analysis and Spatio-temporal analysis using R software and ArcGIS were performed to identify the epidemiological characteristics and clusterings, respectively. RESULTS: 48,756 individuals in total were notified with TB among the migrant population (TBMP), accounting for one-third of all cases identified. The primary sources of TB from migrants outside the province were from Guizhou, Sichuan, and Anhui. Wenzhou, Taizhou, and Lishui were the three mainly outflowing cities among the intra-provincial TBMP and Hangzhou as the primarily inflowing city. Also, results implied that the inconsistency of the TBMP in spatial analysis and the border area of Quzhou and Lishui city had the highest risk of TB occurrence among the migrants. Additionally, one most likely cluster and four secondary clusters were identified by the spatial-temporal analysis. CONCLUSION: The effective control of TB in extra-provincial MP was critical to lowering the TB burden of MP in Zhejiang Province. Also, it is suggested that active TB screening for migrant employees outflowed from high epidemic regions should be strengthened, and further traceability analysis needs to be investigated to clarify the mechanism of TB transmission in clustered areas.