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Seasonality of reported tuberculosis cases from 2006 to 2010 in Wuhan, China

Published online by Cambridge University Press:  13 December 2013

T. LUO
Affiliation:
Department of Infectious Diseases Prevention and Control, Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, China
A. SUMI*
Affiliation:
Department of Hygiene, Sapporo Medical University School of Medicine, Hokkaido, Japan
D. ZHOU
Affiliation:
Department of Infectious Diseases Prevention and Control, Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, China
N. KOBAYASHI
Affiliation:
Department of Infectious Diseases Prevention and Control, Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, China
K. MISE
Affiliation:
Center for Medical Education, Department of Admissions, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
B. YU
Affiliation:
Department of Infectious Diseases Prevention and Control, Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, China
D. KONG
Affiliation:
Department of Infectious Diseases Prevention and Control, Wuhan Centers for Disease Prevention and Control, Wuhan, Hubei, China
J. WANG
Affiliation:
Wuhan Commission of Global Fund TB Project, Wuhan Tuberculosis Institution, Hubei, China
Q. DUAN
Affiliation:
Wuhan Commission of Global Fund TB Project, Wuhan Tuberculosis Institution, Hubei, China
*
* Author for correspondence: Dr A. Sumi, Department of Hygiene, Sapporo Medical University School of Medicine, S-1, W-17, Chuo-ku, Sapporo, 060-8556, Japan. (Email: sumi@sapmed.ac.jp)
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Summary

We investigated the seasonality of tuberculosis (TB) in Wuhan, China, to evaluate the increased risk of disease transmission during each season and to develop an effective TB control strategy. We applied spectral analysis to the weekly prevalence data of sputum smear positive (SSP) and sputum smear negative (SSN) pulmonary TB reported from 2006 to 2010. Cases of both SSP and SSN feature 1·0- and 0·5-year periodic modes. The least squares method was used to fit curves to the two periodic modes for SSP and SSN data. The curves demonstrated dominant peaks in spring similar to cases reported previously for other locations. Notably for SSP, dominant peaks were also observed in summer. The spring peaks of SSP and SSN were explained in terms of poorly ventilated and humid rooms and vitamin D deficiency. For the summer peaks of SSP, summer influenza epidemics in Wuhan may contribute to the increase in TB prevalence.

Information

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2013 
Figure 0

Fig. 1. Locations of Wuhan, Linxia and Guiyang in China.

Figure 1

Fig. 2. Schematic diagram of the process of sputum smear (SS) positive and sputum smear negative pulmonary tuberculosis (TB) diagnosis in Wuhan, China. PTB, Pulmonary tuberculosis.

Figure 2

Fig. 3. Weekly prevalence data for tuberculosis (TB) cases per 100 000 in Wuhan, China from January 2006 to December 2010. (a) Sputum smear positive (SSP) pulmonary TB cases; (b) sputum smear negative (SSN) pulmonary TB cases.

Figure 3

Fig. 4. Ratio of sputum smear positive (SSP) pulmonary tuberculosis (TB) cases and sputum smear negative (SSN) pulmonary TB cases to the total number of TB cases by age group in Wuhan, China from January 2006 to December 2010.

Figure 4

Fig. 5. Prevalence data of sputum smear positive (SSP) and sputum smear negative (SSN) pulmonary TB cases per 100 000 by age and gender in Wuhan, China from January 2006 to December 2010.

Figure 5

Fig. 6. Maximum entropy method-power spectral density (PSD) for the weekly prevalence data for pulmonary TB cases per 100 000 in Wuhan, China from January 2006 to December 2010 (f⩽6·0). (a) Sputum smear positive (SSP) pulmonary TB cases; (b) sputum smear negative (SSN) pulmonary TB cases.

Figure 6

Table 1. Characteristics of the dominant spectral peaks (f⩽12·0) of PSD (Fig. 6) for SSP and SSN pulmonary tuberculosis in Wuhan, China from January 2006 to December 2010

Figure 7

Fig. 7. The least squares fitting (LSF) curve calculated with 1·0- and 0·5-year periodic modes for the weekly prevalence data for pulmonary tuberculosis (TB) cases per 100 000 in Wuhan, China from January 2006 to December 2010. (a) Sputum smear positive (SSP) pulmonary TB cases; (b) sputum smear negative (SSN) pulmonary TB cases.

Figure 8

Fig. 8. Monthly reported number of pulmonary tuberculosis (TB) cases by age group in Wuhan, China from January 2006 to December 2010. (a) Sputum smear positive (SSP) pulmonary TB cases; (b) sputum smear negative (SSN) pulmonary TB cases.

Figure 9

Table 2. χ2 test for the difference in seasonal distribution between the case of winter–spring (November–April) and that of summer–autumn (May–October) of SSP and SSN pulmonary tuberculosis by age group