Abstract
BACKGROUND: In recent years, Shaoxing City, located in central Zhejiang Province, has experienced a slow decline in the incidence of pulmonary tuberculosis (PTB). Therefore, there is an urgent need to elucidate the potential causes for this decline through spatiotemporal analyses to provide a scientific basis for targeted prevention and control. We aimed to explore the spatiotemporal distribution of PTB notification rates in Shaoxing City from 2016 to 2024 and identify high-incidence clusters, thereby offering data-driven insights to optimize regional PTB control strategies. METHODS: Statistical analyses were conducted using R and Excel on all reported active PTB cases in Shaoxing City. Spatiotemporal analysis of case distribution and regional clustering was conducted using ArcGIS and SatScan. RESULTS AND DISCUSSION: In total, 17,298 active PTB cases were registered between 2016 and 2024, including 9,749 laboratory-confirmed and 7,549 clinically diagnosed cases. The male-to-female ratio was 2.34:1. Farmers represented 68.2% of all cases. The PTB notification incidence showed a gradual decline. Spatial autocorrelation results revealed 52 sub-districts with high-high clusters over the nine-year period, primarily in Shengzhou and Xinchang counties. Spatiotemporal scan analysis identified one primary cluster area (RR = 1.62, LLR = 170.87, p < 0.001) and two secondary clusters between 2016 and 2024. The incidence of PTB in Shaoxing City showed a downward trend, though the decline was relatively slow. The southeastern region should be prioritized in efforts to accelerate the End TB Strategy. Overall, comprehensive and intensive interventions, such as large-scale chest X-ray screening and health education programs, should be enhanced to effectively curb PTB transmission, especially among males and farmers.