title: Co-endemicity of Pulmonary Tuberculosis and Intestinal Helminth Infection in the People's Republic of China.
abstract: Both pulmonary tuberculosis (PTB) and intestinal helminth infection (IHI) affect millions of individuals every year in China. However, the national-scale estimation of prevalence predictors and prevalence maps for these diseases, as well as co-endemic relative risk (RR) maps of both diseases' prevalence are not well developed. There are co-endemic, high prevalence areas of both diseases, whose delimitation is essential for devising effective control strategies. Bayesian geostatistical logistic regression models including socio-economic, climatic, geographical and environmental predictors were fitted separately for active PTB and IHI based on data from the national surveys for PTB and major human parasitic diseases that were completed in 2010 and 2004, respectively. Prevalence maps and co-endemic RR maps were constructed for both diseases by means of Bayesian Kriging model and Bayesian shared component model capable of appraising the fraction of variance of spatial RRs shared by both diseases, and those specific for each one, under an assumption that there are unobserved covariates common to both diseases. Our results indicate that gross domestic product (GDP) per capita had a negative association, while rural regions, the arid and polar zones and elevation had positive association with active PTB prevalence; for the IHI prevalence, GDP per capita and distance to water bodies had a negative association, the equatorial and warm zones and the normalized difference vegetation index had a positive association. Moderate to high prevalence of active PTB and low prevalence of IHI were predicted in western regions, low to moderate prevalence of active PTB and low prevalence of IHI were predicted in north-central regions and the southeast coastal regions, and moderate to high prevalence of active PTB and high prevalence of IHI were predicted in the south-western regions. Thus, co-endemic areas of active PTB and IHI were located in the south-western regions of China, which might be determined by socio-economic factors, such as GDP per capita.
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China.|Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China.|National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
authors.forename: Xin-Xu
authors.initials: XX
authors.lastname: Li
authors.affiliation: State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, People's Republic of China.
authors.forename: Zhou-Peng
authors.initials: ZP
authors.lastname: Ren
authors.affiliation: National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
authors.forename: Li-Xia
authors.initials: LX
authors.lastname: Wang
authors.affiliation: National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
authors.forename: Shi-Wen
authors.initials: SW
authors.lastname: Jiang
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China.|Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China.
authors.forename: Jia-Xu
authors.initials: JX
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, People's Republic of China.
authors.forename: Jin-Feng
authors.initials: JF
authors.lastname: Wang
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China.|Key Laboratory of Parasite and Vector Biology, Ministry of Health, WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China.
authors.forename: Xiao-Nong
authors.initials: XN
authors.lastname: Zhou
mesh_terms: D001499:Bayes Theorem; D002681:China / Q000453:epidemiology; D060085:Coinfection; D019353:Endemic Diseases; D006373:Helminthiasis / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000453:epidemiology; D016015:Logistic Models; D008390:Markov Chains; D008954:Models, Biological; D009010:Monte Carlo Method; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000453:epidemiology