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. 2019 Apr-Jun;11(2):63–68. doi: 10.4103/jgid.jgid_95_18

Table 1.

Summary of studies included in the systematic review and meta-analysis of effect of climatic factors and altitude on tuberculosis

Study Country, Population Study period Outcome type
24 Japan, all registered TB cases of the Fukuoka Institute of Health 2008-2012 All forms of TB incidence (5904 TB cases)
21 China, all annual reported TB patients in 32 Mainland provinces 2009-2013 TB prevalence
25 Japan, TB patients registered in 46 prefectures Japanese TB registry 1961-1978 TB prevalence determined by clinicians by clinical factors
29 China, all TB patients in randomly selected medical institutions 2009-2013 TB incidence (n=27, 655 cases)
27 Turkey, all patients receive treatment in state TB dispensaries from randomly selected 56 cities 1999-2005 All forms of TB (378 TB cases; the mean incidence of TB per 100 k=23.8±9.1 [12.07-47.39])
28 Mexico, all annual PTB notification cases registered obtained from Mexican Health Ministry database 1998, 2002 TB incidence
23 Kenya, all annual TB patient reports in 41 districts of National TB Program 1988-1990 TB prevalence
26 China, all registered TB cases from Chinese center of disease control and prevention management information system 2007 TB prevalence
22 China, all TB patients registered (in 31 provinces) China Health Statistics Yearbook 2001-2010 TB prevalence

Study Exposure Adjusted variable Findings

24 Temperature (29.2°C) Age, sex Exposure to extreme heat temperature (RR=1.2, 95% CI: 1.01-1.43)
21 Monthly average temperature NA Average annual temperature (RR=1.00324, 95% CI: 1.00150-1.00550)
25 Annual average temperature (°C) Sunshine hour The monthly average temperature increase in 10°C TB incidence decrease by 9% (β=−0.0060, P<0.001)
27 Monthly average temperature (°C) Latent variable; TB control programs, population density, income, public assist, past TB control, past epidemic 29.9°C-39.8°C and 18.0°C-46.1°C temperature is associated with TB prevalence and incidence rate, respectively
28 Altitude defined as>750 m and 1-750 m Green card, annual income, population density, household size, urbanization rate, number of doctors There is inverse correlation between altitude and mean TB incidence (r=−0.58, 95% CI: −0.73-−0.38, P=0.000)
The incidence higher in cities at an altitude <750 m versus >750 m (OR=3.28, 95% CI [1.83-5.88], P<0.0001)
23 Altitude above sea level (0-2500) NA Altitude above sea level correlated with TB incidence (r=−0.74, 95% CI: −0.87-−0.53, P<0.0001)
26 Altitude Nomads, population density, literacy rate, household size, life expectancy rate, nutritional status The log notification rates negatively associated with altitude (r=−0.71, 95% CI: −0.51-0.83, P<0.001)
22 Altitude Air quality, education, health service, population density, economic level, unemployment Altitude factor (−0.595) had a significant effect on TB prevalence

NA: No information about variable adjustment, TB: Tuberculosis, CI: Confidence interval, RR: Relative risk, OR: Odds ratio

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