Epidemiology and Treatment Outcomes of Pulmonary Tuberculosis in Dazu District, Chongqing, China, 2005-2024: Surveillance Study.

Background: As a high tuberculosis (TB) burden area in China, Dazu District of Chongqing Municipality contains a large rural population and exhibits typical features of TB endemicity. Objective: This study aimed to analyze the epidemiological characteristics and treatment outcomes of pulmonary tuberculosis (PTB) in Dazu District from 2005 to 2024, with the aim of supporting the optimization of regional TB control strategies. Methods: Data on PTB cases in Dazu District from 2005 to 2024 were collected from the China Disease Control and Prevention Information System. Descriptive epidemiological methods were employed to analyze the temporal, demographic, and geographical distributions, along with trends in treatment outcomes. Global and local spatial autocorrelation analyses were performed using Moran I and Getis-Ord Gi* statistics, respectively. Results: A total of 10,236 cases were reported, for an average annual notification incidence of 65.2 per 100,000 population. The annual average notification incidence decline rate was 7.7%. Joinpoint regression analysis revealed a statistically significant decline in annual incidence rates (average annual percent change=-6.81, 95% CI -7.25 to -6.30, P<.0001). The bacteriological positivity rate initially decreased before rising, reaching 81.6% in 2024. Reported case counts peaked in March, while relatively lower numbers were observed during October, November, and December. Cases were predominantly among male patients, with a male-to-female ratio of 3.57:1. The case composition ratio in the ≥65 years age group has gradually increased, from 13.8% in 2006 to 19.9% in 2015 and to 38.5% in 2024. Occupational distribution was primarily among farmers (77.6%, 7948/10,236), homemakers or unemployed individuals (5.6%, 570/10,236), and students (3%, 303/10,236). Cases were concentrated in Longshui Town (13.1%, 1339/10,236), Tangxiang Subdistrict (9.1%, 933/10,236), and Longgang Subdistrict (7.9%, 811/10,236)-areas with large population bases. Among these, Guoliang Town exhibited the highest average annual notification incidence (314.4/100,000). Treatment success rate reached 91.3%. Multivariate binary logistic regression revealed that age 25-44 years (OR 1.755; 95% CI 1.320-2.332; P<.0001), undergoing initial treatment (OR 3.786; 95% CI 2.524-5.680; P<.0001), absence of HIV coinfection (OR 2.499; 95% CI 1.714-3.643; P<.0001), negative bacteriologic test results (OR 2.841; 95% CI 2.214-3.646; P<.0001), and the receipt of full-course supervised treatment (OR 7.705; 95% CI 4.520-13.137; P<.0001) were significantly associated with treatment success. Conclusions: The notification incidence of PTB in Dazu District, Chongqing, has gradually declined. Particular focus is required on the treatment of young children, elderly individuals, patients with HIV coinfection, those under intensive phase supervision, bacteriologically positive cases, and retreatment cases. These measures may reduce the incidence of PTB and improve treatment success rates in our district.