Fine-scale spatiotemporal heterogeneity of potential determinants of drug-resistant tuberculosis incidence: a geographically and temporally weighted regression study in Shanghai, China

To investigate the spatiotemporal heterogeneity of DR-TB incidence and its potential determinants at the small-area level in Pudong New Area, Shanghai, using a geographically and temporally weighted regression (GTWR) model. Data on town-level DR-TB incidence from 2019 to 2023 were collected, together with potential determinants covering socioeconomic development, population characteristics, healthcare resources, tuberculosis (TB) prevention and control, air pollution, and meteorological conditions. Principal component analysis (PCA) was used to derive composite indices for these determinant domains. A geographically and temporally weighted regression (GTWR) model was subsequently employed to quantify the local associations between these determinants and DR-TB incidence and to characterize their spatiotemporal heterogeneity across towns and over time. The GTWR model revealed significant spatiotemporal heterogeneity in the associations between multiple potential determinants and DR-TB incidence from 2019 to 2023. Regarding temporal variation, the temporal trend coefficients were − 0.012 for socioeconomic factors, + 0.203 for population factors, -0.438 for healthcare factors, -1.641 for TB control factors, -3.395 for air pollution factors, and + 0.325 for meteorological factors. Spatially, economic, healthcare, air pollution, and meteorological factors generally showed higher coefficients in the northwestern urban areas, whereas population and TB control factors showed the opposite pattern, indicating clear spatial differentiation across the study area. The associations between potential determinants and DR-TB incidence varied across space and time in Pudong New Area. These findings support the use of fine-scale spatiotemporal approaches to identify areas with different determinant profiles and inform targeted and context-specific DR-TB prevention and control strategies. Not applicable.