Objective:

To identify spatiotemporal patterns of TB incidence at the county level in Iran and determine high-risk areas and contributing factors using advanced spatial epidemiological techniques, emphasizing the need for targeted interventions.

Key Findings:

• Iran is classified as a medium-TB-burden country with an incidence rate of 10.88 per 100,000 population, highlighting the need for targeted public health strategies.
• Significant geographical disparities in TB incidence exist across provinces and counties, influenced by urbanization, migration, and healthcare infrastructure, necessitating localized interventions.
• High immigration rates correlate with elevated TB incidence in border areas, underscoring the impact of migration on disease spread.

Interpretation:

The study highlights the need for localized, evidence-based interventions to address the heterogeneous distribution of TB in Iran, particularly in high-risk areas, and calls for targeted public health strategies.

Limitations:

• The study is limited to data from 2014 to 2019, which may not reflect current trends in TB incidence.
• Potential underreporting of TB cases in certain regions may affect the accuracy of incidence rates, potentially leading to misinformed public health responses.

Conclusion:

Understanding the spatiotemporal dynamics of TB in Iran is crucial for effective public health interventions and resource allocation, particularly in addressing socioeconomic factors that contribute to TB spread.