Abstract: Objective To explore the environmental factors affecting the incidence of pulmonary tuberculosis (PTB) in the Hotan region based on MaxEnt model, and to predict areas of elevated risk, thereby providing a scientific basis for precise prevention and control of PTB in Hotan. Methods The incidence of PTB reported in Hotan from 2015 to 2021, the geographic coordinates of newly diagnosed cases, and relevant environmental variables in Hotan were collected. The risk prediction model for PTB transmission was constructed based on the MaxEnt modeling framework and maximum entropy algorithms. The relative importance of environmental variables was assessed to identify high-risk areas for PTB transmission within the region. Results From 2015 to 2021, a total of 47 291 new PTB were reported in Hotan. Incidence rates peaked slightly in 2018 before exhibiting a sustained annual decline. Spatially, Moyu County (8 906 cases, 18.8%) and Yutian County (8 274 cases, 17.4%) reported the highest case counts. According to the MaxEnt model output, the three environmental variables contributing most significantly to the spatial distribution of PTB were fractional vegetation cover (FVC, 73.9%), annual average temperature (TEM, 13.0%), and normalized difference vegetation index (NDVI, 6.9%). Hotan City, Moyu County, Luopu County, Yutian County, and Cele County were identified as high-risk areas, with mean risk values of 0.604 302, 0.033 288, 0.031 097, 0.027 203, and 0.025 629, respectively. Conclusions The PTB epidemic in Hotan is multifactorially determined, with economic and climatic factors—specifically, low income and high temperature and humidity—constituting key risk factors for disease incidence. High-risk zones are primarily concentrated in the central and western subregions of Hotan.

Key words: Pulmonary tuberculosis, MaxEnt model, Environmental factors, Transmission risk