1979～2000年四次全国儿童结核病流行病学抽样调查分析

The epidemic of childhood tuberculosis in China

目的 分析中国儿童结核病流行情况。方法 总结从 1979～ 2 0 0 0年全国 4次结核病流行病学抽样调查 (流调 )资料 ,并对儿童 (0～ 14岁 )结核病疫情进行分析。结果 4次结核病流调0～ 14岁儿童结核感染率分别为 8 8%、9 6 %、7 5 %和 9 0 % ;1979、1990、2 0 0 0年儿童活动性肺结核患病率分别为 2 4 1 7/ 10万、172 1/ 10万、91 8/ 10万 ,儿童结核杆菌培养阳性 (菌阳 )肺结核患病率 1990年、2 0 0 0年为 12 7/ 10万、12 3/ 10万 ,儿童痰涂片抗酸杆菌阳性 (涂阳 )肺结核患病率 1979年、1990年、2 0 0 0年分别为 7 5 / 10万、7 5 / 10万、6 7/ 10万。结合人口资料 ,估算 2 0 0 0年约有 2 6 0 8万 0～ 14岁儿童感染结核 ,活动性肺结核患儿约 2 6 6万 ,菌阳肺结核患儿约 3 6万 ,涂阳肺结核患儿约 1 9万 ,分别占同期所有病例的 4 5 %、5 9%、1 8%、1 3% ;4次流调城市及农村儿童结核感染率之比分别为 1 8、1 8、1 7、1 2。结论 1979～ 2 0 0 0年 ,儿童结核感染率并没有很大的下降 ;儿童结核中菌阴肺结核患儿占有相当比例 ;儿童结核病疫情城乡差别正在缩小 ;用常规监测数据来代替大规模流调是趋势 ;在新的、更为有效的疫苗发明以前 ,卡介苗接种仍将是我国结核病控制工作的重要内容之一。

Objective To analyze the epidemic situation of children Tuberculosis (TB) in China.Methods To sum up the data of four times national TB epidemic survey from 1979 to 2000, and analyze the epidemic situation of children whose age were between 0 and 14. Results The TB prevalence rates in children were 8 8%, 9 6%, 7 5% and 9 0% in 1979, 1984/85, 1990, 2000. The active pulmonary TB(PTB) prevalence rates in children were 241 7/100 000 172 1/100 000, 91 8/100 000 in 1979, 1990 and 2000, the bacteriological positive PTB prevalence rates were 12 7/100 000, 12 3/100 000 in 1990 and 2000, the smear positive PTB prevalence rates were 7 5/100 000, 7 5/100 000 and 6 7/100 000 in 1979, 1990 and 2000; It was estimated there were 26 08 million children who were infected by microbacterial TB, 266 thousands children active PTB cases, 36 thousands children bacteriological positive PTB cases and 19 thousands children smear positive PTB cases in 2000 according to the data of the national population survey. the rates were 4 5%, 5 9%, 1 8%, 1 3% when comparing them to the all patients. the ratio of children TB prevalence rates between city and country were 1 8,1 8,1 7 and 1 2 in the four survey. Conclusions The TB prevalence rates in children had not obvious decrease from 1979 to 2000 were not allowed to optimize to the epidemic of children TB. The bacteriological negative PTB had a bigger. The difference of children TB prevalance between city and country reduced gradually. The quantity of sample and other factors influenced the forecast value of PPD to disease, so it would be a trend of using the routine surveillance to replace the national epidemic survey. BCG still would be the an important content in our national TB control before the emergence of the new and more efficient vaccine.