中国四省市结核病发病危险因素研究

Study on the risk factors of tuberculosis in four cities and provinces in China

目的探讨中国东、中部广东、湖南、江苏、上海四省市结核病发病的影响因素，为结核病防控工作提供参考依据。方法2009年11月--2011年2月，采用结核病发病监测户卡对四省市若干乡镇／街道的常住人口，共进行3次以全人群为基础的入户调查。调查中的474例结核病患者作为病例组，从源人群中按地区、年龄、性别进行频数匹配，随机抽取1896位非结核病患者作为对照组，进行发病危险因素的病例对照研究。资料分析采用单因素和多因素非条件logistic回归分析。结果多因素分析结果提示，结核病史（OR=52．356，95％CI：18．956～144．607）、人均居住面积≥50m。（OR=8．742，95％CI：1．107～69．064）、结核病患者接触史（OR=6．083，95％CI：2．336～15．839）、外来人口（OR=3．306，95％CI：1．907～5．734）是结核病发生的危险因素，文化程度高（oR=o．284，95％CI：0．110～0．733）是其保护因素。结论加强对既往有结核病史者、结核病接触者以及外来人口的结核病管理控制工作，将有助于降低结核病的流行强度。

Objective To investigate the influencing factors on tuberculosis （TB） in four provinces in the eastern and central parts of China. Methods From Nov. 2009 to Feb. 2011, three population-based field surveys were conducted among the resident population in several townships/ streets in Guangdong, Hunan and Jiangsu provinces and Shanghai municipality to collect TB-related information. 474 sputum smear positive TB patients and 1896 controls were randomly selected from the population under study and each case was matched by province, age and sex using a frequency matching method. Single-variable and multiple non-conditional logistic regression modeling were applied for data analysis, and odds ratios （ORs） and their corresponding 95% confidence intervals （Cls） were estimated. Results Data from Single-variable analysis showed that TB history, history of exposure to TB, DM history, immigrant population and per-capita living space were risk factors for TB, and high level of education was protective factors. Results from multiple logistic regression showed that the risk factors of TB would include the following items： history of having had TB （OR = 52.356, 95%CI： 18.956-144.607）, living space over 50 m2 per-capita （OR=8.742, 95%CI： 1.107- 69.064） ,history of exposure to TB （0R=6.083,95%CI：2.336-15.839） and being immigrants （OR= 3.306,95%CI： 1.907-5.734） , while having had high degree of education as the protective factor of TB（OR=0.284,95%CI： 0.110-0.733）. Conclusion Control programs targeting those ever having TB patients and contacts to TB patients as well as immigrants should be strengthened.