2013—2022年南宁市肺结核流行特征和时空聚集性分析

Analysis of the temporal and spatial distribution characteristics of pulmonary tuberculosis in Nanning City from 2013 to 2022

目的了解2013—2022年广西壮族自治区南宁市肺结核的时空分布和聚集特征,为制定肺结核防治策略提供科学依据。方法从中国疾病预防控制信息系统提取南宁市2013—2022年肺结核病例资料数据,描述疾病的三间分布特征,并采用空间自相关分析和时空扫描分析探索其时空聚集性特征。结果2013—2022年南宁市肺结核年均报告发病率为74.90/10万,男性和女性年均报告发病率分别为101.74/10万和46.25/10万,男性发病率高于女性,差异有统计学意义(χ^(2)=21.19,P<0.01)。全年各月均有病例报告,但无明显季节性。12个县(区)报告发病率差异有统计学意义(χ^(2)=53.31,P<0.01)。自2017年后,南宁市报告肺结核患者中病原学阳性患者数和肺结核报告发病数之间呈空间正相关关系。肺结核发病人数具有明显的全局空间正相关性(Moran's I=0.16~0.30)。“高-高”聚集区主要位于江南区、马山县和上林县的部分街道(乡镇)。肺结核发病存在时空聚集性,共扫描出5个时空聚集区域,一类聚集区以上林县塘红乡为中心,发生时间在2013年1月—2017年11月,涵盖南宁市39个街道(乡镇)。结论南宁市肺结核疫情不容乐观,存在明显的时空聚集性,男性是肺结核防控的重点人群,人群密集和经济发展落后地区应作为结核病防控重点地区,应加强对病原学阳性病例密切接触者的筛查。

Objective To understand the temporal and spatial distribution characteristics and clustering features of pulmonary tuberculosis in Nanning City,Guangxi Zhuang Autonomous Region from 2013 to 2022,and to provide a scientific basis for formulating pulmonary tuberculosis prevention and control strategies.Methods Extract pulmonary tuberculosis case data from the Chinese Disease Prevention and Control Information System for Nanning City from 2013 to 2022 to describe the spatial distribution characteristics of the disease and explore its spatial clustering characteristics through spatial autocorrelation analysis and spatiotemporal scanning analysis.Results The average annual reported incidence rate of pulmonary tuberculosis in Nanning City from 2013 to 2022 was 74.90/100000,with average annual reported incidence rates of 101.74/100000 for males and 46.25/100000 for females.The incidence rate in males was higher than in females(χ^(2)=21.19,P<0.001).Cases were reported every month throughout the year,but no obvious seasonality was observed.There were variations in reported incidence rates among the 12 districts and counties(χ^(2)=53.31,P<0.01).Since 2017,there has been a spatial positive correlation between the number of pulmonary tuberculosis patients with positive pathogenic results and the reported incidence of pulmonary tuberculosis in Nanning City.The number of pulmonary tuberculosis cases demonstrates a significant global spatial positive correlation(Moran's I values ranging from 0.16 to 0.30)."High-high"cluster areas were mainly located in certain streets(townships)of Jiangnan District,Mashan County,and Shanglin County.Pulmonary tuberculosis incidence showed both spatial and temporal clustering,with a total of five spatiotemporal cluster areas identified.One cluster area was centered on Tanghong Township in Shanglin County,occurring from January 2013 to November 2017,covering 39 streets(townships)in Nanning City.Conclusions The pulmonary tuberculosis epidemic in Nanning City is not optimistic,with evident spatial and temporal clustering.Males are the key population for pulmonary tuberculosis prevention and control.Areas with dense populations and underdeveloped economies should be prioritized for epidemic prevention and control,and screening for close contacts of pathogen-positive cases should be strengthened.