广东省第五次结核病流行病学抽样调查分析

Analysis of the 5^(th) tuberculosis epidemiological sampling survey of Guangdong province

目的掌握广东省结核病疫情现状,对2001—2010年广东省结核病防治规划实施成效进行总结和评价,同时为制定下一阶段结核病防治规划提供依据。方法采用分层整群等比例随机抽样的方法进行抽样;以可疑症状调查、X线胸片、痰涂片和结核分枝杆菌培养、药敏等为主要检查和诊断方法,采取问卷形式开展社会经济学调查和知晓率调查。结果 (1)全省活动性肺结核患病率为229.97/10万、涂阳肺结核患病率为39.75/10万,菌阳患病率为62.46/10万。(2)疫情特点为男性患病率高于女性(χ2=59.1,P<0.01);老年人群患病率高于非老年人群(2χ=89.3,P<0.01);农村高于城镇(2χ=19.0,P<0.01);经济欠发达地区高于经济发达地区(χ2=28.7,P<0.01);总耐药率达到22.0%。(3)活动性肺结核患病率较2000年和1990年分别下降36.8%和60.4%;涂阳肺结核患病率较2000年和1990年分别下降66.7%和71.7%。结论 (1)近10年来广东省结核病防治工作取得了突出成效,疫情继续呈现下降趋势,活动性肺结核患病率较1990年下降60.4%,涂阳肺结核患病率平均年递降率10.4%,提前实现了世界卫生组织提出的结核病控制阶段性目标,涂阳肺结核患病率平均年递降率接近世界水平;(2)广东省结核病疫情形势仍然严峻,仍面临着耐药结核病等诸多挑战。因此,应继续加强结核病的控制工作,特别是加强对欠发达地区的支持。

Objective To understand the epidemiological features of tuberculosis in Guangdong province in order to evaluate the implementation of tuberculosis control strategy from 2001 to 2010. Methods Stratified cluster random sampling methods were used for this survey.Patients were diagnosed through inquiry of suspected symptoms,chest radiograph,sputum smear test,Mycobacterium tuberculosis culture and drug resistant test.The social-economic survey and awareness survey were conducted through questionnaires. Results 1） The prevalence of active pulmonary tuberculosis was 229.97/100 000 among which smear positive tuberculosis（39.75/100 000） and bacterial positive tuberculosis（62.46/100 000）.2） The prevalence status was higher in male（χ2=59.1,P0.01）,elderly population（χ2=89.3,P0.01）,rural areas（χ2=19.0,P0.01）,and less developed areas（χ2=28.7,P0.01）,the total drug resistant rate was 22.0%.3） Compared with the survey data of 2000 and 1990,the prevalence of active tuberculosis decreased 36.8% and 60.4% respectively,the smear positive tuberculosis declined 66.7% and 71.7% respectively. Conclusions 1） Remarkable progress in TB control work were made over the past decade in Guangdong province.The epidemic continues to show a downward trend,and the active tuberculosis decreased 60.4% in comparison with the baseline of 1990,the annual descending rate of smear positive PTB was 10.4%.Guangdong finished the TB control target set by WHO ahead of schedule,and the annual descending rate closed to the world level.2） Guangdong province still have high tuberculosis burden with the challenge from drug resistant tuberculosis.National tuberculosis control strategy should be implemented thoroughly with more support for the less developed regions.