2010年湖北省武汉市第5次结核病流行病学抽样调查分析

The fifth tuberculosis epidemiological survey of Wuhan City in 2010

目的了解湖北省武汉市结核病疫情现状,为制定2011-2020年武汉市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方法对5个流行病学抽样调查(简称"流调")点≥15岁应检人口进行胸部X线检查,对所有应查痰对象进行痰涂片和痰培养检查。对所有调查对象进行结核病防治知识知晓情况问卷调查。结果调查对象实际受检率为96.3%,2010年≥15岁人群活动、涂阳和菌阳肺结核的患病率分别为436.3/10万,63.8/10万,178.5/10万。2000-2010年活动性肺结核患病率下降2.6%,年递降率为0.3%;涂阳肺结核患病率下降53.4%,年递降率为7.4%;菌阳肺结核患病率下降23.7%,年递降率为2.7%。疫情特点为男性患病率高于女性(活动性χ2=30.56,P<0.001;涂阳χ2=4.69,P=0.030;菌阳χ2=15.39,P<0.001),老年人活动性和菌阳结核病患病率高于非老年人(活动性χ2=7.83,P=0.007;菌阳χ2=3.98,P=0.046),城区活动性肺结核患病率高于农村(χ2=2.59,P=0.047)。公众结核病知识总知晓率为64.4%,≥65岁老年人总知晓率仅为53.3%,农民知晓率低于城镇居民。结论武汉市近10年来结核病疫情呈下降趋势,防治工作取得了一定的效果;武汉市结核病预防和控制工作仍有许多挑战,应继续提高防治水平。

Objective To investigate the prevalence and trend of pulmonary tuberculosis（ TB）,and to provide relevant references for improving TB control program in Wuhan City from 2011 to 2020. Methods The population under the current study was randomly sampled,using both stratified clustering sampling methods. A total of 5 clusters were established. People over 15 years old in sampled survey points were administered chest X-ray. Sputum microscopy and culture were given to all suspected cases. All surveyed people received TB knowledge awareness questionnaire. Results The examination rate was 96. 3%. The prevalence of active,smear positive and bacteriological positive pulmonary TB were 436. 3/100 000,63. 8 /100 000,and 178. 5 /100 000,respectively among population over 15 years old in 2010. Compared with the survey data of 2000,the prevalence of active TB was decreased by 2. 6%,with the annual descending rate of active TB being 0. 3%,the smear positive was decreased by 53. 4%,with the annual descending rate of smear positive tuberculosis being 7. 4%,the bacteriological positive pulmonary TB decreased by 23. 7%,with the annual descending rate of bacteriological positive pulmonary TB being 2. 7%. The prevalence status was higher in male（ active TB χ2= 30. 56,P 0. 001; smear positive TB χ2= 4. 69,P = 0. 030; bacteriological positive pulmonary TB χ2= 15. 39,P 0. 001）,elderly population（ active TB χ2= 7. 83,P = 0. 007; bacteriological positive pulmonary TB χ2= 3. 98,P = 0. 046）,and rural areas（ active TB χ2= 2. 59,P = 0. 047）. The general public TB knowledge awareness rate was 64. 4%. The general public TB knowledge awareness rate in people over 65 years old was 53. 3%,farmers＇ general public TB knowledge awareness rate was much lower than urban residents. Conclusions Remarkable progress in TB control work has been made since the past decade ago in Wuhan City. The epidemic continues to show a downward trend. Wuhan City still has high TB burden with many challenges. National TB control strategy should be implemented thoroughly with more supports.