2009-2013年重庆市肺结核疫情特征分析

Epidemic characteristics of pulmonary tuberculosis in Chongqing from 2009 to 2013

目的掌握重庆市肺结核疫情的流行特征，为完善防控策略提供数据支持。方法由国家疾病监测信息报告管理系统获得肺结核报告发病例数，根据重庆市统计年鉴和第五次人口普查中的人口数，两者结合计算报告发病率。重庆市常住人口数2009年为28390000人，2010年为28590000人，2011年为28846200人，2012年为29190000人，2013年为29450000人。2009--2013年男性累计人口数为73091900人，女性累计人口数为71374300人。采用描述性流行病学方法分析重庆市2009--2013年肺结核三间分布特征。采用χ2检验对不同年份、不同性别、不同年龄段肺结核患者的发病率进行分析，以P〈0．05为差异有统计学意义。结果2009--2013年重庆市肺结核年均报告发病率为88．8／10万（128346／144466200）。各年度报告发病率分别为96．9／10万（27509／28390000）、89．9／10万（25702／28590000）、88．8／10万（25622／28846200）、85．6／10万（24977／29190ooo）和83．3／10万（24536／29450000），呈逐年下降趋势（χ2趋势=347．8，P〈0．01）。患者主要集中在1、3月份（占21．3％，[（13738＋13617）／128346]）。各区县肺结核疫情不均衡，排名前5位的分别是彭水县161．7／10万（4352／2690600）、城口县156．2／10万（1489／953300）、黔江区152．7／10万（3382／2214900）、巫溪县142．9／10万（3008／2104900）和武隆县141．3／10万（2455／1737900）。男性发病率（124．7／10万，91173／73091900）高于女性（52．1／10万，37173／71374300）（χ2=21476．1，P〈0．01）。不同年龄组发病率差异有统计学意义（χ2=12639．5，P〈0．01），其中75～岁组老年人发病率最高（179．2／10万，774／431918）。农民发病例数最多，占55．9％（71791／128346）。结论重庆市近年来肺结核疫情稳步下降，但不同地区、不同人群特征的肺结核疫情不平衡，需要根据各地实际情况完善防治策略以更好地控制疫情。

Objective To learn the epidemic characteristics of pulmonary tuberculosis （PTB） in Chongqing and provide a data support to improve the tuberculosis prevention and control strategy. Methods We got the data of reported PTB patients from Chinese Infectious Disease Report Information System and abstracted population data from Chongqing Statistical Yearbook and The Fifth Census of Chongqing, then the incidence of reported PTB pa- tients was calculated. The numbers of resident population in Chongqing from 2009 to 2013 were 28 390 000 in 2009, 28 590 000 in 2010, 28 846 200 in 2011, 29 190 000 in 2012 and 29 450 000 in 2013 respectively. The cumulative number of population were 73 091 900 in male and 71 374 300 in female. The descriptive epidemiological methods were used to analyze distribution of PTB from 2009 to 2013. Chi square test was used to analyze the reported inci- dence rate of PTB patients with different year, different gender and different age, with P^0.05 as the statistical difference. Results The average reported PTB incidence was 88. 8/100 000 （128 346/144 466 200）, the incidence rates were 96.9/100 000 （27 509/28 390 000） in 2009, 89. 9/100 000 （25 702/28 590 000） in 2010, 88. 8/100 000 （25 622/28 846 200） in 2011, 85.6/100 000 （24 977/29 190 000） in 2012 and 83.3/100 000 （24 536/29 450 000） in 2013 respectively, which showed a downward trend by year （χ2trend= 347. 8, P〈0. 01）. The cases mainly concentrted in January and March （accounted for 21.3%, （13 738＋13 617）/128 346）. Epidemic situation of PTB in different regions was uneven, the top five regions were Pengshui county （161.7/100 000, 4352/2 690 600）, Chengkou county （156.2/100 000, 1489/953 300）, Qianjiang district （152. 7/100 000, 3382/2 214 900）, Wuxi county （142. 9/100 000, 3008/2 104 900） and Wulong county （141.3/100 000, 2455/1 737 900）. The incidence rate in male （124.7/100 000, 91 173/73 091 900） was higher than in female （52.1/100 000, 37 173/71 374 300）（Z2 =21 476.1, P〈0.01）. There was a statistical difference between different age groups in reported incidence （χ2= 12 639.5, P〈0.01）, peaked in 75-- age group （179.2/100 000, 774/431 918）. Most cases in all occupations was farmer （accounted for 55.9%, 71 791/128 346）. Conclusion The PTB epidemic in Chongqing has steadily declined in recent years. As the epi- demic situation of PTB in different area of different demographic characteristics is imbalance, we need to improve control strategy according to the actual situation to control the epidemic of PTB better.