2011～2015年连云港市连云区肺结核疫情分析

Analysis on the tuberculosis epidemic situation in Lianyun district of Lianyungang city from 2011 to 2015

目的掌握连云区肺结核疫情特征,为制订肺结核防治策略提供科学依据。方法病例资料来源于结核病管理信息系统,人口资料来源于连云区统计局,采用描述性流行病学及卡方(趋势)检验进行统计分析,以P<0.05为有统计学意义。结果2011~2015年累计登记活动性肺结核264例,年均登记发病率为29.22/10万,最高为2012年的33.63/10万。(χ^2=5.465,P=0.243),其中涂阳肺结核患者104例,占39.39%,年均发病率为11.51/10万;涂阴肺结核159例,占60.23%,年均发病率17.60/10万;未痰检1例,占0.38%。患者主要来源为因症就诊(50.76%)、转诊(37.88%)、追踪(10.98%)。患者发现方式差异有统计学意义(χ^2=229.778,P<0.05)。每月均有肺结核散发,其中5、6月及8月发病较多,分别占10.98%(29/264)、11.36%(30/264)和10.23%(27/264)。男、女发病率分别为43.41/10万、14.31/10万,差异有统计学意义(χ^2=65.435,P<0.05),男性发病率高于女性。各年龄组发病率差异有统计学意义(χ^2=148.530,P<0.05),青壮年(15~34岁)和老年人(≥55)多发。职业分布以家政家务及待业(28.03%)、农民(21.59%)、离退人员(12.50%)和工人(11.36%)多发,共占73.48%,学生占8.71%。涂阳肺结核中,治愈89例(85.58%),涂阴肺结核中,完成疗程155例(97.48%)。结论连云区活动性肺结核发病率维持在较低水平,疫情控制取得一定的成效,男性,青壮年、老年人,家政、家务及待业、农民是工作的重点人群。

Objective To understand the epidemic characteristics of tuberculosis(TB) in Lianyun district of Lianyungang city for evidence to plan scientific measures for prevention and control of this entity. Methods Case data were collected from TB management information system, and population data from Lianyun District Statistical Bureau. Descriptive epidemiology and Chi-square test were used for statistical analysis, with P < 0.05 as statistical significance. Results A total of 264 cases of active pulmonary tuberculosis were registered from 2011 to 2015, with an average annually registered incidence of 29.22 per 100 000 population, and the highest incidence of 33.63 per 100 000 residents in 2012.The difference was insignificant in the 5 years(χ^2=5.465, P =0.243). 104 cases (39.39%) were smear-positive pulmonary tuberculosis, and 159 smear-negative, with an average annual incidence of 11.51 and 17.60 per 100 000 population, respectively. Sputum examination was absent in one case(0.38%). The main sources of patients were clinic visit duet to symptom(50.76%), referral (37.88%) and follow-up (10.98%). There was significant difference in patients identification (χ^2= 229.778, P <0.001). Sporadic case of tuberculosis was reported every month, yet the incidence was higher in May, June and August, accounting for 10.98%(29/264), 11.36%(30/264) and 10.23%(27/264) respectively. The incidence was 43.41 and 14.31 per 100 000 male and female population, respectively, with males being higher than females(χ^2=65.435, P <0.001). The incidence was different in age groups(χ^2= 148.530, P < 0.001), and more seen in young adults (15-34 years) and the elderly (≥55 years). Patient's occupational pattern was associated with housekeeping and unemployment (28.03%), farmers (21.59%), retirees (12.50%) and workers (11.36%), which accounted for a total of 73.48%, and 8.71% of them were students. In the cases of smear positive pulmonary tuberculosis, 89 (85.58%) were cured, and 155 cases (97.48%) of smear negative pulmonary tuberculosis completed the medication course. Conclusion The incidence of active pulmonary tuberculosis in Lianyun district is maintained at a relatively lower level, and certain results have been achieved in the epidemic control. Following monitoring over this condition should focus on males, young adults, the elderly, housekeepers, the unemployed and farmers.