西藏地区肺结核病流行特征

Prevalence of tuberculosis in Tibet Autonomous Region, 2014

目的掌握西藏自治区人群肺结核的患病特征,为有效提高结核防治效果及其制定下一阶段的结核病防治方案提供有利依据。方法2014年采用分层整群等比例随机抽样方法,对西藏自治区≥15岁常住人群进行体格检查和问卷调查。结果全区活动性、涂阳和菌阳肺结核加权患病率分别是758/10万、85/10万和144/10万;1979-2014年,西藏地区总体肺结核的患病率呈下降趋势,其中从1990-2014年的年标化后肺结核的患病率递减率是1979-1990年的33.8倍;男性居民的肺结核的患病率高于女性,其差异有统计学意义(P<0.05);人群中患病高峰均出现在60~65岁阶段,随后均呈下降趋势。结论西藏自治区肺结核的防治工作取得了突出成效,其结核病的患病率呈下降趋势,但是总体疫情控制率低于全国水平,仍然面临着严峻的挑战,故应结合西藏地区结核病的流行特征,继续加强疫情防治工作,切实落实保障政策,有效控制全区肺结核流行。

Objective To examine prevalence features of tuberculosis (TB) in Tibet Autonomous Region (Tibet) and to provide evidences for improving measures and developing strategies of tuberculosis prevention in the region. Methods We conducted a survey on TB at 20 sites (8 in urban and 12 in rural regions) selected using stratified random cluster proportional population sampling. Totally 30 312 permanent residents aged 15 years and above in all the study sites were recruited to receive a questionnaire interview and physical examination including chest x-ray screening for TB during 2014. Results Among the residents, the weighted prevalence rate of active pulmonary, smear positive, and sputum culture positive TB were 758/100 000, 85/100 000, and 144/100 000,respectively. The TB prevalence rate was significantly higher among the male residents than among the female residents (P < 0.05) and the highest age-specific TB prevalence rate was observed among the residents aged 60-65 years. The TB prevalence rate showed a continuously decreasing trend during 1979-2014 in Tibet;the standardized annual TB prevalence decline rate during 1990-2014 was 33.8 times higher than that during 1979-1989 averagely. Conclusion Although the TB epidemic was well controlled and the TB prevalence rate showed a continuous decrease trend in Tibet during 1979-2014, the overall control rate of TB prevalence is still lower than that of national level, suggesting that targeted measures should be implemented to control TB epidemic effectively in the region.