基于曲线聚类的肺结核流行特征分析

Epidemiological Characteristics of Pulmonary Tuberculosis Based on Curve Clustering

目的分析我国肺结核发病的流行病学特征,为制订我国肺结核的防控策略提供参考依据。方法采用描述性研究对全国2005-2016年肺结核的流行性特征进行分析,采用基于B-样条的函数型曲线聚类的方法、依据32个地区的发病率时间轨迹的相似性进行聚类分析。结果2005-2016年发病率与发病人数呈下降趋势,2016年肺结核的报告发病人数与2005年同期相比下降了33.59%;14岁及以下的婴幼儿和儿童的发病率较低,60岁及以上的老年人的发病率较高;每年的1月份与3月份是肺结核发病的高峰期,每年的12月份肺结核的发病率最低;海南、广西、贵州、西藏和新疆地区的发病率较高,西北的新疆肺结核年发病率高达180.42/10万;全国32个地区依据发病率时间轨迹的相似性分为四类,第一类的贵州与新疆的发病率轨迹值普遍高于其他三类,且波动起伏较大,第一类地区以及第二类地区的青海与西藏的疫情更加严峻。结论全国60岁及以上的老年人是国家重点防控对象,每年的1月份与3月份应加强肺结核的防控措施,贵州、新疆、青海与西藏地区的肺结核防控需要国家的重点关注与支持。

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis in China,and to provide reference for formulating strategies for prevention and control of pulmonary tuberculosis in China.Methods Descriptive epidemiological method was used to analyze the epidemiological characteristics of tuberculosis in China over the past 2005 to 2016 years,the method of functional curve clustering based on B-spline was applied for cluster analysis based on the similarity of incidence time trajectories in 32 regions.Results The incidence curve for 2005-2016 showed a downward trend.The number of reported cases of tuberculosis in 2016 decreased by 33.59%compared with the same period in 2005;the incidences of infants and children aged 14 and below were relatively low,and the incidences of elderly people aged 60 and above were higher;the incidences of tuberculosis were the highest in January and March each year,the incidences of tuberculosis were lowest in December every year;the incidences of tuberculosis in Hainan,Guangxi,Guizhou,Tibet and Xinjiang were relatively high,and the annual incidence rate of tuberculosis in Xinjiang was as high as 180.42/100 thousand.The 32 regions of the country were divided into four categories based on the similarity of incidence time trajectories.The incidences of Guizhou and Xinjiang of the first type were generally higher than those of the other three types,and the fluctuations were larger;the epidemic situations of the first type and the second type in Qinghai and Tibet were more severe.Conclusion The country′s 60-year old and above is the key target of national prevention and control.Every year in January and March,the prevention and control measures to tuberculosis should be strengthened.The prevention and control of tuberculosis in Guizhou,Xinjiang,Qinghai and Tibet need focus and support of the state.