2011—2019年武汉市肺结核疫情特征及空间聚集性分析

Analysis of epidemic characteristics and spatial clustering of pulmonary tuberculosis in Wuhan,2011-2018

目的分析2011—2019年武汉市肺结核疫情特征及空间聚集性,为科学制定干预策略和措施提供依据。方法对国家结核病信息管理系统登记的武汉市近九年结核病数据进行描述性统计分析;利用ArcGIS 10.5软件对全市155个社区或乡镇肺结核发病率进行空间自相关分析。结果2011—2019年武汉市报告登记肺结核56432例,年均报告发病率为59.24/10万,发病率呈波动下降趋势,平均年递降率为1.99%;男女患者发病数比为2.35∶1,男性发病率高于女性(χ^2=285.36,P<0.001);发病年龄以45~64岁组比例最高,占35.33%;每年报告发病高峰是3~6月,发病低谷是每年12月至次年2月;职业以家政、家务及待业人员、农民和离退休人员为主,分别占总病例数的31.93%、18.81%和12.84%。空间相关分析显示,2011—2019年武汉市肺结核报告发病率呈正向空间自相关性(Moran’s I>0,P<0.001),高-高聚集区域主要分布在二七社区、百步亭社区、六角亭社区、汉水桥街道、和平街社区、厂前街社区、桐湖农场、玉贤镇、纸坊镇、五里界镇以及凤凰街道、李集街道、道观河街道等地。结论武汉市肺结核疫情总体呈缓慢波动下降趋势,发病主要人群和病例集中发现时间相对固定,且整体疫情存在一定的空间聚集性,应对发病高风险人群和高聚集区域进行主动筛查,可因时因地分类地制定防控策略。

Objective To explore the epidemic characteristics and spatial clustering of pulmonary tuberculosis in Wuhan from 2011 to 2019,and to provide a scientific basis for formulating intervention strategies and measures.Methods Descriptive statistical analysis was conducted on the epidemic characteristics of tuberculosis data in Wuhan registered in the national tuberculosis information management system in the last 9 years,and spatial autocorrelation analysis was performed on the incidence of tuberculosis in 155 communities or in the city using Arcgis10.5 software.Results From 2011 to 2019,there were 56,432 cases of tuberculosis reported in Wuhan,and the annual average reported incidence rate of tuberculosis was 59.24/100000.The overall incidence rate showed a fluctuating downward trend,with an average annual decline rate of 1.99%.The ratio of the number of cases between men and women was 2.35∶1,and the incidence rate in males was higher than that in females(χ^2=285.36,P<0.001).The 45-64 years old group had the largest number of patients,accounting for 35.33%of the total.The peak incidence of the disease was from March to June,while the lowest was from December to February of the next year.The main occupations were housekeepers,house and unemployed workers,and farmers and retirees,accounting for 31.93%,18.81%and 12.84%of the total number of cases,respectively.Spatial correlation analysis showed that there was a positive spatial autocorrelation in the incidence of tuberculosis in Wuhan from 2011 to 2019(Moran′s I>0,P<0.001),and the high-high aggregation areas of tuberculosis were mainly distributed in Erqi community,Baibuting community,Liujiaoting community,Yijiadun community,Heping Street,Changqian Street,Tonghu farm,Yuxian Town,Zhifang Town,Wulijie Town,Fenghuang Street,Liji Street,and Daoguanhe Street.Conclusion The overall epidemic situation of pulmonary tuberculosis in Wuhan showed a slow downward trend.The main population and the clustering time of cases were relatively fixed,and the overall epidemic showed a certain spatial clustering.Active screening should be carried out for high-risk populations and high-aggregation areas,and effective prevention and control strategies should be developed based on time and location classification.