2008—2019年重庆市学生肺结核报告发病特征分析

Analysis on characteristics of reported pulmonary tuberculosis among students in Chongqing from 2008 to 2019

目的分析2008—2019年重庆市学生肺结核报告发病特征,为重庆市有效控制学校结核病疫情提供参考。方法收集2008—2019年《传染病报告信息管理系统》中重庆市报告的学生肺结核疫情资料和《重庆市统计年鉴》中有关人口的数据,分析学生肺结核报告发病的三间分布。结果 2008—2019年重庆市共报告学生活动性肺结核25 918例,学生活动性肺结核年平均报告发病率为40.36/10万(25 918/64 222 000),报告发病率从2008年的58.72/10万(3067/5 223 100)下降到2019年的34.30/10万(1959/5 710 600),呈逐年下降趋势(χ趋势2=414.882,P<0.001)。12年间学生肺结核报告高峰为3月,平均报告占比为15.70%(4069/25 918),但在2017年前后报告高峰有所差异,2008—2017年报告高峰为3月,平均报告学生肺结核患者占比为17.42%(3781/21 711),而2018—2019年的报告高峰为9月和12月,平均报告学生肺结核患者占比分别为12.50%(526/4207)和13.00%(547/4207)。渝东南地区学生肺结核疫情最高,2008—2019年平均年报告发病率为88.31/10万(5281/5 980 400),其次为渝东北地区(49.08/10万,8737/17 802 100),主城地区(32.24/10万,5572/17 283 600)和渝西地区(27.33/10万,6328/23 155 500)疫情最低。学生肺结核平均报告发病率排名前5位的区(县)分别是彭水县(153.40/10万,1707/1 112 800)、巫溪县(102.47/10万,889/867 600)、黔江区(102.25/10万,1010/987 800)、酉阳县(88.69/10万,1074/1 210 900)和巫山县(82.45/10万,837/1 015 200)。学生肺结核患者男∶女为1.29∶1,高中年龄段(16~18岁)患者占比最高(46.92%,12 161/25 918)。结论 2008—2019年重庆市学生肺结核疫情呈下降趋势,16~18岁患者占比最高,发病高峰时间从2018年开始由3月转变为9月和12月,渝东南地区疫情较高。应重点关注高疫情地区,继续加强学生的健康体检工作。

Objective To analyze the characteristics of reported pulmonary tuberculosis(PTB)in students in Chongqing during 2008-2019. Methods The epidemiological data of reported PTB in students and population data of Chongqing during 2008-2019 were collected from Infectious Diseases Reporting System(IDRS)and Chongqing Statistical Yearbook respectively,and the spatial,temporal and population distributions of reported PTB in students were analyzed. Results A total of 25 918 PTB cases in students in Chongqing were reported from 2008 to 2019,with an average annual reported incidence of 40.36/100 000(25 918/64 222 000).The reported PTB incidence decreased from 58.72/100 000(3067/5 223 100)in 2008 to 34.30/100 000(1959/5 710 600)in 2019,which showed a reduction trend by year(χtrend2=414.882,P<0.001).March was the peak period for students to report PTB,accounting for 15.70%(4069/25 918)of total cases.However,there was a slightly difference before and after 2017.The reporting peak period was March from 2008 to 2017,with an average percentage of 17.42%(3781/21 711)in all reported PTB.While the reporting peak periods were in September and December from 2018 to2019,with an average percentage of 12.50%(526/4207)and 13.00%(547/4207)in all reported PTB,respectively.Southeast district had the highest reported PTB incidence in students,with an average annual reported incidence being 88.31/100 000(5281/5 980 400),followed by Northeast district(49.08/100 000,8737/17 802 100).Central district(32.24/100 000,5572/17 283 600)and West district(27.33/100 000,6328/23 155 500)had the lowest incidence.The top five counties with highest reported incidence of PTB in students were Pengshui county(153.40/100 000,1707/1 112 800),Wuxi county(102.47/100 000,889/867 600),Qianjiang district(102.25/100 000,1010/987 800),Youyang county(88.69/100 000,1074/1 210 900)and Wushan county(82.45/100 000,837/1 015 200).The ratio of male to female students with PTB was 1.29∶1.PTB patients in senior high school age group(16-18 years old)accounted for the highest proportion(46.92%,12 161/25 918)in all cases. Conclusion The reported PTB incidence among students in Chongqing showed a decreasing trend from 2008 to 2019,and PTB patients aged 16-18 years old had the highest percentage.The reporting peak period changed from March to September and December from 2018,and southeast district in Chongqing had the highest reported incidence of PTB.More attention should be paid to high TB epidemic areas,and physical examination should be continuously strengthened in students.