青海省南部2009—2019年肺结核时空分布特征演变研究

The dynamic change of spatio-temporal distribution of pulmonary tuberculosis in southern Qinghai,2009—2019

目的研究2009—2019年青海省南部地区(黄南州、果洛州、玉树州)肺结核时空分布特征演变过程。方法建立青海南部地区2009—2019年肺结核数据库,分析其空间流行特征、空间聚集、发病风险等演变历程。结果青南地区2009—2019年肺结核年平均发病率为158.12/10万,2016年之前基本平稳,2016之后呈上升趋势;肺结核常年流行,冬季报告病例较少。患者男性多于女性(男女性别比为1.21∶1);15~<25岁病患最多,占总发病人数的30.34%;职业以农牧民为主,其次是学生病例。肺结核年均发病率玉树州(196.50/10万)>果洛州(158.60/10万)>黄南州(104.36/10万)。2009—2013、2017—2019年肺结核发病率存在空间正相关,相关系数分别为0.40、0.36、0.42、0.40、0.29、0.04、0.23、0.29、0.33;青海南部地区有两个肺结核聚集区域,一级区域覆盖了玉树州,聚集时长3年,二级区域则包括了黄南州与果洛州大部分地区。结论青海南部地区肺结核病流行形势严峻,且存在空间相关性,其中玉树州最为严重。应继续加强该地区肺结核病防控工作,尤其是农牧群体及15~<25岁人群的肺结核防控。

Objective To understand the dynamic change of the temporal and spatial distribution of pulmonary tuberculosis in southern Qinghai from 2009 to 2019. Methods Database of pulmonary tuberculosis in southern Qinghai from 2009 to 2019 was created, and the change of epidemiological characteristics of spatio-temporal distribution was analyzed. Results The average annual incidence of tuberculosis in southern Qinghai from 2009 to 2019 was 158.12/100 000.The incidence of TB was relatively stable before 2016 while showed an upward trend after 2016.Patients with TB appeared all year round, with less cases reported in winter.There were more male cases than female ones with male to female ratio of 1.21∶1.Majority of TB cases(30.34%) were 15-<25 years old and were farmers and herdsmen.The TB incidence rate was the highest in Yushu(196.50/100 000), and the lowest in Huangnan(104.36/100 000).There were positive spatial correlations between the reported incidence of tuberculosis from 2009 to 2013 and from 2017 to 2019 with correlation coefficient of 0.40, 0.36, 0.42, 0.40, 0.29, 0.04, 0.23, 0.29 and 0.33.Two TB gathering areas were observed in southern Qinghai, with the first in Yushu, which lasted 3 years, and the second in Huangnan and most areas of Guoluo. Conclusions The TB epidemic in southern Qinghai is severe with a correlated spatial distribution, and Yushu is the most affected area.The prevention and control of TB should continue to be strengthened, especially among farmers and herdsmen as well as young adults aged 15-<25 years.