2016—2020年浙江省肺结核流行特征分析

Epidemiological characteristics of pulmonary tuberculosis in Zhejiang Province from 2016 to 2020

目的分析2016—2020年浙江省肺结核发病和死亡流行特征,为制定肺结核防制策略提供依据。方法通过中国疾病预防控制信息系统结核病管理信息系统收集2016—2020年浙江省肺结核病例资料,描述性分析不同时间、人群、地区的肺结核发病和死亡情况。结果2016—2020年浙江省累计报告肺结核129985例,报告发病率为45.81/10万,呈下降趋势(χ^(2)_(趋势)=298.899,P<0.001),年递降率为3.72%;其中利福平耐药、病原学阳性、病原学阴性和无病原学结果分别占1.51%、47.17%、46.67%和4.65%。报告肺结核死亡546例,报告死亡率为0.19/10万,呈下降趋势(χ^(2)_(趋势)=10.818,P<0.001),年递降率为11.99%;其中利福平耐药、病原学阳性、病原学阴性和无病原学结果分别占1.83%、82.97%、13.37%和1.83%。≥65岁人群肺结核报告发病率和死亡率最高,分别为92.18/10万和1.19/10万。职业以农民为主,发病和死亡例数分别为60774和345例,分别占46.75%和63.19%。报告发病率较高的地区为衢州市(66.43/10万)、金华市(64.24/10万)和丽水市(53.91/10万),报告死亡率较高的地区为衢州市(0.67/10万)、丽水市(0.27/10万)和嘉兴市(0.26/10万)。结论2016—2020年浙江省肺结核报告发病率和死亡率均呈下降趋势,病原学阳性病例占比升高。应重点关注≥65岁人群和农民,开展肺结核主动筛查和健康教育;衢州市、金华市和丽水市等高疫情地区仍需进一步加大肺结核防控力度。

Objective To investigate the epidemiological characteristics of pulmonary tuberculosis(PTB)incidence and mortality in Zhejiang Province from 2016 to 2020,so as to provide the evidence for formulating the PTB control strategy.Methods The data regarding the PTB patients in Zhejiang Province from 2016 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System.The reported cases and deaths of PTB cases were descriptively analyzed by time,population and regions.Results A total of 129985 PTB cases were reported in Zhejiang Province from 2016 to 2020,and the overall reported incidence rate of PTB was 45.81/10^(5),with a tendency toward a decline in the reported incidence(χ^(2)_(trend)=298.899,P<0.001)and an annual decline rate of 3.72%.The prevalence rates of rifampicin resistance,positive etiological tests,negative etiological tests and no etiological results were 1.51%,47.17%,46.67%and 4.65%,respectively.A total of 546 PTB deaths occurred in Zhejiang Province from 2016 to 2020,and the reported mortality of PTB was 0.19/105,with a tendency towards a decline(χ^(2)_(trend)=10.818,P<0.001)and an annual decline rate of 11.99%.The prevalence rates of rifampicin resistance,positive etiological tests,negative etiological tests and no etiological results were 1.83%,82.97%,13.37%and 1.83%,respectively.The highest reported incidence(92.18/105)and mortality(1.19/10^(5))of PTB was found in pa⁃tients aged 65 years and older,and farmer was the predominant occupation of PTB cases(60774 cases,46.75%)and dead PTB cases(345 cases,63.19%).In addition,the top three cities with the highest incidence of PTB included Quzhou City(66.43/10^(5)),Jinhua City(64.24/10^(5))and Lishui City(53.91/10^(5)),and the top three cities with the highest mortality of PTB included Quzhou City(0.67/10^(5)),Lishui City(0.27/10^(5))and Jiaxing City(0.26/10^(5)).Conclusions Both the reported incidence and mortality of PTB appeared a tendency towards a decline in Zhejiang Province from 2016 to 2020;however,the proportion of positive etiological tests increased.Higher attention should be paid to the elderly aged 65 years and older and and farmers,and active screening and health education are recommended;in addition,PTB control requires to be intensified in highly prevalent regions,including Quzhou City,Jinhua City and Lishui City.