基于传染病监测系统的肺结核疫情和流行特征

Epidemic situation and epidemic characteristics of pulmonary tuberculosis based on infectious disease surveillance system

目的探讨2011—2020年长沙市肺结核发病趋势和流行特征。方法采用回顾性分析方法,从中国疾病预防控制信息系统的传染病监测系统中导出长沙市2011—2020年肺结核报告发病信息,对肺结核病例在时间、地区、年龄、性别和职业等方面的分布特征及流行趋势进行描述性分析。结果2011—2020年间,长沙市肺结核报告发病人数共48587例,年均报告发病率为62.94/10万(56.44/10万~84.34/10万);报告病原学阳性肺结核共18455例,年均报告发病率23.91/10万(19.91/10万~28.88/10万);2017—2020年报告利福平耐药共251例,年均利福平耐药发病率0.81/10万(0.61/10万~0.85/10万)。长沙市2011—2020年肺结核报告发病率总体呈下降趋势(Z=32.4355,P=0.0001),年递降率为4.36%。地区分布位居前三位的分布是浏阳市、宁乡市和望城区,年均发病率分别为79.98/10万、79.31/10万和67.80/10万;性别分布以男性为主,年均报告发病率男性和女性分别为87.92/10万和39.71/10万,男性和女性年均递减率分别为5.38%和2.47%。年龄分布中,<15岁年龄组、15~岁组和65岁及以上组的年均肺结核报告发病率分别为2.38/10万、62.31/10万和150.19/10万。职业分布中以农民为主,其次是家务及待业人员和离退人员;学生的发病数及占比都有明显升高,2020年占比达第四位(5.64%)。结论2011—2020年长沙市肺结核报告发病总体呈稳定下降趋势,应进一步加强对农村人口、学生和65岁以上老年人等重点人群的结核病防控工作。

Objective To explore the incidence trend and epidemic characteristics of pulmonary tuberculosis in Changsha City from 2011 to 2020.Methods A retrospective analysis was used in this study.The reported incidence information of pulmonary tuberculosis in Changsha City from 2011 to 2020 was extracted from the Infectious Disease Surveillance System of China Disease Control and Prevention Information System.The time,region,age,gender and occupation distribution features and epidemic trend of pulmonary tuberculosis cases were descriptively analyzed.Results A total of 48,587 cases of pulmonary tuberculosis were reported in Changsha City during 2011-2020,with the annual average reported incidence rate being 62.94/100,000(56.44/100,000-84.34/100,000).A total of 18,455 cases of pulmonary tuberculosis with positive etiology were reported,with the annual average reported incidence rate of 23.91/100,000(19.91/100,000-28.88/100,000).A total of 251 cases with rifampicin resistance were reported in 2017-2020,and the annual average incidence rate of rifampin resistance was 0.81/100,000(0.61/100,000-0.85/100,000).The reported incidence rate of pulmonary tuberculosis in Changsha City in 2011-2020 showed a general downward trend(Z=32.4355,P=0.001),with the annual decline rate of 4.36%.Region distribution displayed that the top three regions were Liuyang City,Ningxiang City and Wangcheng District,and the annual average incidence rates were 79.98/100,000,79.31/100,000 and 67.80/100,000,respectively.Gender distribution presented that most of the cases were males.The annual average reported incidence rates in males and females were 87.92/100,000 and 39.71/100,000,respectively.The annual average decline rates in males and females were 5.38%and 2.47%,respectively.Age distribution revealed that the annual average reported incidence rates of pulmonary tuberculosis in the age groups<15 years,15-years and≥65 years were 2.04/100,000,62.31/100,000 and 150.19/100,000,respectively.Occupation distribution indicated that the majority of the cases were farmers,followed by houseworkers,the unemployed and the retired.The incidence and proportion of students increased significantly,with the proportion reaching the fourth place in 2020(5.64%).Conclusion The reported incidence rate of pulmonary tuberculosis in Changsha City in 2011-2020 showed a steady downward trend.We should further strengthen prevention and control of pulmonary tuberculosis among the key populations like rural residents,students and the elderly aged 65 years and above.