2019-2021年我国4省份报告儿童肺结核病例特征分析

Analysis on characteristic of pulmonary tuberculosis cases reported in children from four provinces in China,2019-2021

目的:分析北京市、湖北省、重庆市和四川省(4省份)报告的0~14岁儿童肺结核的情况,为儿童结核病防治政策提供依据。方法:利用中国疾病预防控制信息系统传染病报告信息管理系统和结核病信息管理系统收集儿童肺结核病例报告资料,采用描述流行病学方法,分析儿童肺结核病例的就诊流向、流行特征及纳入管理等情况。利用 Excel 2015、R 4.1.2及Echart 4.7.0软件进行统计学和数据可视化分析。结果:2019-2021年4省份共报告6 811例儿童肺结核病例,其中,临床诊断病例4 741例(69.6%),确诊病例2 070例(30.4%)。共有526家不同类型的医疗卫生机构报告儿童肺结核病例,其中综合医院356家(67.7%,356/526),共报告4 706例;传染病医院11家(2.1%,11/526),共报告836例;儿童医院5家(1.0%,5/526),共报告542例。报告的本地病例6 249例(91.7%),外地病例562例(8.3%);2019-2021年本地病例报告发病率分别为6.20/10万、7.10/10万和7.20/10万,呈逐年上升趋势。男女性别比为0.98∶1(3 373∶3 438);年龄分布以10~14岁组为主,共4 887例(71.8%);人群分类以学生为主,共5 167例(75.9%)。本地病例和外地病例的纳入管理率分别为20.60%和2.67%。结论:2019-2021年4省份儿童肺结核病例的主要就诊医疗机构为儿童医院、传染病医院和结核病专科医院,四川省儿童结核病疫情较严重,2020年外省病例跨省就医的比例明显降低。男性发病数低于女性,10~14岁学生是儿童肺结核高发人群。外地病例的纳入管理率低于本地病例。

Objective To analyze the reported characteristics of pulmonary tuberculosis(TB)in children aged 0-14 years in four provinces(municipalities),Beijing,Hubei,Chongqing and Sichuan,in China,and provide evidence for the prevention and control of pulmonary TB in children.Methods The incidence data of childhood pulmonary TB were collected from notifiable disease and tuberculosis management information system of Chinese information system for disease control and prevention,and descriptive epidemiological methods were used to analyze the medical care seeking flow,characteristics and management inclusion of pulmonary TB cases in children.Statistical analysis and data visualization were conducted with softwares Excel 2015,R 4.1.2 and Echart 4.7.0.Results A total of 6811 pulmonary TB cases in children were reported in the four provinces during 2019-2021,in which 4741(69.6%)were clinically diagnosed and 2070(30.4%)were laboratory confirmed.A total of 526 medical institutions reported TB cases in children,including 356 general hospitals(67.7%,356/526)reporting 4706 cases,11 infectious disease hospitals(2.1%,11/526)reporting 836 cases and 5 children's hospitals(1.0%,5/526)reporting 542 cases.A total of 6249(91.7%)local cases and 562(8.3%)non-local cases were reported.The reported local incidence rates of TB from 2019-2021 were 6.20/100000,7.10/100000 and 7.20/100000,respectively,showing an increase trend year by year.The sex ratio of the cases were 0.98∶1(3373∶3438).The cases were mainly distributed in age group 10-14 years(4887 cases,71.8%).The cases were mainly students(5167 cases,75.9%).The management inclusion rates of the local cases and non-local cases were 20.60%and 2.67%,respectively.Conclusions The main medical institutions reporting pulmonary TB cases in children were children's hospitals,infectious disease hospitals and TB special hospitals,the incidence of pulmonary TB in children in Sichuan was higher.In 2020,the inter-provincial medical seeking behavior of the pulmonary TB cases decreased significantly.The incidence rate in boys was lower than that in girls,and children aged 10-14 years were the population with high incidence of pulmonary TB.The management inclusion rate in non-local cases was lower than that in local cases.