2011—2020年新疆维吾尔自治区喀什地区结核病登记患者流行病学特征分析

Epidemiological analysis of registered tuberculosis cases in Kashgar District,Xinjiang Uygur Autonomous Region from 2011 to 2020

【目的】掌握喀什地区结核病登记治疗现况和特征,为采取针对性防控措施提供科学依据。【方法】通过中国疾病预防控制信息系统的子系统结核病管理信息系统导出2011—2020年喀什地区结核病患者登记信息,采用Stata 12.0软件进行描述性流行病学分析。【结果】2011—2020年喀什地区肺结核患者登记数呈现“先升后降”的趋势,2018—2020年结核病患者登记发病率年均递减率为40.48%。2011—2016年女性登记肺结核患者数高于男性,男女性别比约0.90,2017年男女性别比基本持平(1.00),2018—2020年男性患者数高于女性,性别比分别为1.05、1.20和1.12。随着年龄上升,各年份年龄别登记人数和登记发病率均上升,年龄别登记发病率差异有统计学意义(χ2=547.79,P<0.001)。肺结核登记病例构成比较大的有莎车县(16.43%~23.64%)、英吉沙县(9.51%~13.87%)、喀什市(8.11%~11.40%)、叶城县(6.98%~13.40%)和巴楚县(4.92%~16.65%)。2018年起喀什地区复治比例上升至27.29%,2019年和2020年分别为20.77%和28.39%。多因素分析显示年龄、耐药情况、年份、病原学诊断结果与复治比例有关(均P<0.05)。【结论】2018年以来喀什地区结核病发现和治疗力度加大,疫情明显下降,但仍面临结核病患者登记发病率较高的形势,中老年、耐药、病原学阳性人群是防治的重点人群,易导致复治比例上升,应针对上述人群提出针对性的防控措施。

[Objective]To determine the current status and characteristics of tuberculosis(TB)registration and treatment in Kashgar,and to provide scientific evidence for targeted prevention and control measures in future.[Methods]Kashgar registered TB cases information in 2011 to 2020 was exported from the National Tuberculosis Management Information System.Descriptive epidemiological analysis was conducted using Stata 12.0.[Results]From 2011 to 2020,number of Kashgar registered TB patients showed rising trend,followed by a falling one.Average proportion of annual decline in registered TB incidence was 40.48%from 2018 to 2020.From 2011 to 2016,number of registered TB patients in women was always higher than that in men,with a gender ratio(male:female)of about 0.90.In 2017,the gender ratio was 1.00.From 2018 to 2020,the gender ratios were 1.05,1.20,and 1.12,respectively.Moreover,number of registered TB cases increased with age(χ2=547.79,P<0.001).Proportion of registered TB cases was relatively large in Shache County(16.43%‒23.64%),Yengisar County(9.51%‒13.87%),Kashgar City(8.11%‒11.40%),Yecheng County(6.98%‒13.40%)and Bachu County(4.92%‒16.65%).Proportion of recurrent TB cases in Kashgar had increased to 27.29%,20.77%and 28.39%in 2018,2019 and 2020,respectively.Multivariate analysis showed that age,drug resistance,calendar year and etiological diagnosis were significantly correlated with the proportion of recurrent cases(all P<0.05).[Conclusion]Since 2018,TB incidence has decreased significantly due to the increasing efforts for identification and treatment of TB cases.However,Kashgar remains facing a high TB incidence.TB cases that are elderly,drug-resistant and positive for pathogen are susceptible to recurrent treatment.In future,targeted prevention and control measures should be improved for these groups.