2018-2021年四川省自贡市结核病流行病学特征分析

Epidemiological characteristics of tuberculosis in Zigong city,Sichuan province,2018-2021

目的了解2018-2021年四川省自贡市结核病的流行特征,比较新冠疫情前后结核病的流行情况,为结核病防控提供依据。方法从结核病管理信息系统收集2018年1月1日-2021年12月31日自贡市报告的结核病患者资料,对资料进行描述性流行病学分析。结果2018-2021年自贡市累计报告结核病5289例,4年报告发病率49.29/10万~55.19/10万,平均52.54/10万。2018、2019及2021年,每年均有2个报告发病高峰,而2020年报告发病高峰集中在9月。所有登记报告患者中,男女患者比例为3.14:1(4010:1279),农民为患者的主要职业(占56.06%),结核性胸膜炎(占肺外结核的69.17%)和糖尿病(占合并症的74.32%)分别是患者最主要的肺外结核和合并症类型。自流井区是自贡市发病率最低的区县,初治患者是自贡市结核病患者的主要治疗类型,初治患者与复治患者之比为14.60:1(4950:339),就诊延迟率较高的是干部职员(74.29%)、复治(73.75%)、因症就诊(74.95%)/因症推荐(78.57%)人群。新冠疫情后,自贡市结核病报告发病率降低,实验室阳性检出率也降低。结论中老年男性及农民是自贡市结核病防治的重点人群。新冠疫情对结核病患者的性别构成影响不大,但新冠疫情可能使结核病隐匿患者增加,因此新冠疫情期间应有针对性地加大对结核病的宣传、教育及筛查力度。

Objective To identify the epidemiological characteristics of tuberculosis in Zigong from 2018 to 2021,and to compare the epidemic situation of tuberculosis before and during the COVID-19 pandemic,so as to provide guidance for further prevention and control.Methods The data of tuberculosis cases reported in Zigong from January 1,2018 to December 31,2021 were derived from the"Tuberculosis Information Management System".And further descriptive epidemiological analysis was carried out based on the collected data.Results A total of 5289 tuberculosis cases were reported in Zigong from 2018 to 2021 with the range of reported incidence from 49.29/100000 to 55.19/100000,and the average incidence reported was 52.54/100000.The incidence showed two peaks every year from 2018 to 2021,except for 2020 with only one peak in September.The ratio of male to female patients was 3.14:1(4010:1279)and farmers were the main occupation of patients(56.06%).Tuberculous pleurisy was the main type of extrapulmonary tuberculosis(69.17%),and diabetes was the main type of comorbidities(74.32%),respectively.Ziliujing district showed the lowest incidence among these districts in Zigong.Newly treated patients have been the main treatment type of tuberculosis patients in Zigong in the past four years with the ratio of newly patients to retreatment patients of 14.60:1(4950:339).There were four types of patients showing high rates of consultation delays,including officers(74.29%),retreatment patients(73.75%),diagnosed(74.95%)and recommended(78.57%)due to symptoms.During the COVID-19 pandemic,while the reported incidence of tuberculosis in Zigong city has decreased,the rate of laboratory positive detection has also decreased.Conclusions Middle-aged male and farmers are still the focus of tuberculosis prevention and treatment in Zigong.The COVID-19 pandemic has little effect on the gender structure of patients.However,the COVID-19 pandemic might cause a slight increase in the number of hidden tuberculosis patients in Zigong.It is suggested to strengthen publicity,education and screening for the target population.