南京市2016-2021年病原学阳性肺结核患者流行特征

Epidemiological characteristics of pathogenic-positive pulmonary tuberculosis patients in Nanjing from 2016 to 2021

目的 分析南京市2016-2021年病原学阳性肺结核患者流行病学特征,为开展肺结核的防治工作提供科学依据。方法 对通过《结核病信息管理系统》收集的南京市2016-2021年登记的6 980例病原学阳性肺结核患者资料进行流行特征统计分析。结果 南京市病原学阳性肺结核患者登记率从2016年的10.79/10万(892/827万)上升至2021年14.61/10万(1 377/942.34万),差异有统计学意义(χ2趋势=96.487,P<0.001)。病原学阳性肺结核患者中男性占69.34%(4 840/6 980);40~<65岁年龄组占比最高,为36.85%(2 572/6 980);职业中工人与农民从2016年占比35.20%(314/892)下降至2021年的26.00%(358/1 377),差异有统计学意义(χ2趋势=25.028,P<0.001);因症就诊是发现病原学阳性肺结核患者的主要方式,占47.13%(3 290/6 980);初治患者占比从2016年的80.38%(717/892)上升至93.17%(1 283/1 377),差异有统计学意义(χ2趋势=535.288,P<0.001)。每年2月份病例数较少(季节指数为73.14),4、9月份病例数较多(季节指数分别为112.41、113.80)。全局空间自相关分析显示2016年和2019年有聚集性,其余年份无聚集性;局部空间自相关分析结果显示,2016-2021年分别有6、5、0、7、4、2个区(县)处于“低-低”(LL)区域,无“高-高”(HH)区域。结论 2016-2021年南京市病原学阳性肺结核患者登记率总体呈现上升趋势,呈现季节变化,不同地区流行情况不同,应根据当地情况并结合流行病学特点,采取精准防控措施。

Objective To analyze the epidemiological characteristics of pathogenic-positive pulmonary tuberculosis patients in Nanjing in the past 6 years,and provide a scientific basis for the prevention and treatment of tuberculosis.Methods The information of 6980 cases of pathogenic-positive pulmonary tuberculosis patients registered in Nanjing from 2016 to 2021 was collected through the subsystem"Tuberculosis Information Management System"and analyzed for epidemiological characteristics.Results The total registration rate of pathogenic-positive pulmonary tuberculosis patients in Nanjing increased from 10.79/100000(892/8.27 million)in 2016 to 14.61/100000(1377/9.4234 million)in 2021,with the significant trend(χ^(2) trend=96.487,P<0.001).Among the pathogenic-positive pulmonary tuberculosis patients,male patients account for 69.34%(4840/6980),the age group of 40-<65 had the highest proportion,accounting for 36.85%(2572/6980);the proportion of workers and farmers among occupations decreased from 35.20%(314/892)in 2016 to 26.00%(358/1377)in 2021,with a statistically significant trend(χ^(2) trend=25.028,P<0.001);medical consultation was the main way to find pathogenicpositive pulmonary tuberculosis patients,accounting for 47.13%(3290/6980);the percentage of newly diagnosed patients increased from 80.38%(717/892)in 2016 to 93.17%(1283/1377)in 2021,with a statistically significant trend(χ2 trend=535.288,P<0.001).The number of pathogenic-positive pulmonary tuberculosis patients in Nanjing was relatively in February each year(seasonal index was 73.14),while the number of cases in April and September was relatively high(seasonal index were 112.41 and 113.80,respectively).From 2016 to 2021,global spatial autocorrelation analysis showed aggregation in 2016 and 2019 and no aggregation in the remaining years;local spatial autocorrelation analysis show that 6,5,0,7,4,2 districts were in"low-low"(LL)area,and no"high-high"(HH)area.Conclusions From 2016 to 2021,the overall registration rate of pathogenic-positive pulmonary tuberculosis patients in Nanjing showed an overall upward trend,with seasonal variation and different epidemic situations in different regions.Therefore,precise prevention and control measures should be taken according to the local situation and combined with epidemiological characteristics.