陕西省安康市2011—2021年肺结核流行病学特征及趋势预测

Epidemiological characteristics and trend prediction of pulmonary tuberculosis in Ankang City,Shaanxi Province from 2011 to 2021

目的分析2011—2021年安康市肺结核流行病学特征及流行规律,为制定结核病防治措施提供科学依据。方法用描述性流行病学方法对2011—2021年安康市肺结核流行病学特征进行描述性分析,建立时间序列模型,对2023年发病情况进行定量预测。结果2011—2017年安康市发病率有所上升,2017—2021年呈较明显下降趋势(P<0.05),2021年较2017年下降幅度为40.36%;病原学阳性构成比由2016年的10.26%上升至2021年61.79%;发病季节主要集中在第一季度,占全年发病的28.39%;发病较高地区集中于安康南部的岚皋县、紫阳县、镇坪县,发病率分别为128.32/10万、117.07/10万、110.44/10万,发病较低地区位于安康北部的宁陕县,发病率为60.62/10万;以农民、学生为高发人群,分别占发病总数的81.80%、4.97%,低龄儿童发病占比较低,但每年均有病例报告;男性肺结核发病率是女性的2.39倍;发病年龄自15岁上升明显,发病峰值为60~<80岁年龄组,其次为45~<60岁年龄组,年平均发病率分别为136.44/10万和104.47/10万;建立时间序列模型ARIMA(0,1,1)(0,1,1)_(12)预测:2022年10月至2023年3月发病总体呈上升趋势,后稳步下降,12月又有所上升。结论安康市不同地区肺结核发病有所差异,而男性、农民、学生、老年人等均为结核高发因素,应针对不同地区人群特点采取不同防控策略;安康市2023年发病数总体呈下降趋势,可为结核病防控提供参考。

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis(PTB)in Ankang City from 2011 to 2021,so as to provide a scientific basis for the formulation of PTB prevention and control strategy.Methods Descriptive statistics were used to analyze the epidemiological characteristics of PTB in Ankang City from 2011 to 2021,and a time series model was established to quantitatively predict the incidence of pulmonary tuberculosis in 2023.Results The incidence rate in Ankang City showed a significant upward trend from 2011 to 2017,and a more obvious downward trend in 2017-2021(P<0.05),and the decrease rate in 2021 was 40.36%compared with that in 2017.The proportion of etiological positivity increased from 12.5%in 2014 to over 50.00%after 2019.The incidence season was mainly concentrated in the first quarter,accounting for 28.39%of the annual incidence.High incidence areas were concentrated in the south of Ankang:Langao County,Ziyang County and Zhenping County,with 128.32/100000,117.07/100000 and 110.44/100000,respectively.Low incidence areas were located in the north of Ankang:Ningshan County,with 60.62/100000.Farmers and students were the high incidence groups,accounting for 81.80%and 4.97%of the total cases respectively.The incidence of young children was relatively low,but cases were reported every year.The incidence rate of male was 2.39 times that of female.The age of onset increased significantly from 15 years old,and the peak incidence was in the age group of 60-<80 years old,followed by the age group of 45-<60 years old,the average annual incidence was 136.44/100000 and 104.47/100000,respectively.The model ARIMA(0,1,1)(0,1,1)12 predicted that the incidence of the disease generally increased from October 2022 to March 2023,then steadily decreased,and increased again in December.Conclusions The incidence of tuberculosis varies in different areas of Ankang City,and males,farmers,students and the elderly are all factors of high incidence of tuberculosis.Therefore,different prevention and control strategies should be adopted according to the characteristics of population in different areas.The number of cases in Ankang City in 2023 showed an overall downward trend,which can provide a reference for the prevention and control of PTB.