2016-2020年内蒙古自治区老年人肺结核空间分布特征分析

Spatial distribution of pulmonary tuberculosis in the elderly in Inner Mongolia Autonomous Region,2016-2020

目的了解内蒙古自治区(内蒙古)老年人肺结核空间分布特征,探索老年人肺结核高发区域,为制定相关防控措施提供依据。方法收集2016—2020年内蒙古105个旗(县、区)老年人肺结核患者登记数据,结合中国矢量化省界电子地图,利用空间分析方法对其进行时空聚集性分析。结果2016—2020年内蒙古老年人肺结核年均登记率为126.2/10万,其中2018年登记率最高为163.6/10万;男女性别比为1.5∶1,低于<65岁人群男女性别比(2.2∶1);三维趋势分析图显示,2016—2020年内蒙古老年人肺结核年均报告登记率总体情况为由西向东呈先大幅下降又缓慢上升的趋势,由北向南呈逐渐上升的趋势;空间自相关结果显示,2016、2017、2019和2020年内蒙古老年人肺结核登记率整体存在空间正相关性,Moran I分别为0.180、0.188、0.260和0.239(均P<0.05),高–高聚集区位于阿拉善盟的额济纳旗和阿拉善盟右旗、巴彦淖尔市的临河区和五原县、包头市的固阳县(均P<0.05);时空扫描结果显示,共发现5个可能聚集区域覆盖9个旗(县、区),其中一类最大可能聚集区以乌拉特中旗为中心,覆盖西部5个旗(县、区),聚集时间为2018—2019年,该区域内老年人肺结核登记率是周边旗(县、区)的3.235倍[相对危险度(RR)=3.235]。结论2016、2017、2019以及2020年内蒙古老年人肺结核登记率呈空间聚集性分布,且聚集区域主要位于西部地区,应加强对西部地区老年人的肺结核防控工作。

Objective To understand the spatial distribution of pulmonary tuberculosis(TB)in the elderly in Inner Mongolia Autonomous region,identify the areas with high incidence of pulmonary TB,and provide evidence for the development of pulmonary TB prevention and control measures.Methods The registered data of pulmonary TB in the elderly in 105 banners(counties and districts)of Inner Mongolia from 2016 to 2020 were collected.Combined with the vectorized provincial boundary electronic map of China,spatial analysis method was used to analyze the spatiotemporal clustering.Results From 2016 to 2020,the annual registered rate of pulmonary TB in the elderly in Inner Mongolia was 126.2/100000,and the highest registered rate was 163.6/100000 in 2018.The male to female ratio of the cases was 1.5∶1,lower than that in those under 65 years old(2.2∶1);The three-dimensional trend chart showed a sharp decline and a slow increase from the west to the east,and a gradual increase from the north to the south for the annual registration rate of pulmonary TB in the elderly in Inner Mongolia from 2016 to 2020.The spatial autocorrelation showed that there was a positive spatial correlation in pulmonary TB registration rate in the elderly in Inner Mongolia in 2016,2017,2019 and 2020,and the Moran I were 0.180,0.188,0.260 and 0.239(P<0.05).The high-high clustering areas were in Ejin banner and Right banner of Alxa league,Linhe district and Wuyuan county of Bayan Nur,and Guyang county of Baotou(P<0.05).The spatiotemporal scanning results showed that there were 5 clustering areas covered 9 districts,the first type of clustering area covered 5 districts in western area with Urad Middle banner as the center during 2017−2018.The pulmonary TB registration rate in the elderly in this area was 3.235 times higher than that in neighboring areas(RR=3.235).Conclusion In 2016,2017,2019 and 2020,the pulmonary TB registration rate in the elderly in Inner Mongolia showed spatial clustering distribution,and the clustering areas were mainly in the western area.The prevention and control of tuberculosis in the elderly in the western area should be strengthened.