2011年-2021年南充市老年肺结核流行特征分析

Analysis on the Epidemic Characteristics of Pulmonary Tuberculosis in the Elderly in Nanchong City from 2011 to 2021

目的了解南充市老年肺结核的流行病学特征,为进一步加强老年人群结核病防控工作提供科学依据。方法采用描述流行病学方法分析2011年1月1日-2021年12月31日南充市60岁及以上老年肺结核的三间分布和就诊情况。结果2011年1月1日-2021年12月31日南充市共登记60岁及以上老年肺结核患者11556例,登记率从2011年的89.67/10万下降至2021年的58.86/10万,总体呈下降趋势,APC为-4.832%(t=-5.953,P<0.05),在全市患者的构成比从2011年的23.4%上升至2021年的36.02%,总体呈上升趋势,APC为3.498%(t=6.686,P<0.05)。男女比例为4.16:1,登记率分别为127.77/10万和30.98/10万,差异有统计学意义(χ^(2)=4275.203,P<0.05)。60岁~64岁年龄段登记率最高,85~岁年龄段登记率最低。职业以农民为主,占全人群老年肺结核患者的88.31%(10205/11556)。9个县(市、区)均登记了老年肺结核患者,南部县老年肺结核登记率最高(92.35/10万)。老年肺结核患者就诊延迟率(70.13%)、病原学阳性率(37.7%)和复治患者比例(6.94%)均高于同期非老年肺结核患者(分别为68.66%、32.15%、5.25%),差异有统计学意义(P值均<0.05),主动就诊率(0.32%)和成功治疗率(97.01%)均低于同期非老年肺结核患者(分别为2.1%、97.99%),差异有统计学意义(P值均<0.05)。结论南充市老年肺结核疫情呈下降趋势,但老年肺结核在全市肺结核患者的占比呈上升趋势,就诊延迟病例占比较高,疫情形势仍十分严峻,老年人依旧是结核病防控的重点人群,尤其是男性以及农民群体,应采取综合防控措施及早发现患者。

Objectives This study aims to understand the epidemic characteristics of pulmonary tuberculosis(TB)in the elderly people in Nanchong to provide a scientific basis for further strengthening the prevention and control of tuberculosis among the elderly.Methods Descriptive epidemiological methods were used to analyze the distribution and medical treatment of pulmonary tuberculosis in the elderly aged 60 and above in Nanchong City from January 1,2011 to December 31,2021.Results A total of 11,556 elderly pulmonary tuberculosis patients aged 60 and above were registered in Nanchong from January 1,2011 to December 31,2021.The registration rate decreased from 89.67/100000 in 2011 to 58.86/100000 in 2021,showing a downward trend.APC was-4.832%(t=-5.953,P<0.05).The proportion of patients in Nanchong increased from 23.40%in 2011 to 36.02%in 2021,showing an upward trend.APC was 3.498%(t=6.686,P<0.05).The male to female ratio was 4.16:1.The registration rates were 127.77/100000 and 3098/100000,respectively,with a statistically significant difference(χ^(2)=4275.203,P<0.05).The highest registration rate was in the age group of 60 to 64 years old,and the lowest was in the age group of 85 years or older.The main occupation of elderly tuberculosis patients in the entire population was farming,accounting for 88.31%(10,205 out of 11,556).Nine counties(cities,districts)had registered elderly tuberculosis patients,among which Southern County had the highest registration rate(92.35/100000).The delayed treatment rate(70.13%),pathogen positive rate(37.70%),and proportion of retreated patients(6.94%)in elderly pulmonary tuberculosis patients were higher than those in non-elderly pulmonary tuberculosis patients during the same period(68.66%,32.15%,5.25%,respectively),with statistically significant differences(P<0.05).The active treatment rate(0.32%)and successful treatment rate(97.01%)were lower than those in non-elderly pulmonary tuberculosis patients during the same period(2.10%,97.99%,respectively),and the difference was statistically significant(P<0.05).Conclusions The epidemic situation of tuberculosis among the elderly in Nanchong City has shown a downward trend,but its proportion among all tuberculosis patients has been increasing.There is a relatively high proportion of cases with delayed medical treatment,indicating that the situation remains serious.The elderly,especially males and farmers,continue to be the key population for tuberculosis prevention and control.Comprehensive prevention and control measures should be implemented to identify patients as early as possible.