2017—2019年阿克苏地区结核病流行特征分析

Analysis of epidemic characteristics of tuberculosis in Aksu prefecture from 2017 to 2019

目的了解2017—2019年新疆阿克苏地区结核病流行病学特征,探索适合阿克苏地区的结核病预防和控制策略,为进一步控制结核病疫情提供依据。方法选取中国疾控预防控制信息系统(结核病监测管理)2017年1月至2019年12月登记的新疆维吾尔自治区阿克苏地区结核病患者病案,采用描述流行病学方法分析时间,地区和人群等分布特征,以卡方检验比较率的差异。结果2017—2019年阿克苏地区共登记结核病患者29403例,年均登记发病率383.26/10万,登记发病率2018年最高(520.67/10万)、2017年最低(268.40/10万),不同年度登记发病率差异有统计学意义(χ^(2)=2182.81,P<0.001)。结核病患者主要来源于健康体检和转诊、占67.00%,健康体检的结核病患者构成比持续上升、由34.11%上升至50.46%,而推介构成比持续下降,由26.21%下降至3.20%。男女性别比为1.40∶1。以50~79岁组发病为主、占登记患者数的68.28%,其中60岁~组占比最高、占登记患者数的29.43%。农民人群占登记患者数的86.82%。阿克苏地区8县1市均有病例登记,其中乌什县、拜城县和阿瓦提县登记发病率较高,分别为634.39/10万、491.32/10万和391.92/10万。5—6月登记患者数较多、占登记患者总数的27.67%,9月登记患者最少、占登记患者总数的5.34%。结论2017—2019年阿克苏地区结核病疫情较为严峻;应重点加强阿克苏地区尤其是乌什县、拜城县和阿瓦提县的结核病防控工作并加强结核病病例检测,继续坚持全民健康体检,重点关注老年男性农民的结核病筛查和治疗工作,以控制结核病。

Objective To understand the epidemiological characteristics of tuberculosis in Aksu prefecture from 2017 to 2019,and explore the prevention and control strategy which was suitable for Aksu prefecture,so as to provide the basis for further control the epidemic of tuberculosis.Methods The medical records of tuberculosis cases registered in Aksu prefecture of Xinjiang Uygur Autonomous Region from January 2017 to December 2019 were collected from China Disease Control and Prevention Information System(Tuberculosis Surveillance and Management),and analyzed the time,space and population distribution characteristics with descriptive epidemiological methods.The difference was compared with Chisquare test in morbidities.Results From 2017 to 2019,there were 29403 cases with tuberculosis registered in Aksu prefecture,with average annual registered incidence of 383.26/100000.The registered incidence rate was the highest in 2018(520.67/100000),and the lowest in 2017(268.40/100000),with statistical difference among the registered incidences in different years(χ^(2)=2182.81,P<0.001).The cases with tuberculosis mainly came from physical examination and referral,accounting for 67.00%.The proportion of the cases through physical examination continuous increased from 34.11%to 50.46%,and the proportion of referral continuous decreased from 26.21%to 3.20%.The ratio of the male cases to the female cases was 1.40:1.The number of cases aged 50-79 years was the main,accounting for 68.28%,and the proportion of the age group of 60-69 years was the highest of 29.43%.Farmer cases accounted for 86.82%.There were cases registered in 8 counties and 1 city in Aksu prefecture,and the registered incidences in Wushi county,Baicheng county and Awati county were high,and were 634.39/100000,491.32/100000 and 391.92/100000,respectively.More patients were registered during May to June,accounting for 27.60%.The number of patients registered in September was the least,accounting for 5.34%.Conclusions From 2017 to 2019,the epidemic of tuberculosis are severe in Aksu prefecture.The prevention and control of tuberculosis should be focused and strengthened in Aksu prefecture,especially in Wushi county,Baicheng county and Awati county.The detection of the cases with tuberculosis should be strengthened.The tuberculosis could be controlled by the national health examination,tuberculosis screening and treatment for elderly male farmers.