1997-2023年全国肺结核报告发病流行病学特征

Analysis of the epidemiological characteristics of national reported pulmonary tuberculosis incidence,1997-2023

目的:系统性描述和分析1997—2023年全国肺结核报告发病的流行病学特征,为制订和完善结核病防控策略提供科学依据。方法:收集1997—2023年《全国疫情资料汇编》和《疾病监测统计报告》及“传染病报告信息管理系统”报告的肺结核发病数据,分析全国及各地区肺结核报告发病的时空变化趋势,不同性别、年龄和职业的人群分布特征,以及肺结核患者病原学阳性率。结果:1997—2023年,全国共报告肺结核患者2190.66万例,由1997年的41.82万例逐年上升至2005年最高的125.93万例,随后下降至2023年的61.31万例。2005—2023年肺结核报告发病率总体呈下降趋势(AAPC=-4.78%,95%CI:-5.44%~-4.13%,P<0.001),西部地区下降较慢(AAPC=-4.42%,95%CI:-5.77%~-2.89%,P<0.001);1997—2023年,全国肺结核报告发病数男女性别比为2.22∶1,<15岁儿童组构成比呈下降趋势(AAPC=-5.74%,95%CI:-6.01%~-5.50%,P<0.001),≥65岁老年组构成比呈上升趋势(AAPC=3.80%,95%CI:3.61%~3.99%,P<0.001);报告发病数排在前5位的职业依次是农牧渔民(61.50%,13421197/21822416)、家务及待业(9.32%,2033078/21822416)、工人(5.89%,1285335/21822416)、学生(5.44%,1186104/21822416)、离退休人员(4.69%,1022406/21822416);2023年报告肺结核患者的病原学阳性率为67.08%(392569/585187)。结论:1997年以来,中国肺结核报告发病率呈现先上升后下降的趋势,反映了各个时期卓有成效的结核病防治策略实施的成果。今后需要根据不同地区和人群的疫情特点分类施策,推动新技术新措施的应用实施,加速终结结核病流行。

Objective:To systematically description and analyze the epidemiological characteristics of reported cases of pulmonary tuberculosis(TB)in China from 1997 to 2023,and to provide scientific evidences for development and improvement of TB prevention and control strategies in China.Methods:The incidence data of pulmonary TB from 1997 to 2023 were collected from the National Epidemic Data Collection,Disease Surveillance and Statistics Report,and Infectious Disease Reporting Information Management System.The temporal and spatial trends of reported incidence of pulmonary TB in the whole country and various regions,the distribution characteristics of different gender,age and occupation group,and the positive rate of etiology in TB patients were analyzed.Results:From 1997 to 2023,a total of 21.9066 million pulmonary TB cases were reported in China,increasing from 418234 in 1997 to 1259308 in 2005,and then decreasing to 613091 in 2023.From 2005 to 2023,the reported incidence rate of pulmonary TB showed an decreasing trend(AAPC=-4.78%,95%CI:-5.44%to-4.13%,P<0.001),and the decline was slower in the western region(AAPC=-4.42%,95%CI:-5.77%to-2.89%,P<0.001).From 1997 to 2023,the male-to-female ratio of reported TB cases in China was 2.22∶1,the proportion of children younger than 15 years showed a decreasing trend(AAPC=-5.74%,95%CI:-6.01%to-5.50%,P<0.001),and the proportion of elderly aged≥65 years showed an increasing trend(AAPC=3.80%,95%CI:3.61%to 3.99%,P<0.001).The top five occupations reporting the number of cases were farmers,animal keepers and fishermen(61.50%,13421197/21822416),homemakers and unemployed persons(9.32%,2033078/21822416),workers(5.89%,1285335/21822416),students(5.44%,1186104/21822416)and retired persons(4.69%,1022406/21822416).The etiological positive rate of reported TB patients in 2023 was 67.08%(392569/585187).Conclusion:Since 1997,the reported incidence of pulmonary TB in China increased first and then decreased,reflecting the effect of effective TB prevention and control measures in different periods.In the future,different strategies should be implemented according to the epidemic characteristics of TB in different regions and populations,and the application of new technologies and measures should be promoted to accelerate the end of the TB epidemic.