Changes in Notified Incidence of Pulmonary Tuberculosis in China,2005–2020

Objective To evaluate the trend of notified incidence of pulmonary tuberculosis(PTB)in China at different periods by population and region and to explore the effect of TB prevention and control in recent years.Methods Using pooled data on TB cases reported by the TB Information Management Reporting System(TBIMS)from 2005 to 2020,we calculated the annual percentage change(APC)using the Joinpoint regression model.Results From 2005 to 2020,a total of 16.2 million cases of PTB were reported in China,with an average notified incidence of 75.5 per 100,000 population.The age standardization rate(ASR)continued to decline from 116.9(/100,000)in 2005 to 47.6(/100,000)in 2020,with an average annual decrease of5.6%[APC=-5.6,95%confidence interval(CI):-7.0 to-4.2].The smallest decline occurred in2011–2018(APC=-3.4,95%CI:-4.6 to-2.3)and the largest decrease in 2018–2020(APC=-9.2,95%CI:-16.4 to-1.3).From 2005 to 2020,the ASR in males(159.8 per 100,000 in 2005,72.0 per 100,000 in2020)was higher than that in females(62.2 per 100,000 in 2005,32.3 per 100,000 in 2020),with an average annual decline of 6.0%for male and 4.9%for female.The average notified incidence was the highest among older adults(65 years and over)(182.3/100,000),with an average annual decline of6.4%;children(0–14 years)were the lowest(4.8/100,000),with an average annual decline of 7.3%,but a significant increase of 3.3%between 2014 and 2020(APC=3.3,95%CI:1.4 to 5.2);middle-aged(35–64years)decreased by 5.8%;and youth(15–34 years)decreased by an average annual rate of 4.2%.The average ASR in rural areas(81.3/100,000)is higher than that in urban areas(76.1/100,000).The average annual decline in rural areas was 4.5%and 6.3%in urban areas.South China had the highest average ASR(103.2/100,000),with an average annual decline of 5.9%,while North China had the lowest(56.5/100,000),with an average annual decline of 5.9%.The average ASR in the southwest was 95.3(/100,000),with the smallest annual decline(APC=-4.5,95%CI:-5.5 to-3.5);the average ASR in the Northwest China was 100.1(/100,000),with the largest annual decline(APC=-6.4,95%CI:-10.0 to-2.7);Central,Northeastern,and Eastern China declined by an average of 5.2%,6.2%,and 6.1%per year,respectively.Conclusions From 2005 to 2020,the notified incidence of PTB in China continued to decline,falling by55%.For high-risk groups such as males,older adults,high-burden areas in South,Southwest,and Northwest China,and rural regions,proactive screening should be strengthened to provide timely and effective anti-TB treatment and patient management services for confirmed cases.There is also a necessity to be vigilant about the upward trend of children in recent years,the specific reasons for which need to be further studied.

Association between Selenium in Soil and Diabetes in Chinese Residents Aged 35–74 Years:Results from the 2010 National Survey of Chronic Diseases and Behavioral Risk Factors Surveillance

Objective To explore the association between soil selenium levels and the risk of diabetes in Chinese adults aged 35–74 years.Methods Data for this study were derived from the China Chronic Diseases and Behavioral Risk Factors Surveillance 2010 survey.Selenium concentrations in soil were obtained from the Atlas of Soil Environmental Background Values in China.A two-level binary logistic regression model was used to determine the association between soil selenium concentrations and the risk of diabetes,with participants nested within districts/counties.Results A total of 69,332 participants aged 35–74 years,from 158 districts/counties were included in the analysis.Concentrations of selenium in soil varied greatly across the 158 districts/counties,with a median concentration of 0.219 mg/kg(IQR:0.185–0.248).The results showed that both Quartile 1(0.119–0.185 mg/kg)and Quartile 4(0.249–0.344 mg/kg)groups were positively associated with diabetes compared to a soil selenium concentration of 0.186–0.219 mg/kg(Quartile 2),crude odds ratios(ORs)(95%CI)were 1.227(1.003–1.502)and 1.280(1.048–1.563).The P values were 0.045 and 0.013,for Quartile 1 and Quartile 4 groups,respectively.After adjusting for all confounding factors of interest,the Quartile 1 group became non-significant,and the Quartile 4 group had an adjusted OR(95%CI)of 1.203(1.018–1.421)relative to the reference group(Quartile 2),the P values was 0.030.No significant results were seen for the Quartile 3 group(0.220–0.248 mg/kg)compared to the reference group.Conclusion Excessive selenium concentrations in soil could increase the risk of diabetes among Chinese adults aged 35–74 years.