2016—2021年河南省MTB/HIV双重感染流行特征分析

doi:10.19982/j.issn.1000-6621.20220366

摘要/Abstract

摘要：

目的: 分析河南省结核分枝杆菌(MTB)/HIV双重感染流行特征,为河南省乃至全国相关疫情防控提供依据。方法: 从河南省“MTB/HIV双重感染防治管理工作年度报表”中收集2016—2021年MTB/HIV双重感染者相关资料,采用描述性统计方法和线性趋势卡方检验分析河南省2016—2021年MTB/HIV双重感染双向筛查率、登记率、三间分布及变化趋势。结果: 2016—2021年河南省常住总人口为591960000名,共登记可随访结核病(TB)患者290450例、HIV/AIDS患者387785例,其中,MTB/HIV双重感染者1756例,年均登记率为0.30/10万,占TB患者的0.60%,占HIV/AIDS患者的0.45%。HIV/AIDS患者中TB的检出率从2016年的0.46%(263/57116)下降至2021年的0.28%(199/69862);TB患者中HIV抗体阳性的检出率从2016年的0.17%(47/27955)下降至2021年的0.10%(21/21914),MTB/HIV双重感染登记率从2016年的0.32/10万(310/97780000)下降至2021年的0.22/10万(220/98830000),均呈波动下降趋势( $χ 趋势 2$ 值分别为49.965、44.786、38.841,P值均<0.001)。2016—2021年男性MTB/HIV双重感染者比例[78.72%(1365/1734)]明显高于女性[21.28%(369/1734)],但5年间男女性别构成比的差异无统计学意义( $χ 趋势 2$ =5.137,P=0.399)。同时,郑州市和周口市MTB/HIV双重感染年均登记率分别由2016年的0.38/10万(43/11190000)和0.15/10万(14/9220000)上升至2021年的0.46/10万(58/127420000)和0.26/10万(23/88530000),各年份均呈波动上升趋势( $χ 趋势 2$ =26.088,P<0.001; $χ 趋势 2$ =15.536,P=0.008)。结论: 2016—2021年河南省MTB/HIV双重感染患者数呈逐年下降趋势,MTB/HIV双重感染疫情控制有效,但应关注男性、郑州市和周口市的感染情况。

关键词: 分枝杆菌,结核, HIV感染, 共病现象, 流行病学研究特征(主题)

Abstract:

Objective: To analyze the epidemiological characteristics of Mycobacterium tuberculosis and HIV (MTB/HIV) co-infection in Henan, in order to provide a scientific basis for the prevention and control in the Henan and even in China. Methods: Data of co-infection in Henan from 2016 to 2021 were collected from the Annual Report of Prevention and Management of MTB/HIV co-infection in Henan Province, the statistical descriptive methods and chi-square test for linear trend were used to analyze the rate of bi-directional screening, registration, the distribution and change tendency of MTB/HIV co-infection from 2016 to 2021 in Henan. Results: Of the 591960000 permanent resident population in Henan, 290450 tuberculosis (TB) and 387785 HIV/AIDS patients were registered from 2016 to 2021. Among them, 1756 were MTB/HIV co-infection, the average annual registration rate was 0.30/100000 (1756/591960000), accounting for 0.60% (1756/290450) of TB and 0.45% (1756/387785) of HIV/AIDS patients. The detection rate of TB diagnosis from HIV/AIDS patients decreased from 0.46% (263/57116) in 2016 to 0.28% (199/69862) in 2021, and HIV antibody detected positive from TB patients decreased from 0.17% (47/27955) in 2016 to 0.10% (21/21914) in 2021, the registration rate of MTB/HIV co-infection decreased from 0.32/100000 (310/97780000) in 2016 to 0.22/100000 (220/98830000), showing a fluctuating downward trend ( $χ t r e n d 2$ =49.965, 44.786 and 38.841, respectively; all Ps<0.001). The proportion of MTB/HIV co-infected patients in male was significantly higher than that in female (78.72% (1365/1734) vs. 21.28% (369/1734)) from 2016 to 2021, but the difference in the proportion of male and female in the past five years was not significant ( $χ t r e n d 2$ =5.137, P=0.399). Meanwhile, the average annual registration rate of MTB/HIV co-infection in Zhengzhou and Zhoukou increased from 0.38/100000 (43/11190000) and 0.15/100000 (14/9220000) in 2016 to 0.46/100000 (58/127420000) and 0.26/100000 (23/88530000) in 2021, respectively, showing a fluctuating upward trend in each year ( $χ t r e n d 2$ =26.088, P<0.001; $χ t r e n d 2$ =15.536, P=0.008). Conclusion: The number of MTB/HIV co-infected patients in Henan showed a decreased trend year by year from 2016 to 2021, indicating that the MTB/HIV co-infection was effectively controlled, however, attention should be paid to the infection in male, as well as in the cities of Zhengzhou and Zhoukou.

Key words: Mycobacterium tuberculosis, HIV infections, Comorbidity, Epidemiologic study characteristics as topic

中图分类号:

张沛, 赵阿会, 高敏, 甄新安, 要玉霞, 蒋建国, 孙建伟, 孙定勇. 2016—2021年河南省MTB/HIV双重感染流行特征分析[J]. 中国防痨杂志, 2023, 45(4): 377-382. doi: 10.19982/j.issn.1000-6621.20220366

Zhang Pei, Zhao Ahui, Gao Min, Zhen Xinan, Yao Yuxia, Jiang Jianguo, Sun Jianwei, Sun Dingyong. Epidemiological characteristics of MTB/HIV co-infection in Henan from 2016 to 2021[J]. Chinese Journal of Antituberculosis, 2023, 45(4): 377-382. doi: 10.19982/j.issn.1000-6621.20220366

图/表 5

表1

2016—2021年河南省HIV/AIDS患者开展结核病筛查情况

年份	新登记和随访HIV/ AIDS患者例数	症状筛查患者例数	筛查率 (%)	接受胸片/ 痰检例数	胸片/痰检筛查率(%)	诊断结核病例数	结核病检出率(%)
2016	57116	54804	95.95	46975	82.24	263	0.46
2017	60187	58345	96.94	51533	85.62	233	0.39
2018	59749	56571	94.68	50080	83.82	285	0.48
2019	69116	63780	92.28	59844	86.58	251	0.36
2020	71755	69758	97.22	66125	92.15	227	0.32
2021	69862	69758	99.85	63959	91.55	199	0.28
合计	387785	373016	96.19	338516	87.29	1458	0.38
$χ 趋势 2$ 值			6117.472		4816.398		49.965
P值			<0.001		<0.001		<0.001

表1

表2

2016—2021年河南省结核病患者中HIV/AIDS患者筛查情况

年份	结核病患者例数	HIV抗体检测例数	HIV抗体检测接受率(%)	HIV抗体阳性检出例数	HIV抗体阳性检出率(%)
2016	58360	27955	47.90	47	0.17
2017	56771	26392	46.49	82	0.31
2018	53341	28875	54.13	73	0.25
2019	49477	28287	57.17	34	0.12
2020	38667	23431	60.60	41	0.18
2021	33834	21914	64.77	21	0.10
合计	290450	156854	54.00	298	0.19
$χ 趋势 2$ 值			4621.412		44.786
P值			<0.001		<0.001

表2

表3

表4

2016—2021年河南省MTB/HIV双重感染者年龄及性别分布情况

年份	年龄[例(构成比,%)]		性别[例(构成比,%)]^a
年份	<15岁	≥15岁	男性	女性
2016	11(3.55)	299(96.45)	233(77.67)	67(22.33)
2017	4(1.27)	311(98.73)	239(77.60)	69(22.40)
2018	6(1.68)	352(98.32)	276(77.31)	81(22.69)
2019	6(2.11)	279(97.89)	219(76.84)	66(23.16)
2020	0(0.00)	268(100.00)	218(81.65)	49(18.35)
2021	2(0.91)	218(99.09)	180(82.95)	37(17.05)
合计	29(1.65)	1727(98.35)	1365(78.72)	369(21.28)
$χ 趋势 2$ 值	12.667		5.137
P值	0.018		0.399

表4

表5

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