关键词: 结核,肺, 老年, 治疗结果, 流行病学研究特征(主题)

Abstract:

Objective: To analyze the epidemiological characteristics and treatment outcomes of pulmonary tuberculosis (PTB) in the elderly people (≥60 years old) in Tongzhou District of Beijing from 2016 to 2022, and provide reference for formulating prevention and control strategies in Tongzhou District. Methods: Data information of 4208 patients with active PTB in Tongzhou District of Beijing from 2016 to 2022 were collected from the subsystem “Tuberculosis Management Information System” of the China Information System for Disease Control and Prevention including medical records, diagnosis and treatment information, laboratory examination and so on. Descriptive statistics methods were used to analyze the patients’ characteristics, treatment and outcomes. The seasonal indexes were used to analyze the seasonal effects of time series. Results: From 2016 to 2022, a total of 963 elderly cases aged 60 and above were registered in Tongzhou District of Beijing, accounting for 22.88% (963/4208) of the total reported patients in the same period. The proportion increased from 22.75% (157/690) in 2016 to 28.06% (142/506) in 2022, showing an increasing trend year by year ($χ^{2}_{trend}=5.749$, P=0.016).The registration rate in the elderly people (53.18/100000 (963/1810800)) was significantly higher than that in the whole population (37.67/100000 (4208/11171400)). The registration rate of PTB patients in both the elderly people and the general population declined from 82.81/100000 (157/189600) and 50.07/100000 (690/1378000) in 2016 to 43.80/100000 (142/324200) and 27.45/100000 (506/1843100) in 2022, showing declining trends (elderly population $χ^{2}_{trend}=10.266$, P=0.001; whole population $χ^{2}_{trend}=52.560$, P<0.001). The etiological positive rate (53.27% (513/963)) and positive rate of 0-month sequence sputum smear (30.22% (291/963)) of elderly patients was significantly higher than that in non-elderly group (38.34% (1244/3245)) and (18.86% (612/3245)) (etiologically positive rate χ²=68.534, P<0.001; positive rate 0-month sequence sputum smear χ²=56.844, P<0.001). The elderly patients were mainly male (68.95% (664/963)), the majority were aged 60-69 years old (48.81% (470/963)), the sources were mainly passive finding (90.24% (869/963)), and among which the most were referral from general hospitals (81.83% (788/963)). The mean delay rate was 40.08% (386/963). The prevalence of PTB in the elderly people was from June to September per year, and the seasonal indexes were 127.15%, 103.47%, 134.63% and 102.22%, respectively. The overall treatment success rate was 84.29% (692/821), and showed a upward trend from 82.80% (130/157) in 2016 to 90.78% (128/141) in 2021 ($χ^{2}_{trend}=4.359$, P=0.026). The treatment success rate of female (88.45% (222/251)) was higher than that the male (82.46% (470/570))(χ²=4.721, P=0.030). The treatment successful rates of the young, middle and old groups (89.63% (363/405), 82.44% (216/262) and 73.38% (113/154)) were significantly different ($χ^{2}_{trend}=23.243$, P<0.001). Conclusion: The epidemic situation of PTB in the elderly people showed a downward trend in Tongzhou District of Beijing from 2016 to 2022. However, the proportion of elderly tuberculosis patients registered was still high and showed a upward trend, and the majority of elderly tuberculosis patients were 60-69 years old, male, non-urban, and referrals, and had the characteristics of high etiological positive rate, high delay rate, and unsatisfactory treatment outcome.Thus corresponding prevention and control strategies should be formulated according to these epidemic characteristics of PTB among elderly.

Key words: Tuberculosis, pulmonary, Elderly, Treatment outcome, Epidemiologic study characteristics as topic