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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (10): 1039-1045.doi: 10.3969/j.issn.1000-6621.2021.10.012

• 论著 • 上一篇    下一篇

动力学模型在天津市肺结核发病率预测及防控策略效果评估中的应用

俞社根*, 贾忠伟()   

  1. 100191 北京大学公共卫生学院流行病与卫生统计学系(俞社根),全球卫生学系(贾忠伟);北京大学人工智能研究院(贾忠伟)
  • 收稿日期:2021-06-30 出版日期:2021-10-10 发布日期:2021-10-11
  • 通信作者: 贾忠伟 E-mail:urchinjj@163.com
  • 基金资助:
    国家自然科学基金(U1611264);国家自然科学基金(91546203)

Application of a dynamic model on the prediction of pulmonary tuberculosis incidence and control strategy evaluation in Tianjin, China

YU She-gen*, JIA Zhong-wei()   

  1. *Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
  • Received:2021-06-30 Online:2021-10-10 Published:2021-10-11
  • Contact: JIA Zhong-wei E-mail:urchinjj@163.com

摘要:

目的 通过建立肺结核动力学模型,对天津市肺结核报告发病率进行预测,为优化肺结核防控策略提供科学依据。方法 根据肺结核传播机制,构建肺结核动力学传播模型,计算模型的基本再生数?0。利用2008—2015年天津市肺结核报告发病率数据,预测天津市肺结核报告发病率变化趋势,并计算2016—2018年肺结核报告发病率的预测值与验证数据的相对误差。通过降低易感者的感染率(β1β2),或降低结核分枝杆菌潜伏感染者到活动性肺结核患者的进展率(κ1κ2),或降低治疗成功者的复发率(ω1ω2),评价不同肺结核防控策略效果。结果 天津市肺结核传播的基本再生数?0=0.259<1,模型的无病平衡点全局渐进稳定。模型对2016—2018年报告发病率的预测值与验证数据相对误差分别为0.76%、1.30%和-1.54%,预测较准确。模型预测天津市肺结核的报告发病率在2035年时将下降至18.3/10万。保持其他参数取值不变,β1β2下降50%时,预测2035年天津市肺结核报告发病率为17.8/10万;κ1κ2下降50%时,预测2035年天津市肺结核报告发病率为9.86/10万;ω1ω2下降50%时,预测2035年天津市肺结核报告发病率为17.9/10万。结论 应加强对结核分枝杆菌潜伏感染人群的有效管理,否则天津市难以实现世界卫生组织终止结核病战略在2035年的目标(发病率<10/10万)。

关键词: 结核, 肺, 动力学, 模型, 理论, 预测, 天津市

Abstract:

Objective A dynamic model was established to predict the pulmonary tuberculosis (PTB) reporting incidence rate in Tianjin, and to provide scientific evidences for optimizing PTB control strategies. Methods Based on PTB transmission mechanism, a dynamic transmission model of TB was established and the basic regeneration number ?0 was calculated. Fitting the model with the PTB reporting incidence rates in Tianjin from 2008 to 2015, the trends of PTB reporting incidence rate in Tianjin were predicted, and the relative errors between the predicted value and the validation data of PTB reporting incidence rates from 2016 to 2018 were calculated. The effects of different TB prevention and control strategies were evaluated by adjusting the value of parameters: reducing the infection rate of susceptible people (β1, β2); reducing the progressing rate of latent infection to active tuberculosis patients (κ1, κ2); reducing the recurrence rate of patients with successful treatment (ω1, ω2). Results The basic regeneration number ?0 of PTB transmission in Tianjing was 0.259 <1, the disease-free equilibriums was global asymptotically stable. The relative errors between predicted values and validation data of reporting incidence rates were 0.76%, 1.30% and -1.54% in 2016, 2017 and 2018, respectively, which were relatively accurate. The PTB reporting incidence rate in Tianjin will decline to 18.3 per 100000 in 2035. Keeping other parameter values unchanged, the PTB reporting incidence rate in Tianjin will be 17.8 per 100000 in 2035 if β1 and β2 declined by 50%; the PTB reporting incidence rate will be 9.86 per 100000 in 2035 if κ1 and κ2 declined by 50%; and the PTB reporting incidence rate will be 17.9 per 100000 in 2035 if ω1 and ω2 declined by 50%. Conclusion The WHO End TB Strategies target in 2035 (incidence rate <10 per 100000) is hard to be achieved in Tianjin under current prevention and control strategies. It is suggested to enhance effective management of latent TB infection population.

Key words: Tuberculosis, pulmonary, Kinetics, Models, theoretical, Forecasting, Tianjin City