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中国防痨杂志 ›› 2015, Vol. 37 ›› Issue (1): 14-18.doi: 10.3969/j.issn.1000-6621.2015.01.004

• 论著 • 上一篇    下一篇

2009—2013年重庆市学生肺结核的流行特征分析

庞艳 张舜 胡代玉 林辉   

  1. 400050  重庆市结核病防治所(庞艳、张舜、胡代玉);第三军医大学热带流行病学教研室(林辉)
  • 收稿日期:2014-05-26 出版日期:2015-01-10 发布日期:2015-02-08
  • 通信作者: 胡代玉 E-mail:hukaixiou@263.net

Epidemiological features of students’ pulmonary tuberculosis in Chongqing from 2009 to 2013

PANG Yan, ZHANG Shun, HU Dai-yu, LIN Hui   

  1. Institute of Tuberculosis Prevention and Treatment of Chongqing, Chongqing 400050, China
  • Received:2014-05-26 Online:2015-01-10 Published:2015-02-08
  • Contact: HU Dai-yu E-mail:hukaixiou@263.net

摘要: 目的 了解重庆市学生肺结核流行特征,为学校肺结核防治工作提供依据。 方法 收集重庆市2009—2013年结核病管理信息系统学生肺结核的发病资料,查阅《重庆统计年鉴》,2009—2013年重庆市在校学生总数分别为559.55万名、558.85万名、564.62万名、608.11万名、612.88万名,计算重庆市学生肺结核登记率并分析其变化趋势,描述学生肺结核患者三间分布,并对数据进行检验,显著性水平设为0.05。 结果 2009—2013年重庆市报告学生活动性肺结核患者分别为2169、2045、1960、1782、1777例,学生涂阳肺结核患者分别为809、806、624、439、331例,学生活动性肺结核和涂阳肺结核平均年登记率分别为33.52/10万(9733/29 040 100)、10.36/10万(3009/29 040 100)。2009—2013年学生肺结核涂阴患者分别占活动性肺结核患者的57.08%(1238/2169)、54.52%(1115/2045)、63.42%(1243/1960)、71.04%(1266/1782)、78.05%(1387/1777),涂阴患者比例逐年上升(χ2趋势=280.51,P<0.01)。2009—2013年健康检查发现患者的方式分别占4.47%(97/2169)、6.99%(143/2045)、8.01%(157/1960)、7.18%(128/1782)、11.25%(200/1777),比率逐年上升(χ2趋势=53.82,P<0.01)。学生肺结核患者男∶女≈1.24∶1(5396/4337),高发年龄为15~19岁; 2009—2013年15~19岁年龄段患者分别占66.62%(1445/2169)、68.26%(1396/2045)、67.65%(1326/1960)、68.69%(1224/1782)、72.04%(1280/1777),比率逐年上升(χ2趋势=11.06,P<0.01)。2009—2013年学生肺结核3月份发病的患者分别占21.48%(466/2169)、18.63%(381/2045)、17.70%(347/1960)、23.46%(418/1782)、16.49%(293/1777)。2013年重庆市报告学生肺结核患者登记率居前3位的区县均为国家级贫困县,分别是巫溪县(137.84/10万,102/73 999)、彭水县(81.61/10万, 102/124 980)、武隆县(64.69/10万,42/64 925)。 结论 2009—2013年重庆市学生肺结核疫情防治形势仍然严峻,健康体检发现方式比例逐年上升,学生肺结核患者以涂阴患者为主,男性发病人数多于女性,学生患者主要集中在初、高中,3月份为学生肺结核的发病高峰,国家级贫困县学生肺结核疫情较重。

关键词: 结核, 肺/流行病学, 学生, 重庆

Abstract: Objective To understand the epidemiological characteristics of pulmonary tuberculosis (TB) in students in Chongqing and provide evidence for the pulmonary TB prevention and control in schools. Methods We collected the pulmonary (PTB) reporting data from the infectious Diseases Reporting System, and refered to the Statistical Yearbooks Chongqing, the total number of students in Chongqing were 5 595 500 in 2009, 5 588 500 in 2010, 5 646 200 in 2011, 6 081 100 in 2012 and 6 128 800 in 2013 respectively. The reported incidence of pulmonary tuberculosis was calculated, statistical analysis was made on the student registration rate, and the situation of the population was described, the Chi-square value was calculated. 0.05 was set as the significance level. Results The total PTB cases of students were 2169 in 2009, 2045 in 2010, 1960 in 2011, 1782 in 2012 and 1777 in 2013 respectively. The smear-positive pulmonary cases of students were 809 in 2009, 806 in 2010, 624 in 2011, 439 in 2012 and 331 in 2013 respectively. The average registration rate of pulmonary TB and smear-positive pulmonary tuberculosis among students was 33.52/100 000(9733/29 040 100) and 10.36/100 000(3009/29 040 100) respectively. The proportion of smear negative pulmonary tuberculosis was 57.08%(1238/2169) in 2009, 54.52%(1115/2045) in 2010, 63.42%(1243/1960) in 2011, 71.04%(1266/1782) in 2012 and 78.05%(1387/1777) in 2013 respectively, the proportion rose by year(χ2trend=280.51,P<0.01). The proportion of health examination was 4.47%(97/2169) in 2009, 6.99%(143/2045) in 2010, 8.01%(157/1960) in 2011, 7.18%(128/1782) in 2012 and 11.25%(200/1777) in 2013 respectively, the proportion rose by year(χ2trend=53.82,P<0.01). The number of male student PTB were much higher than female(1.24∶1, 5396/4337). Most of them were between 15 and 19 age group,the proportion of PTB dropped in this group was 66.62%(1445/2169) in 2009, 68.26%(1396/2045) in 2010, 67.65%(1326/1960)in 2011, 68.69%(1224/1782) in 2012 and 72.04%(1280/1777) in 2013 respectively, the proportion rose by year(χ2trend=11.06,P<0.01). The proportion of student PTB peaked in March, which was 21.48%(466/2169) in 2009, 18.63%(381/2045) in 2010, 17.70%(347/1960)in 2011, 23.46%(418/1782) in 2012 and 16.49%(293/1777) in 2013 respectively. The top three school PTB incidence county were Wuxi(137.84/100 000,102/73 999), Pengshui(81.61/100 000,102/124 980), Wulong(64.69/100 000,42/64 925), which were national poverty county.  Conclusion The epidemic situation of tuberculosis in Chongqing city among students is serious. The proportion of student PTB detected by health examination rose by year.The majority are smear negative. More PTB patients were male, mainly detected from the middle and high school. The PTB cases peaks in March, and the national poverty county was more serious.

Key words: Tuberculosis, pulmonary/epidemiology, Students, Chongqing