关键词: 结核,肺, 季节, 空间自相关分析, 流行病学研究特征(主题)

Abstract:

Objective To analyze the epidemiological characteristics of smear-positive pulmonary tuberculosis patients in Guangzhou from 2014 to 2019, and to provide scientific evidence for development of pulmonary tuberculosis prevention and control measures. Methods The information of 24344 smear-positive pulmonary tuberculosis patients registered in Guangzhou from 2014 to 2019 was collected through the subsystem “Tuberculosis Information Management System” of the “China Disease Prevention and Control Information System”, including household registration, gender, occupation, case detection channel and treatment category, etc. Seasonal index was applied to analyze the seasonal effect of time series, and Moran index was applied to analyze the global spatial autocorrelation of geographic information. Results The average annual registration rate of smear-positive tuberculosis in Guangzhou from 2014 to 2019 was 28.53/100000 (24344/85.3338 million), and the average annual registration rate in each district was 20.49/100000 to 43.74/100000. The average registration rate performed “high in the west and low in the east”. The annual average registration rate of smear-positive tuberculosis in Yuexiu District was the highest (43.74/100000 (3069/7.0168 million)). The total registration rate decreased from 38.39/100000 (5022/13.0805 million) in 2014 to 21.39/100000 (3274/15.3059 million) in 2019 with a significant trend ($x^{2}_{trend}$=1110.440, P<0.01). Among the smear-positive pulmonary tuberculosis patients, there were 17331 male patients and 7013 female patients, with a male-female ratio of 2.47∶1; the proportion of the transient population increased year by year ($x^{2}_{trend}$=12.197, P<0.01), from 30.19% (1516/5022) in 2014 to 47.62% (1559/3274) in 2019; domestic workers accounted for the highest proportion of occupations, which was 36.59% (8908/24344); medical consultation was the main way to find smear-positive tuberculosis patients, accounting for 48.66% (11846/24344); the smear-positive rate of retreated patients reached 68.16% (2894/4246). The prevalence of smear-positive pulmonary tuberculosis was January (with the seasonal index 110.40) and March to August (seasonal indexes were 108.00, 105.70, 112.90, 104.50, 110.40 and 106.90 respectively) each year; global spatial autocorrelation analysis showed that there was no spatial clustering of smear-positive pulmonary tuberculosis patients in Guangzhou as a whole (Moran I values from 2014 to 2019 were -0.180, -0.160, 0.180, 0.141, -0.097 and -0.095, Z values were -0.440, -0.391, 1.382, 1.038, -0.006 and 0.032, P values were 0.374, 0.393, 0.101, 0.158, 0.472 and 0.463, respectively). Conclusion The overall prevalence of smear-positive pulmonary tuberculosis in Guangzhou is on a downward trend, and smear-positive pulmonary tuberculosis registration presents a seasonal variation. The prevalence of smear-positive pulmonary tuberculosis in different regions is different, and the transient population should be regarded as the key population for tuberculosis control.

Key words: Tuberculosis,pulmonary, Seasons, Spatial autocorrelation analysis, Epidemiologic study characteristics (topic)