2008—2019年重庆市学生肺结核报告发病特征分析

doi:10.3969/j.issn.1000-6621.2021.07.013

摘要/Abstract

摘要： 目的分析2008—2019年重庆市学生肺结核报告发病特征,为重庆市有效控制学校结核病疫情提供参考。方法收集2008—2019年《传染病报告信息管理系统》中重庆市报告的学生肺结核疫情资料和《重庆市统计年鉴》中有关人口的数据,分析学生肺结核报告发病的三间分布。结果 2008—2019年重庆市共报告学生活动性肺结核25918例,学生活动性肺结核年平均报告发病率为40.36/10万(25918/64222000),报告发病率从2008年的58.72/10万(3067/5223100)下降到2019年的34.30/10万(1959/5710600),呈逐年下降趋势(X²_趋势=414.882,P<0.001)。12年间学生肺结核报告高峰为3月,平均报告占比为15.70%(4069/25918),但在2017年前后报告高峰有所差异,2008—2017年报告高峰为3月,平均报告学生肺结核患者占比为17.42%(3781/21711),而2018—2019年的报告高峰为9月和12月,平均报告学生肺结核患者占比分别为12.50%(526/4207)和13.00%(547/4207)。渝东南地区学生肺结核疫情最高,2008—2019年平均年报告发病率为88.31/10万(5281/5980400),其次为渝东北地区(49.08/10万,8737/17802100),主城地区(32.24/10万,5572/17283600)和渝西地区(27.33/10万,6328/23155500)疫情最低。学生肺结核平均报告发病率排名前5位的区(县)分别是彭水县(153.40/10万,1707/1112800)、巫溪县(102.47/10万,889/867600)、黔江区(102.25/10万,1010/987800)、酉阳县(88.69/10万,1074/1210900)和巫山县(82.45/10万,837/1015200)。学生肺结核患者男∶女为1.29∶1,高中年龄段(16~18岁)患者占比最高(46.92%,12161/25918)。结论 2008—2019年重庆市学生肺结核疫情呈下降趋势,16~18岁患者占比最高,发病高峰时间从2018年开始由3月转变为9月和12月,渝东南地区疫情较高。应重点关注高疫情地区,继续加强学生的健康体检工作。

关键词: 结核, 肺, 学生, 病例发现, 发病率, 结果评价(卫生保健), 重庆市

Abstract: Objective To analyze the characteristics of reported pulmonary tuberculosis (PTB) in students in Chongqing during 2008-2019. Methods The epidemiological data of reported PTB in students and population data of Chongqing during 2008-2019 were collected from Infectious Diseases Reporting System (IDRS) and Chongqing Statistical Yearbook respectively, and the spatial, temporal and population distributions of reported PTB in students were analyzed. Results A total of 25918 PTB cases in students in Chongqing were reported from 2008 to 2019, with an average annual reported incidence of 40.36/100000 (25918/64222000). The reported PTB incidence decreased from 58.72/100000 (3067/5223100) in 2008 to 34.30/100000 (1959/5710600) in 2019, which showed a reduction trend by year (X ²_trend=414.882,P<0.001). March was the peak period for students to report PTB, accounting for 15.70% (4069/25918) of total cases. However, there was a slightly difference before and after 2017. The reporting peak period was March from 2008 to 2017, with an average percentage of 17.42% (3781/21711) in all reported PTB. While the reporting peak periods were in September and December from 2018 to 2019, with an average percentage of 12.50% (526/4207) and 13.00% (547/4207) in all reported PTB, respectively. Southeast district had the highest reported PTB incidence in students, with an average annual reported incidence being 88.31/100000 (5281/5980400), followed by Northeast district (49.08/100000, 8737/17802100). Central district (32.24/100000, 5572/17283600) and West district (27.33/100000,6328/23155500) had the lowest incidence. The top five counties with highest reported incidence of PTB in students were Pengshui county (153.40/100000,1707/1112800), Wuxi county (102.47/100000,889/867600), Qianjiang district (102.25/100000,1010/987800), Youyang county (88.69/100000,1074/1210900) and Wushan county (82.45/100000,837/1015200). The ratio of male to female students with PTB was 1.29∶1. PTB patients in senior high school age group (16-18 years old) accounted for the highest proportion (46.92%,12161/25918) in all cases. Conclusion The reported PTB incidence among students in Chongqing showed a decreasing trend from 2008 to 2019, and PTB patients aged 16-18 years old had the highest percentage. The reporting peak period changed from March to September and December from 2018, and southeast district in Chongqing had the highest reported incidence of PTB. More attention should be paid to high TB epidemic areas, and physical examination should be continuously strengthened in students.

Key words: Tuberculosis, pulmonary, Students, Case finding outcomes, Incidence, Outcome assessment (health care), Chongqing City

范君, 张文, 张婷, 汪清雅, 余雅, 成君. 2008—2019年重庆市学生肺结核报告发病特征分析[J]. 中国防痨杂志, 2021, 43(7): 716-723. doi: 10.3969/j.issn.1000-6621.2021.07.013

FAN Jun, ZHANG Wen, ZHANG Ting, WANG Qing-ya, YU Ya, CHENG Jun. Analysis on characteristics of reported pulmonary tuberculosis among students in Chongqing from 2008 to 2019[J]. Chinese Journal of Antituberculosis, 2021, 43(7): 716-723. doi: 10.3969/j.issn.1000-6621.2021.07.013

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年份	重庆市			主城地区		渝西地区		渝东北地区		渝东南地区
年份	常住人口数 (万)	学生人数 (万)	学生占常住人口比例(%)^a	常住人口数 (万)	学生人数 (万)^b	常住人口数 (万)	学生人数 (万)^b	常住人口数 (万)	学生人数 (万)^b	常住人口数 (万)	学生人数 (万)^b
2008	2839.00	522.31	18.40	684.41	125.93	1025.53	188.70	848.16	156.06	280.90	51.69
2009	2859.00	517.02	18.08	694.49	125.56	1030.77	186.36	851.39	153.93	282.35	51.05
2010	2884.62	519.68	18.02	745.76	134.39	1018.73	183.58	836.54	150.74	283.59	51.10
2011	2919.00	526.66	18.04	772.31	139.32	1032.23	186.21	832.57	150.20	281.89	50.85
2012	2945.00	526.61	17.88	795.36	142.21	1041.78	186.27	827.43	147.94	280.43	50.14
2013	2970.00	528.47	17.79	808.53	143.84	1062.04	188.94	821.20	146.09	278.23	49.50
2014	2991.40	531.06	17.75	818.98	145.37	1079.19	191.56	816.65	144.96	276.58	49.09
2015	3016.55	535.37	17.75	834.82	148.18	1095.60	194.47	811.19	143.99	274.94	48.80
2016	3048.43	540.43	17.73	851.80	151.02	1110.86	196.96	812.66	144.08	273.11	48.42
2017	3075.16	547.42	17.80	865.06	153.98	1124.09	200.09	813.58	144.82	272.43	48.49
2018	3101.79	556.11	17.93	875.00	156.89	1134.89	203.49	818.76	146.80	273.14	48.97
2019	3124.32	571.06	18.28	884.39	161.67	1142.90	208.92	823.83	150.60	273.20	49.94

年份	学生人数 (万)	活动性肺结核				病原学阳性肺结核			病原学阳性患者占活动性患者比例(%)
年份	学生人数 (万)	报告发病例数	报告发病率 (/10万)		报告发病例数		报告发病率 (/10万)		病原学阳性患者占活动性患者比例(%)
2008	522.31	3067		58.72		829		15.87	27.03
2009	517.02	2573		49.77		841		16.27	32.69
2010	519.68	2291		44.08		851		16.38	37.15
2011	526.66	2152		40.86		632		12.00	29.37
2012	526.61	1942		36.88		441		8.37	22.71
2013	528.47	1972		37.32		342		6.47	17.34
2014	531.06	1929		36.32		229		4.31	11.87
2015	535.37	1742		32.54		249		4.65	14.29
2016	540.43	1856		34.34		281		5.20	15.14
2017	547.42	2187		39.95		352		6.43	16.10
2018	556.11	2248		40.42		516		9.28	22.95
2019	571.06	1959		34.30		629		11.01	32.11
合计	6422.20	25918		40.36		6192		9.64	23.89

年份	主城片区			渝西片区			渝东北片区			渝东南片区
年份	学生人数 (万)	报告发病例数	报告发病率 (/10万)	学生人数 (万)	报告发病例数	报告发病率 (/10万)	学生人数 (万)	报告发病例数	报告发病率 (/10万)	学生人数 (万)	报告发病例数	报告发病率 (/10万)
2008	125.93	780	61.94	188.70	689	36.51	156.06	1033	66.19	51.69	565	109.31
2009	125.56	559	44.52	186.36	631	33.86	153.93	949	61.65	51.05	434	85.01
2010	134.39	540	40.18	183.58	565	30.78	150.74	793	52.61	51.10	393	76.91
2011	139.32	490	35.17	186.21	504	27.07	150.20	746	49.67	50.85	412	81.02
2012	142.21	431	30.31	186.27	522	28.02	147.94	646	43.67	50.14	343	68.41
2013	143.84	391	27.18	188.94	481	25.46	146.09	700	47.92	49.50	400	80.81
2014	145.37	430	29.58	191.56	514	26.83	144.96	656	45.25	49.09	329	67.02
2015	148.18	374	25.24	194.47	450	23.14	143.99	534	37.09	48.80	384	78.69
2016	151.02	369	24.43	196.96	429	21.78	144.08	610	42.34	48.42	448	92.52
2017	153.98	422	27.41	200.09	484	24.19	144.82	726	50.13	48.49	555	114.46
2018	156.89	421	26.83	203.49	615	30.22	146.80	687	46.80	48.97	525	107.21
2019	161.67	365	22.58	208.92	444	21.25	150.60	657	43.63	49.94	493	98.72
合计	1728.36	5572	32.24	2315.55	6328	27.33	1780.21	8737	49.08	598.04	5281	88.31

年份	活动性肺结核						病原学阳性肺结核
年份	患者例数	男性例数	男性构成比(%)	女性例数	女性构成比(%)	男∶女	患者例数	男性例数	男性构成比(%)	女性例数	女性构成比(%)	男∶女
2008	3067	1727	56.31	1340	43.69	1.29∶1	829	442	53.32	387	46.68	1.14∶1
2009	2573	1468	57.05	1105	42.95	1.33∶1	841	452	53.75	389	46.25	1.16∶1
2010	2291	1294	56.48	997	43.52	1.30∶1	851	466	54.76	385	45.24	1.21∶1
2011	2152	1217	56.55	935	43.45	1.30∶1	632	350	55.38	282	44.62	1.24∶1
2012	1942	1078	55.51	864	44.49	1.25∶1	441	234	53.06	207	46.94	1.13∶1
2013	1972	1052	53.35	920	46.65	1.14∶1	342	160	46.78	182	53.22	0.88∶1
2014	1929	1092	56.61	837	43.39	1.30∶1	229	121	52.84	108	47.16	1.12∶1
2015	1742	996	57.18	746	42.82	1.34∶1	249	139	55.82	110	44.18	1.26∶1
2016	1856	1048	56.47	808	43.53	1.30∶1	281	137	48.75	144	51.25	0.95∶1
2017	2187	1259	57.57	928	42.43	1.36∶1	352	164	46.59	188	53.41	0.87∶1
2018	2248	1280	56.94	968	43.06	1.32∶1	516	264	51.16	252	48.84	1.05∶1
2019	1959	1076	54.93	883	45.07	1.22∶1	629	339	53.90	290	46.10	1.17∶1
合计	25918	14587	56.28	11331	43.72	1.29∶1	6192	3268	52.78	2924	47.22	1.12∶1

年份	活动性肺结核例数	<6岁		6~12岁		13~15岁		16~18岁		19~22岁		23~30岁
年份	活动性肺结核例数	例数	构成比 (%)	例数	构成比 (%)	例数	构成比 (%)	例数	构成比 (%)	例数	构成比 (%)	例数	构成比 (%)
2008	3067	4	0.13	244	7.96	453	14.77	1341	43.72	895	29.18	130	4.24
2009	2573	4	0.16	158	6.14	352	13.68	1129	43.88	816	31.71	114	4.43
2010	2291	2	0.09	111	4.85	313	13.66	1047	45.70	711	31.03	107	4.67
2011	2152	1	0.05	103	4.79	330	15.33	956	44.42	666	30.95	96	4.46
2012	1942	2	0.10	80	4.12	261	13.44	912	46.96	610	31.41	77	3.96
2013	1972	1	0.05	75	3.80	275	13.95	970	49.19	577	29.26	74	3.75
2014	1929	3	0.16	77	3.99	256	13.27	978	50.70	557	28.88	58	3.01
2015	1742	0	0.00	83	4.76	209	12.00	849	48.74	547	31.40	54	3.10
2016	1856	0	0.00	69	3.72	275	14.82	851	45.85	599	32.27	62	3.34
2017	2187	1	0.05	79	3.61	285	13.03	1125	51.44	636	29.08	61	2.79
2018	2248	0	0.00	90	4.00	366	16.28	1104	49.11	617	27.45	71	3.16
2019	1959	0	0.00	85	4.34	385	19.65	899	45.89	530	27.05	60	3.06
合计	25918	18	0.07	1254	4.84	3760	14.51	12161	46.92	7761	29.94	964	3.72