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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (8): 796-802.doi: 10.3969/j.issn.1000-6621.2021.08.008

• 论著 • 上一篇    下一篇

2014—2020年广州市流动人口肺结核流行特征分析

赖铿, 江坤洪, 谢玮, 杨洁莹, 雷宇, 杜雨华()   

  1. 510095 广州市胸科医院结核病控制管理科(赖铿、杨洁莹、雷宇、杜雨华),第二门诊部(江坤洪),预防保健科(谢玮)
  • 收稿日期:2021-02-22 出版日期:2021-08-10 发布日期:2021-07-30
  • 通信作者: 杜雨华 E-mail:du.yuhua@163.com
  • 基金资助:
    “十三五”国家科技重大专项(2018ZX10715004-002-017);广州市高水平临床重点专科和培育专科建设项目(穗卫函〔2019〕1555号);广东省转化医学创新平台培育建设项目(粤卫函〔2018〕1254号);广州市卫生健康科技重大项目(2020A031003);学生人群潜伏感染干预技术研究广州现场实施(2017ZX10201302-005-003)

Analysis of epidemiologic characteristics of pulmonary tuberculosis patients in floating population in Guangzhou City from 2014 to 2020

LAI Keng, JIANG Kun-hong, XIE Wei, YANG Jie-ying, LEI Yu, DU Yu-hua()   

  1. Department of Tuberculosis Control and Management,Guangzhou Chest Hospital, Guangzhou 510095, China
  • Received:2021-02-22 Online:2021-08-10 Published:2021-07-30
  • Contact: DU Yu-hua E-mail:du.yuhua@163.com

摘要:

目的 分析2014—2020年广州市流动人口肺结核流行特征,为制定流动人口结核病防控策略提供科学依据。方法 通过《中国疾病预防控制信息系统》子系统《结核病信息管理系统》收集广州市2014—2020年流动人口肺结核患者资料,包括年龄、性别、职业、患者发现方式、治疗分类、病原学结果等,分析该类人群的分布特征,应用季节指数对时间序列进行季节效应分析。结果 2014—2020年广州市共登记68329例肺结核患者,其中流动人口肺结核患者30692例,占全市患者总数的44.92%,并呈现逐年上升趋势,由2014年的30.81%(3530/11457)上升至2020年的50.73%(4185/8249)(χ2趋势=441.57,P<0.01)。30692例患者的中位年龄为33(23,46)岁,年龄以25~34岁为主(32.69%,10034/30692),职业以家政、家务及待业为主(45.85%,14073/30692)。患者来源以因症就诊为主(44.22%,13572/30692),患者普遍存在就诊延误(47.12%,14462/30692)。随着年份的变化,户籍类型省内市间流动占比逐年上升,由2014年的25.89%(914/3530)上升至2020年的36.39%(1523/4185)(χ2=208.57,P<0.01);患者来源于因症就诊的占比先降后升,由2014年的45.69%(1613/3530)降低至2017年的30.74%(1285/4180),再上升至2020年的57.51%(2407/4185)(χ2=971.89,P<0.01)。流动人口肺结核流行期为每年的3~9月,发病高峰为4月和7月。流动人口患者主要集中在白云区和天河区,分别由2014年的13.85%(489/3530)和11.47%(405/3530)上升至2020年的24.64%(1031/4185)和16.94%(709/4185)。结论 广州市流动人口结核病疫情依然严峻,流动人口肺结核呈现季节变化规律。患者以男性、青壮年为主,职业以家政、家务及待业为主,具有就诊延误率高的特征,且存在地区分布差异,应针对其流行特征制定相应的防控策略。

关键词: 结核,肺, 居住流动性, 流行病学研究特征(主题)

Abstract:

Objective To analyze the characteristics of pulmonary tuberculosis (PTB) in floating population in Guangzhou City, and provide evidence for PTB control strategies of floating population. Methods The data of PTB patients of floating population in Guangzhou City from 2014 to 2020 was collected in the “Tuberculosis Information Management System”, which included age, gender, occupation, patient discovery method, treatment classification, etiological results and so on. The distribution characteristics of this population were analyzed, and the seasonal effect of time series was analyzed by using seasonal index. Results From 2014 to 2020, a total of 68329 cases of PTB patients were registered in Guangzhou, among which 30692 cases were from floating population, accounting for 44.92% of total cases, from 30.81% (3530/11457) in 2014 to 50.73% (4185/8249) in 2020 (χ2trend=441.57, P<0.01). The median age was 33 (23,46) years and the main age group was 25-34 years old (32.69%, 10034/30692). The main occupation was housework and unemployment (45.85%, 14073/30692). The main source of patients was due to symptoms (44.22%, 13572/30692), and the patients were generally delayed (47.12%, 14462/30692). With the change of the year, the proportion of provincial mobility of household registration type increased (χ2=208.57, P<0.01), increasing from 25.89% (914/3530) in 2014 to 36.39% (1523/4185) in 2020; the source of clinical consultation decreased first then increased (χ2=971.89, P<0.01), from 45.69% (1613/3530) in 2014 to 30.74% (1285/4180) in 2017, and then up to 57.51% (2407/4185) in 2020. The prevalence of PTB in floating population was from March to September per year, with peak incidence in April and July. The proportion of PTB patients of floating population mainly concentrated in Baiyun and Tianhe Districts, increasing from 13.85% (489/3530) and 11.47% (405/3530) in 2014 to 24.64% (1031/4185) and 16.94% (709/4185) in 2020, respectively. Conclusion The epidemic situation of PTB among the floating population in Guangzhou is still severe, and shows seasonal variation. The patients are mainly male, young adults, housekeeping, housework and unemployment and have high delay rates and regional distribution, corresponding prevention and control strategies should be formulated according to the epidemic characteristics.

Key words: Tuberculosis,pulmonary, Residential mobility, Epidemiologic study characteristics (topic)