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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (4): 370-377.doi: 10.3969/j.issn.1000-6621.2021.04.013

• 论著 • 上一篇    下一篇

2008—2019年上海市非户籍人口肺结核流行病学特征分析

王欢, 沈鑫, 陈静, 夏珍, 徐飚(), 袁政安()   

  1. 200032 上海,复旦大学公共卫生学院流行病学教研室(王欢、徐飚);上海市疾病预防控制中心(沈鑫、陈静、夏珍、袁政安)
  • 收稿日期:2020-12-31 出版日期:2021-04-10 发布日期:2021-04-09
  • 通信作者: 王欢,徐飚,袁政安 E-mail:bxu@shmu.edu.cn;yuanzhengan@scdc.sh.cn
  • 基金资助:
    上海市公共卫生学科带头人计划(GW-10.2-XD23)

Analysis of the epidemiological characteristics of pulmonary tuberculosis among migrants in Shanghai from 2008 to 2019

WANG Huan*, SHEN Xin, CHEN Jing, XIA Zhen, XU Biao(), YUAN Zheng-an()   

  1. *Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
  • Received:2020-12-31 Online:2021-04-10 Published:2021-04-09
  • Contact: WANG Huan*,XU Biao,YUAN Zheng-an E-mail:bxu@shmu.edu.cn;yuanzhengan@scdc.sh.cn

摘要:

目的 分析2008—2019年上海市非户籍人口肺结核流行特征及发病趋势,为完善针对非户籍人口的防控策略提供依据。方法 依据《传染病报告信息管理系统》中2008—2019年上海市非户籍肺结核患者的报告发病数据和人口数据,利用Joinpoint回归模型分析时间趋势,并计算各年度报告发病率和年度百分比变化(APC)及平均年度百分比变化(AAPC)。结果 2008—2019年上海市共报告非户籍肺结核患者36748例,占全人口报告发病例数的44.79%(36748/82047);12年间非户籍人口报告发病率由2008年的43.66/10万(3273例)下降至2019年的26.70/10万(2563例)(APC=-3.42%,t=-9.838,P<0.01),平均报告发病率为33.02/10万(36748例);男性患者23685例,女性患者13063例,男性的平均报告发病率为39.28/10万(23685例),高于女性的平均报告发病率(25.61/10万,13063例),差异有统计学意义(χ2=68.742,P<0.01),男性与女性报告发病率均呈下降趋势(APC=-3.27%,t=-7.444,P<0.01;APC=-3.74%,t=-9.791,P<0.01);不同年龄组中15~29岁年龄组患者占比最多,为52.69%(19364/36748),平均报告发病率最高的年龄组为75~104岁,为104.67/10万(365例),各年龄组间报告发病率差异有统计学意义(χ2=486.537,P<0.01),60~74岁年龄组报告发病率在2010年后呈上升趋势(APC=3.94%,t=3.443,P<0.01),由50.44/10万(104例)上升至69.24/10万(154例)。首诊地区为中心城区肺结核报告发病率2010年前呈明显下降趋势(APC=-7.99%,t=-2.758,P<0.01),2010年后下降趋势变缓(APC=-1.28%,t=-4.726,P<0.01),非中心城区报告发病率呈下降趋势(APC=-6.04%,t=-12.173,P<0.01)。涂阳肺结核和涂阴肺结核报告发病率均呈下降趋势(APC=-7.26%,t=-28.533,P<0.01;APC=-1.67%,t=-3.852,P<0.01)。结论 2008—2019年上海市非户籍肺结核报告发病率总体呈下降趋势,男性报告发病率高于女性,60~74岁患者在2010—2019年发病率呈上升趋势,应在综合管理的基础上进一步完善针对非户籍人口的防控策略以迅速降低发病率。

关键词: 结核, 发病率, 流行病学研究, 回归分析, 数据说明,统计

Abstract:

Objective To improve the tuberculosis control management of migrants by analyzing the epidemiological characteristics and incidence trend of pulmonary tuberculosis (PTB) of migrants in Shanghai during 2008—2019. Methods The data of PTB incidence and population were calculated from the Infectious Disease Reporting Information Management System. Joinpoint Regression Analysis was performed to analyze chronological trends, Annual Percentage Changes (APC) and Average Annual Percent Change (AAPC) were also estimated. Results A total of 36748 cases of PTB in migrants were reported in Shanghai from 2008 to 2019, accounting for 44.79% (36748/82047) of the reported cases in the whole population, the overall reported incidence rate decreased from 43.66/100000 (3273 cases) in 2008 to 26.70/100000 (2563 cases) in 2019, with APC=-3.42% (t=-9.838, P<0.01), the average reported incidence of PTB was 33.02/100000 (36748 cases). Of the reported PTB cases 23685 were males, with an average reported incidence of 39.28/100000 (23685 cases), and 13063 were female with an average reported incidence of 25.61/100000 (13063 cases), the difference were statistically significant (χ2=68.742, P<0.01). The reported incidences in male and female both decreased from 2008 to 2019 (APC=-3.27%, t=-7.444, P<0.01 and APC=-3.74%, t=-9.791, P<0.01, respectively). In different age groups, the number of patients aged 15-29 years was the most (52.69% (19364/36748)). The peak in average reported incidence of the total population was 104.67/100000 (365 cases) in the 75-104 years, there were significant differences in the incidences of PTB among different age groups (χ2=486.537, P<0.01). The reported incidence of PTB increased in the 60-74 years from 50.44/100000 (104 cases) in 2010 to 69.24/100000 (154 cases) in 2019 (APC=3.94%, t=3.443, P<0.01). The reported incidence of PTB in urban districts showed a significant decrease trend from 2008 to 2010 with APC=-7.99% (t=-2.758, P<0.01) and a stable decrease trend from 2010 to 2019 with APC=-1.28% (t=-4.726, P<0.01); while the reported incidence of PTB in rural districts showed a decrease trend from 2008 to 2019 with APC=-6.04% (t=-12.173, P<0.01). Both the reported incidence of smear-positive PTB and smear-negative PTB showed a decrease trend from 2008 to 2019 with APC=-7.26% (t=-28.533, P<0.01), APC=-1.67% (t=-3.852, P<0.01). Conclusion The epidemic of PTB of migrants in Shanghai steadily declined from 2008 to 2019, and the reported incidence rate of males was higher than that of females; the reported incidence of PTB showed a increase trend in the 60-74 years from 2010 to 2019. A better strategy especially for migrants should be developed to rapidly reduce the incidence rate.

Key words: Tuberculosis, Incidence, Epidemiologic studies, Regression analysis, Data interpretation, statistical