Abstract:

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) among children aged 0-14 in Sichuan Province from 2009 to 2018, and provide scientific evidence for strengthening prevention and control of PTB in children. Methods Based on the reported incidence data and population data of childhood PTB patients aged 0-14 years reported in the Infectious Disease Reporting Information Management System and Basic Information System of the China Disease Prevention and Control Information System from 2009 to 2018 in Sichuan Province, the Joinpoint regression model was used for trend analysis. Results From 2009 to 2018, a total of 10981 childhood PTB cases aged 0-14 years were reported, accounting for 1.79% (10981/612506) of the reported PTB cases in the whole population. The actual reported incidence rate of PTB in children increased from 8.91/100000 (1349/15140100) in 2009 to 9.35/100000 (1229/13141100) in 2018, with an average annual growth rate of 0.50%; Joinpoint regression analysis showed that the standardized reported incidence of childhood PTB showed a periodic change during 2009—2015 (annual percentage change (APC)=-1.98%, P=0.196) and 2015—2018 (APC=10.13%, P=0.061), but both of them tended to be stable. The reported cases of PTB in boys aged 0-14 was 6011, with an average reported incidence of 8.43/100000 (6011/71339600), and 4970 reported in girls with an average reported incidence of 7.64/100000 (4970/65071300). The reported incidence of PTB in boys was generally higher than that in girls (χ²=26.261, P<0.001). Among different age groups, there were significant differences in the incidence of PTB (χ²=3629.827, P<0.001); the reported incidence of PTB was generally higher in children aged 0- years old (9.08/100000, 774/8523100) and 10-14 years old (14.37/100000, 6575/45769900)than that in children aged 1-4 years old (4.09/100000, 1423/34833900) and 5-9 years old (4.67/100000, 2209/47284100). Joinpoint regression analysis revealed that the reported incidence of childhood PTB aged 0- years rapidly decreased from 13.32/100000 (132/991000) in 2009 to 3.73/100000 (31/831900) in 2018 (APC=-10.80%, P=0.002), and the reported incidence of childhood PTB aged 10-14 years significantly increased after 2016, from 13.39/100000 (760/5676700) to 18.88/100000 (786/4162100) (APC=17.99%, P=0.042). Conclusion Although the reported incidence of PTB among children in Sichuan Province tends to be stable in recent years, there is still an upward trend. It is necessary to strengthen the BCG vaccination of newborns, the prevention and control of tuberculosis in students, and the screening of close contacts of PTB patients and children in families.

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