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