The impact of the COVID-19 epidemic on tuberculosis notification in Sichuan Province

doi:10.3969/j.issn.1000-6621.2021.09.013

Abstract

Abstract:

Objective To analyze the impact of COVID-19 epidemic on tuberculosis (TB) case notification in Sichuan Province in 2020, and to provide experience for TB detection under the situation of normalized COVID-19 control. Methods Medical records of TB patients from TB Management Information System of Chinese Diseases Control Information System were divided into three phases (control phase, intensive intervention phase and normalized phase, each phase contain 11 weeks) in relation to two time point: national response to COVID-19 (January 25, 30 provinces launched public health emergency response level 1) and Wuhan reopen (April 8). Data from 2017-2019 were used as baseline. The changes of TB notification number and the percentage of bacteriologically confirmed cases in each phases were analyzed as well as the changes of spatial distribution and characteristics of notified TB patients before and after the epidemic. Results In the first quarter of 2020, the number of visitors in designated TB hospitals (22656 cases) in Sichuan Province decreased by 35.97% (12730/35386) year-on-year and 33.94% (11642/34298) quarter-on-quarter. The notification number of TB patients and the percentage of bacteriologically confirmed cases decreased sharply in the 1st week of the intensive intervention phase by 62.52% (452/723) and 5.10% (from 48.27% (349/723) 1 week before Sprint Festival to 43.17% (117/271) 1 week after), respectively. It took 8 weeks and 4 weeks for these two indicators rebounding to their pre-epidemic levels. Among all 183 counties in the province, 131 (71.58%) showed a year-on-year decline on notification number and 98 (53.55%) showed a quarter-on-quarter decline. The notification number of male, student, Han, inter-provincial migrants, patients from Hong Kong, Macao, Taiwan and foreign countries showed larger year-on-year decline rates (25.06% (1805/7203), 38.77% (352/908), 25.01% (2088/8348) and 38.46% (100/260) respectively). Also, the notification number among patients under 15, 15-24, 25-34, 35-44, 45-54, 55-64 and over 65 had declined 8.89% (16/180), 26.28% (488/1857), 4.52% (61/1350), 18.68% (203/1087), 24.83% (498/2006), 28.53% (432/1514) and 28.57% (558/1953), respectively, which showed an upward trend (Z=2.520, P<0.001). Conclusion The COVID-19 epidemic has caused a very significant impact on the notification level of TB patients in Sichuan in short term and the number of cases notified has been greatly reduced. We should establish an emergency mechanism for TB control program, and enhance the active case finding activities for students and elders when the situation becomes normalized.

Key words: Tuberculosis,pulmonary, Coronavirus infections, Registries, Comparative study

LI Ting, HE Jin-ge, XIA Lan, CHEN Chuang, XIAO Yue, LU Jia, WANG Dan-xia. The impact of the COVID-19 epidemic on tuberculosis notification in Sichuan Province[J]. Chinese Journal of Antituberculosis, 2021, 43(9): 929-938. doi: 10.3969/j.issn.1000-6621.2021.09.013

Figures/Tables 9

距离春节周数	2017年			2018年			2019年			2020年
距离春节周数	病原学阳性结核病患者例数	结核病患者例数	病原学阳性率 (%)	病原学阳性结核病患者例数	结核病患者例数	病原学阳性率 (%)	病原学阳性结核病患者例数	结核病患者例数	病原学阳性率 (%)	病原学阳性结核病患者例数	结核病患者例数	病原学阳性率 (%)
-11	199	971	20.49	190	877	21.66	247	707	34.94	327	733	44.61
-10	215	924	23.27	237	1013	23.40	282	925	30.49	328	739	44.38
-9	278	1104	25.18	252	1155	21.82	267	928	28.77	370	810	45.68
-8	254	1095	23.20	243	969	25.08	297	849	34.98	337	793	42.50
-7	277	1127	24.58	208	755	27.55	292	977	29.89	349	832	41.95
-6	270	1136	23.77	202	793	25.47	214	685	31.24	350	795	44.03
-5	227	983	23.09	208	824	25.24	207	694	29.83	352	890	39.55
-4	178	840	21.19	210	815	25.77	237	759	31.23	260	617	42.14
-3	203	919	22.09	218	878	24.83	232	842	27.55	284	692	41.04
-2	215	906	23.73	249	922	27.01	281	881	31.90	403	852	47.30
-1	229	916	25.00	172	759	22.66	279	890	31.35	349	723	48.27
1	43	177	24.29	49	198	24.75	71	197	36.04	117	271	43.17
2	255	1111	22.95	355	1266	28.04	346	978	35.38	252	586	43.00
3	272	1200	22.67	294	1136	25.88	327	1041	31.41	193	463	41.68
4	215	1030	20.87	306	1079	28.36	352	1001	35.16	271	567	47.80
5	229	1070	21.40	291	1068	27.25	321	937	34.26	286	655	43.66
6	241	1043	23.11	298	1151	25.89	296	904	32.74	349	780	44.74
7	215	1017	21.14	196	820	23.90	308	951	32.39	350	779	44.93
8	221	991	22.30	296	1088	27.21	374	1112	33.63	390	920	42.39
9	295	1163	25.37	300	1052	28.52	282	845	33.37	428	926	46.22
10	218	872	25.00	296	995	29.75	355	1021	34.77	405	925	43.78
11	234	1053	22.22	216	782	27.62	316	960	32.92	351	819	42.86
12	245	1052	23.29	296	1007	29.39	430	1131	38.02	371	822	45.13
13	241	997	24.17	279	939	29.71	267	686	38.92	410	873	46.96
14	190	812	23.40	273	892	30.61	429	1000	42.90	408	839	48.63
15	268	1044	25.67	272	943	28.84	353	895	39.44	347	723	47.99
16	222	924	24.03	275	857	32.09	361	925	39.03	460	976	47.13
17	262	967	27.09	279	926	30.13	357	950	37.58	457	989	46.21
18	220	790	27.85	200	743	26.92	296	766	38.64	486	1017	47.79
19	284	1059	26.82	297	945	31.43	341	876	38.93	451	972	46.40
20	238	926	25.70	290	926	31.32	397	980	40.51	487	973	50.05
21	252	971	25.95	263	805	32.67	398	990	40.20	478	929	51.45
22	264	1111	23.76	276	915	30.16	339	875	38.74	367	752	48.80

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年份分期	结核病患者		病原学阳性患者^a		病原学阳性率(%)	Z_趋势值^b	P值
年份分期	登记例数	构成比(%)	登记例数	构成比(%)	病原学阳性率(%)	Z_趋势值^b	P值
2017						3.274	0.001
1期	10921	33.81	2545	33.19	23.30
2期	10727	33.21	2438	31.79	22.73
3期	10653	32.98	2686	35.02	25.21
合计	32301	100.00	7669	100.00	23.74
2018						9.172	<0.001
1期	9760	32.22	2389	28.83	24.48
2期	10635	35.11	2897	34.96	27.24
3期	9898	32.67	3000	36.21	30.31
合计	30293	100.00	8286	100.00	27.35
2019						12.229	<0.001
1期	9137	31.34	2835	27.93	31.03
2期	9947	34.11	3348	32.98	33.66
3期	10074	34.55	3968	39.09	39.39
合计	29158	100.00	10151	100.00	34.81
2020						5.679	<0.001
1期	8476	32.56	3709	31.37	43.76
2期	7691	29.54	3392	28.69	44.10
3期	9865	37.90	4722	39.94	47.87
合计	26032	100.00	11823	100.00	45.42

人口学特征		疫情期		疫情同比期		同比递降率(%)	χ²值^a	P值
人口学特征		登记例数	构成比(%)	登记例数	构成比(%)	同比递降率(%)	χ²值^a	P值
性别							83.765	<0.001
男		5398	70.19	7203	72.41	25.06
女		2293	29.81	2744	27.59	16.44
年龄组(岁)							370.600	<0.001
<15		164	2.13	180	1.81	8.89
15~24		1369	17.80	1857	18.67	26.28
25~34		1289	16.76	1350	13.57	4.52
35~44		884	11.49	1087	10.93	18.68
45~54		1508	19.61	2006	20.17	24.83
55~64		1082	14.07	1514	15.22	28.53
≥65		1395	18.14	1953	19.63	28.57
职业							198.250	<0.001
农、牧、渔民		5280	68.65	6843	68.79	22.84
学生		556	7.23	908	9.13	38.77
家政、家务及待业		779	10.13	926	9.31	15.87
其他^b		1076	13.99	1270	12.77	15.28
民族							219.320	<0.001
汉族		6260	81.39	8348	83.92	25.01
人口学特征	疫情期			疫情同比期		同比递降率(%)	χ²值^a	P值
人口学特征	登记例数		构成比(%)	登记例数	构成比(%)	同比递降率(%)	χ²值^a	P值
彝族	1028		13.37	1082	10.88	4.99
藏族	335		4.36	432	4.35	22.45
其他少数民族	68		0.88	85	0.85	20.00
户籍地类型							154.990	<0.001
本地	5971		77.64	7884	79.26	24.26
市内流动	1188		15.44	1333	13.40	10.88
市间(省内)流动	372		4.84	470	4.73	20.85
省间流动、港澳台及外籍	160		2.08	260	2.61	38.46

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