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中国防痨杂志 ›› 2026, Vol. 48 ›› Issue (2): 230-237.doi: 10.19982/j.issn.1000-6621.20250344

• 论著 • 上一篇    下一篇

2015—2024年重庆市肺结核患者密切接触者筛查情况及其时间变化趋势分析

刘书亚1,2, 张婷2, 汪清雅2, 范君2, 王倪3()   

  1. 1 中国现场流行病学培训项目, 北京 100050
    2 重庆市结核病防治所区县防治科, 重庆 400050
    3 中国疾病预防控制中心(中国预防医学科学院)结核病预防控制中心应用技术部, 北京 102206
  • 收稿日期:2025-08-23 出版日期:2026-02-10 发布日期:2026-02-03
  • 通信作者: 王倪 E-mail:wangni@chinacdc.cn
  • 基金资助:
    结核病患者关爱行动公益项目(09107)

Analysis of close contacts screening situation and time changing trends of pulmonary tuberculosis patients in Chongqing from 2015 to 2024

Liu Shuya1,2, Zhang Ting2, Wang Qingya2, Fan Jun2, Wang Ni3()   

  1. 1 Chinese Field Epidemiology Training Program, Beijing 100050, China
    2 Department of District and County Prevention and Control, Institute of Tuberculosis Prevention and Treatment of Chongqing, Chongqing 400050, China
    3 Department of Applied Technology, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing 102206, China
  • Received:2025-08-23 Online:2026-02-10 Published:2026-02-03
  • Contact: Wang Ni E-mail:wangni@chinacdc.cn
  • Supported by:
    Public-Benefit Project on Tuberculosis Patient Care Action(09107)

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摘要：

目的: 分析2015—2024年重庆市肺结核患者密切接触者筛查情况,为提高肺结核患者发现效率和密切接触者规范管理提供依据。方法: 从“中国疾病预防控制信息系统”中收集2015年1月1日至2024年12月31日重庆市登记的所有活动性肺结核患者数和病原学阳性肺结核患者数,以及密切接触者在首次诊断时、6个月后、1年后的3次随访筛查数据,并使用Joinpoint回归模型以年度平均变化百分比(AAPC)和年度变化百分比(APC)对平均每例指示病例登记的密切接触者数、密切接触者结核病检查率、密切接触者活动性肺结核患者检出率及密切接触者筛查对肺结核患者发现贡献率的时间变化趋势进行分析。结果: 2015—2024年,全市共登记161163例肺结核患者、81280例肺结核指示病例、210311名密切接触者。其中,家庭内密切接触者占69.72%(146624/210311),家庭外密切接触者占30.28%(63687/210311),平均每例指示病例登记的密切接触者数为2.59名。接受肺结核可疑症状筛查者206067名,筛查率为97.98%,但发现肺结核可疑症状者仅占6.44%(13265/206067);接受结核病检查的密切接触者152991名,检查率为72.75%;共检出1501例活动性肺结核患者,检出率为0.98%(1501/152991);密切接触者筛查对肺结核患者发现的贡献率为0.93%(1501/161163)。Joinpoint时间趋势分析显示,2015—2024年平均每例指示病例登记的密切接触者数呈上升趋势(AAPC=12.287%,95%CI:7.800%~15.508%,P<0.001),且仅在2021—2024年呈明显上升趋势(APC=41.482%,95%CI:21.084%~76.752%,P<0.001);而肺结核检查率和患者检出率均呈明显下降趋势(AAPC=-6.631%,95%CI:-10.722%~-2.017%,P=0.004;AAPC=-27.791%,95%CI:-46.442%~-2.882%,P=0.032),且检查率以2021—2024年呈明显下降趋势(APC=-18.192%,95%CI:-36.210%~-7.334%,P=0.002)。结论: 2015—2024年重庆市平均每例指示病例登记的密切接触者数呈上升趋势,而密切接触者的肺结核检查率和肺结核患者检出率均呈下降趋势,密切接触者筛查对肺结核患者发现的贡献率较低。建议进一步规范密切接触者筛查工作,提高结核病检查率,以提高肺结核患者检出率及密切接触者筛查对病例发现的贡献。

关键词: 结核,肺, 接触者追踪, 分枝杆菌感染, 人群监测, 传染病控制

Abstract:

Objective: To analyze the screening situation of close contacts and time changing trends of pulmonary tuberculosis (PTB) patients in Chongqing from 2015 to 2024, and to provide a basis for improving the efficiency of PTB detection and the standardized management of close contacts. Methods: Data on all registered active PTB patients and etiologically-positive PTB patients in Chongqing from January 1, 2015, to December 31, 2024, as well as data from three times of follow-up screening of close contacts (at initial diagnosis, 6 months, and 1 year), were collected from the China Information System for Disease Control and Prevention. Joinpoint regression was used to analyze the temporal trends of average number of close contacts registered per index case, tuberculosis examination rate, detection rate of active PTB among close contacts, and contribution rate of close contact screening to PTB patient discovery, using Annual Average Percent Change (AAPC) and Annual Percent Change (APC). Results: From 2015 to 2024, a total of 161163 cases of PTB cases, 81280 PTB index cases and 210311 close contacts were registered in Chongqing. Among them, household contacts accounted for 69.72% (146624/210311), and non-household contacts accounted for 30.28% (63687/210311), with an average of 2.59 close contacts registered per index case. A total of 206067 close contacts were screened for suspicious PTB symptoms, with a screening rate of 97.98%; however, only 6.44% (13265/206067) were found to have suspicious symptoms. A total of 152991 close contacts underwent tuberculosis examinations, representing an examination rate of 72.75%. In total, 1501 active PTB patients were detected, yielding a detection rate of 0.98% (1501/152991). The contribution rate of close contact screening to overall PTB patient discovery was 0.93% (1501/161163). Joinpoint trend analysis indicated that the average number of registered close contacts per index case showed an upward trend from 2015 to 2024 (AAPC=12.287%, 95%CI: 7.800% to 15.508%, P<0.001), with a significant increase observed from 2021 to 2024 (APC=41.482%, 95%CI: 21.084% to 76.752%, P<0.001). Conversely, both the tuberculosis examination rate and the detection rate of active PTB among close contacts showed downward trends (AAPC=-6.631%, 95%CI: -10.722% to-2.017%, P=0.004; AAPC=-27.791%, 95%CI:-46.442% to -2.882%, P=0.032), with the examination rate declining significantly from 2021 to 2024 (APC=-18.192%, 95%CI:-36.210% to -7.334%, P=0.002). Conclusion: From 2015 to 2024, the average number of close contacts registered for each index case in Chongqing showed an upward trend, while the tuberculosis screening rate and the detection rate of PTB patients among close contacts decreased. The contribution of close contacts screening to case detection was relatively low. It is recommended to further standardize the close contacts screening work, increase the tuberculosis screening rate, so as to enhance the detection rate of PTB patients and the contribution of close contacts screening to case detection.

Key words: Tuberculosis, pulmonary, Contact tracing, Mycobacterium infections, Population surveillance, Communicable disease control

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