关键词: 结核, 肺/预防和控制, 老年, 疫情特征

Abstract:

Objective: To analyze the characteristics of pulmonary tuberculosis (PTB) patients aged 60 years and above (elderly PTB patients) in Hefei City from 2015 to 2024, and to provide a scientific basis for the early detection of elderly PTB patients. Methods: A retrospective study was conducted, data of 14205 records of PTB patients aged ≥60 years registered in Hefei City from 2015 to 2024 were collected from the China Disease Prevention and Control Information System. Information such as gender, age, current residential address, patient source, registration date, and etiological results were included in the study. Time trend analysis of the registration rate of PTB patients was conducted using Joinpoint Regression Program 5.0.2 software, obtaining the average annual percentage change (AAPC). Results: From 2015 to 2024, there were 14205 elderly PTB patients in Hefei, accounting for 39.33% (14205/36122) of all PTB patients. The registration rate decreased from 148.16/100000 (1649/1.113 million) in 2015 to 85.06/100000 (1418/1.667 million) in 2024, with an average annual decline of 5.98% (AAPC=-5.98%, P=0.021). The male-to-female ratio of elderly PTB patients was 2.85∶1. The registration rate for males (155.34/100000 (10512/6.767 million)) was significantly higher than that for females (52.89/100000 (3693/6.982 million)), with a statistically significant difference (χ²=3494.594, P<0.001). Over the 10 years, the registration rate of elderly PTB patients showed a downward trend, with the largest average annual decline observed in the 60-64 age group (AAPC=-8.79%, P<0.001), followed by the 70-74 age group (AAPC=-8.76%, P<0.001). However, the registration rate increased with advancing age ( ${\chi }_{trend}^{2}$=1116.539, P<0.001), reaching the highest in the 75-79 age group (150.56/100000 (2674/1.776 million)). The peak registration period occurred mainly in May (9.62% (1366/14205)) and March (9.57% (1360/14205)). The registration rate of elderly PTB patients decreased in all regions of Hefei over the decade. Among urban areas, Shushan District had the largest annual decline (AAPC=-5.97%, P=0.003), followed by Baohe District (AAPC=-5.70%, P=0.009). Among suburban counties, Changfeng County had the largest annual decline (AAPC=-9.57%, P<0.001), followed by Chaohu City (AAPC=-8.59%, P=0.001), and Lujiang County had the smallest (AAPC=-4.15%, P=0.010). Passive detection accounted for 98.49% (13990/14205) of registered patients, while active detection accounted for only 1.38% (196/14205). Among passive detection cases, referral was the main source (66.34% (9424/14205)), followed by tracing (18.09% (2570/14205)). The number of patients detected by referral showed a annual downward trend ( ${\chi }_{trend}^{2}$=175.954, P<0.001), whereas that detected by tracing showed an upward trend ( ${\chi }_{trend}^{2}$=609.935, P<0.001). The etiological positive rate of elderly PTB patients was 53.76% (7637/14205), increasing from 40.93% (675/1649) in 2015 to 67.70% (960/1418) in 2024 ( ${\chi }_{trend}^{2}$=596.068, P<0.001). A total of 1238 patients had comorbid diabetes, with the comorbidity rate rising from 2.49% (41/1649) in 2015 to 17.42% (247/1418) in 2024 ( ${\chi }_{trend}^{2}$=468.359, P<0.001). Conclusion: From 2015 to 2024, the registration rate of PTB patients aged ≥60 years in Hefei showed a downward trend. However, high registration rates were observed in some regions, male patients, and the ≥75 age group, who should be prioritized in TB prevention and control. All regions need to strengthen multi-departmental collaboration, enhance public health awareness, and continuously optimize prevention and control strategies based on the characteristics of the elderly population to further reduce the incidence of PTB among the elderly.

Key words: Tuberculosis, Lung/prevention and control, Elderly, Epidemiological characteristics