Abstract:

Objective: To systematically describe and analyze the reported incidence and epidemic trends of pulmonary tuberculosis (PTB) in Shandong Province from 2005 to 2023, thereby providing a scientific basis for the formulation and enhancement of regional TB prevention and control strategies. Methods: The epidemic data of PTB in Shandong Province from 2005 to 2023 were collected from the Infectious Disease Surveillance System of China Information System for Disease Control and Prevention. Population data were obtained from Shandong Statistical Yearbook. The national population distribution released by the National Bureau of Statistics based on the Seventh National Population Census in 2020 was adopted as the standard population for calculating the age-standardized reported incidence rate. Joinpoint regression and heat map were employed to analyze the epidemic trends of PTB. Results: From 2005 to 2023, a total of 632763 PTB cases were reported in Shandong Province, the average reported incidence rate was 34.06/100000. The overall reported incidence rate decreased by 51.09% from 2005 (43014 cases, 46.51/100000) to 2023 (23027 cases, 22.75/100000). The top six regions reporting the number of cases were Liaocheng (2693 cases, 46.11/100000), Linyi (4191 cases, 40.57/100000), Heze (3393 cases, 40.08/100000), Dezhou (2129 cases, 37.93/100000), Tai’an (2029 cases, 36.84/100000) and Ji’nan (2646 cases, 35.15/100000). Weifang (2214 cases, 24.12/100000), Dongying (576 cases, 27.47/100000) and Qingdao (2608 cases, 28.51/100000) exhibited relatively lower average reported incidence rate. From 2005 to 2023, the standardized reported incidence rate in Shandong Province demonstrated an overall downward trend (AAPC=-4.25, 95%CI: -5.15--3.33, t=-8.936, P<0.001). Among the cities, Binzhou (AAPC=-6.45, 95%CI: -9.58--3.22, t=-3.843, P<0.001), Tai’an (AAPC=-6.20, 95%CI: -8.41--3.93, t=-5.247, P<0.001), Jinan (AAPC=-5.82, 95%CI: -6.83--4.80, t=-10.867, P<0.001), Dongying (AAPC=-5.74, 95%CI: -6.58--4.89, t=-13.893, P<0.001), Dezhou (AAPC=-5.66, 95%CI: -6.31--5.01, t=-17.788, P<0.001), Linyi (AAPC=-5.33, 95%CI: -7.24--3.39, t=-5.238, P<0.001) experienced the fastest decline, while the decline rates in Yantai (AAPC=-1.63, 95%CI: -2.73--0.52, t=-2.878, P=0.004), Qingdao (AAPC=-1.96, 95%CI: -2.52--1.40, t=-7.312, P<0.001), Weihai (AAPC=-2.55, 95%CI: -3.87--1.20, t=-3.688, P<0.001), Weifang (AAPC=-3.61, 95%CI: -4.16--3.07, t=-13.732, P<0.001), Heze (AAPC=-4.22, 95%CI: -5.48--2.94, t=-6.357, P<0.001) were lower than the average level of Shandong Province. Conclusion: Since 2005, the reported incidence of PTB in Shandong Province has shown a continuous downward trend, reflecting the success of the TB prevention and control strategies implemented during various periods. The TB epidemic situation exhibits significant regional disparities in Shandong Province. Therefore, it is essential to conduct an in-depth analysis of the influencing factors and develop targeted prevention and control policies tailored to the specific characteristics of each region.

Key words: Tuberculosis, pulmonary, Incidence, Communicable disease control