Abstract:

Objective: To analyze the reported incidence of pulmonary tuberculosis (PTB) and cross-regional health care seeking of students in Fujian Province from 2005 to 2021, to provide reference for effective tuberculosis control in schools. Methods: The reported incidence data of PTB among students in Fujian Province from 2005 to 2022 were retrieved from the National Health Security Information Project Disease Prevention and Control Information System-Surveillance Management System. After clearing data according to inclusion and exclusion criteria, patients with onset dates from 2005 to 2021 were retained as study subjects. Retrospective description and Joinpoint regression model were used to analyze the incidence change trend among different age groups, and patients’ cross-regional medical visits. Results: From 2005 to 2021, a total of 12529 student patients with PTB were reported in Fujian Province. The reported incidence rates of PTB among students showed a significant downward trend, from 17.00/100000 (1202/7069000) in 2005 to 5.12/100000 (466/9103300) in 2021, the average annual change was -6.79% (Z=-2.706, P=0.007). Among different age groups, the reported incidence rates of students ≤12 years old and 13-15 years old were relatively low, averaged as 0.84/100000 (595/71009200) and 5.95/100000 (1359/22829500) respectively, but showed a significant upward trend since 2012 (APC=6.40,t=2.526, P=0.027;APC=5.57, t=2.208, P=0.047), from 0.41/100000 (16/3927100) and 4.11/100000 (46/1120400) in 2012 to 0.56/100000 (29/5201700) and 5.90/100000 (90/1526100) in 2021, respectively. The reported incidence rates of students aged 16-18 years old was 24.93/100000 (5165/20715300) averagely which was at a higher level and the overall downward trend was not obvious. The reported incidence rates of students aged ≥19 years old was 38.97/100000 (5410/13881800), which was at a higher level but showed a large overall decline (Z=-3.836, P<0.001), from 102.60/100000 (494/481500) in 2005 to 11.77/100000 (139/1181400) in 2021. 94.43% (11831/12529) of the students with PTB were treated in the medical institutions of the city where their current address was located. 5.57% (698/12529) of patients made cross-regional medical visits, and the proportion showed an increasing trend, from 4.24% (51/1202) in 2005 to 7.51% (35/466) in 2021 (Z=-4.901, P<0.001), the cross-regional medical care seeking obviously happened mostly in nearby regions. Conclusion: The reported incidence of PTB among students in Fujian Province was low, and the overall trend was obviously decreasing. The proportion of cross-regional medical visits was relatively low. It is necessary to continue to strengthen the prevention and control of tuberculosis in schools, especially focusing on 16-18 years of high school students.

Key words: Tuberculosis, pulmonary, Students, Incidence, Floating population, Regression analysis