Abstract:

Objective: This study aims to evaluate the effectiveness of pulmonary tuberculosis (PTB) prevention and control by analyzing the long-term trend of PTB reported incidence in Hunan Province and to reveal its epidemiological characteristics across different populations and regions, providing a scientific basis for optimizing prevention and control strategies. Methods: Data on PTB reported incidence in Hunan Province from 2009 to 2023 was extracted from the “China Disease Prevention and Control Information System”. The PTB age-standardized reported incidences across years were calculated, and stratified analyses were conducted by sex, age, region, and etiological test result category. The Joinpoint regression model was used to analyze the change trend, identify turning points, and calculate the Annual Percentage Change (APC) and the Average Annual Percentage Change (AAPC) as evaluation metrics. Results: From 2009 to 2023, the age-standardized reported incidence of PTB in Hunan Province showed an overall declining trend (AAPC=-3.91%; 95%CI:-5.21% to -2.59%). The year 2020 marked a turning point, after which the decline accelerated (AAPC=-8.61%; 95%CI:-14.36% to -2.48%). The age-standardized reported incidence of PTB was higher in males than in females, with a faster decline rate in males (AAPC:-4.19% vs. -3.03%). The average reported incidence of PTB was highest among individuals aged 60 and above (194.51/100000 (322929/166026000)), but the decline was slower (AAPC=-2.42%; 95%CI:-3.01% to -1.82%). For those aged 15-59-year, the average reported incidence was (75.37/100000 (490884/651287000)), showing a faster decline (AAPC=-3.73%; 95%CI:-4.11% to -3.30%). The average reported incidence in the 0-14-year age group was low (2.98/100000 (5491/184359000)) and exhibited multiple fluctuations, with an upward trend observed from 2016 to 2019 (APC=19.50%; 95%CI: 9.90% to 25.45%). Regionally, the average reported incidences ranked as follows: Western Hunan (94.04/100000), Southern Hunan (86.10/100000), Northern Hunan (78.47/100000) and Central Hunan (76.57/100000), with Central Hunan showing the fastest decline (AAPC=-2.76%; 95%CI:-3.36% to -2.15%), while Southern Hunan showed a slower decline (AAPC=-1.93%; 95%CI:-2.85% to -0.63%). The standardized reported incidence of bacteriologically confirmed PTB decreased rapidly during 2009—2017 (APC=-6.83%; 95%CI:-9.20% to -5.20%), while the reported incidence of bacteriologically negative PTB declined sharply after 2018 (APC=-14.97%; 95%CI:-18.06% to -11.45%). Conclusion: The reported incidence of PTB in Hunan Province has significantly declined, demonstrating effective prevention and control measures. There are notable differences in incidences among various populations and regions, with the elderly, males, and areas in Western Hunan identified as high-risk groups and key areas.

Key words: Tuberculosis, pulmonary, Models, statistical, Incidence, Epidemiologic research design