Spatial distribution of pulmonary tuberculosis in the elderly in Inner Mongolia Autonomous Region, 2016-2020
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摘要:
目的 了解内蒙古自治区（内蒙古）老年人肺结核空间分布特征，探索老年人肺结核高发区域，为制定相关防控措施提供依据。 方法 收集2016—2020年内蒙古自治区105个旗（县、区）老年人肺结核患者登记数据，结合中国矢量化省界电子地图，利用空间分析方法对其进行时空聚集性分析。 结果 2016—2020年内蒙古老年人肺结核年均登记率为126.2/10万，其中2018年登记率最高为163.6/10万；男女性别比例为1.5∶1，低于<65岁人群男女性别比（2.2∶1）；三维趋势分析图显示，2016—2020年内蒙古老年人肺结核年均报告登记率总体情况为由西向东呈先大幅下降又缓慢上升的趋势，由北向南呈逐渐上升的趋势；空间自相关结果显示，2016、2017、2019和2020年内蒙古老年人肺结核登记率整体存在空间正相关性， Moran I分别为0.180，0.188，0.260和0.239（均P＜0.05），高-高聚集区位于阿拉善盟的额济纳旗和阿拉善盟右旗、巴彦淖尔市的临河区和五原县、包头市的固阳县（均P＜0.05）；时空扫描结果显示，共发现5个可能聚集区域覆盖9个旗（县、区），其中一类最大可能聚集区以乌拉特中旗为中心，覆盖西部5个旗（县、区），聚集时间为2018—2019年，该区域内老年人肺结核登记率是周边旗（县、区）的3.235倍（RR=3.235）。 结论 2016、2017、2019以及2020年内蒙古老年人肺结核登记率呈空间聚集性分布，且聚集区域主要位于西部地区，应加强对西部地区老年人的肺结核防控工作。 Abstract:Objective To understand the spatial distribution of pulmonary tuberculosis (TB) in the elderly in Inner Mongolia Autonomous region, identify the areas with high incidence of pulmonary TB, and provide evidence for the development of pulmonary TB prevention and control measures. Methods The registered data of pulmonary TB in the elderly in 105 banners (counties and districts) of Inner Mongolia from 2016 to 2020 were collected. Combined with the vectorized provincial boundary electronic map of China, spatial analysis method was used to analyze the spatiotemporal clustering. Results From 2016 to 2020, the annual registered rate of pulmonary TB in the elderly in Inner Mongolia was 126.2/100 000, and the highest registered rate was 163.6/100 000 in 2018.The male to female ratio of the cases was 1.5∶1, lower than that in those under 65 years old (2.2∶1); The three-dimensional trend chart showed a sharp decline and a slow increase from the west to the east, and a gradual increase from the north to the south for the annual registration rate of pulmonary TB in the elderly in Inner Mongolia from 2016 to 2020. The spatial autocorrelation showed that there was a positive spatial correlation in pulmonary TB registration rate in the elderly in Inner Mongolia in 2016, 2017, 2019 and 2020, and the Moran I were 0.180, 0.188, 0.260 and 0.239 (P < 0.05). The high-high clustering areas were in Ejin banner and Right banner of Alxa league, Linhe district and Wuyuan county of Bayan Nur, and Guyang county of Baotou (P < 0.05). The spatiotemporal scanning results showed that there were 5 clustering areas covered 9 districts, the first type of clustering area covered 5 districts in western area with Urad Middle banner as the center during 2017−2018. The pulmonary TB registration rate in the elderly in this area was 3.235 times higher than that in neighboring areas (RR=3.235). Conclusion In 2016, 2017, 2019 and 2020, the pulmonary TB registration rate in the elderly in Inner Mongolia showed spatial clustering distribution, and the clustering areas were mainly in the western area. The prevention and control of tuberculosis in the elderly in the western area should be strengthened. -
Key words:
- Inner Mongolia /
- The elderly /
- Tuberculosis /
- Spatiotemporal clustering
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图 1 2016－2020年内蒙古自治区老年人肺结核年均登记率分布图［审图号GS（2020）4619］
Figure 1. Distribution of annual tuberculosis registration rate among the elderly in Inner Mongolia, 2016−2020
图 2 2016－2020年内蒙古自治区老年人肺结核年均登记率三维趋势
Figure 2. Three-dimensional trend chart of annual tuberculosis registration rate among the elderly in Inner Mongolia from 2016 to 2020
图 3 2016－2020年内蒙古自治区老年人肺结核年均登记率空间聚类分析［审图号GS（2020）4619］
Figure 3. Spatial clustering analysis chart of annual tuberculosis registration rate among the elderly in Inner Mongolia, 2016−2020
图 4 2016－2020年内蒙古自治区老年人肺结核年均登记率时空扫描分析［审图号GS（2020）4619］
Figure 4. Spatial and temporal scanning analysis of annual tuberculosis registration rate among the elderly in Inner Mongolia from 2016 to 2020
表 1 2016－2020年内蒙古自治区各年度各盟市老年人肺结核登记率（1/10万）
Table 1. Registration rate of pulmonary tuberculosis in each cities of Inner Mongolia Autonomous Region from 2016 to 2020 (1/100 000)
盟市 2016年 2017年 2018年 2019年 2020年 平均 呼和浩特市 79.1 95.8 112.2 100.0 68.2 91.1 包头市 103.6 88.8 166.2 150.8 148.1 131.5 乌海市 101.0 124.3 165.1 115.1 103.8 121.8 赤峰市 116.3 121.6 137.2 94.7 68.5 107.7 通辽市 150.2 126.6 177.0 116.7 84.5 131.0 鄂尔多斯市 115.4 97.4 111.4 103.8 92.6 104.1 呼伦贝尔市 48.8 68.8 112.8 102.1 77.0 81.9 巴彦淖尔市 222.9 223.5 334.0 295.7 196.4 254.5 乌兰察布市 116.5 122.7 181.0 135.0 89.5 129.0 兴安盟 113.8 94.4 139.9 117.1 77.2 108.5 锡林郭勒盟 26.6 27.6 41.2 38.1 33.9 33.5 阿拉善盟 255.8 199.9 285.4 188.6 168.9 219.7 平均 120.8 116.0 163.6 129.8 100.7 126.2 
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表 2 2016－2020年内蒙古自治区老年人肺结核登记率全局自相关分析
Table 2. Global autocorrelation analysis of tuberculosis registration rate among the elderly in Inner Mongolia, 2016−2020
年份 莫兰指数 Z值 P值 2016年 0.180 3.072 0.002 2017年 0.188 3.242 0.001 2018年 0.103 1.904 0.057 2019年 0.260 4.320 ＜0.001 2020年 0.239 3.970 ＜0.001
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表 3 2016－2020年内蒙古自治区老年人肺结核登记时空扫描结果
Table 3. Spatial and temporal scanning results of tuberculosis registration among the elderly in Inner Mongolia from 2016 to 2020
聚集类别 聚集数量 聚集半径（km） 聚集时间（年） 病例数 期望病例数 RR值 LLR值 P值 一类 5 130.13 2018−2019 943 305.34 3.235 439.753 ＜0.001 二类 1 0.00 2016−2017 373 85.97 4.421 263.152 ＜0.001 三类 1 0.00 2018−2019 289 84.73 3.462 151.723 ＜0.001 四类 1 0.00 2016−2017 216 78.20 2.791 82.302 ＜0.001 五类 1 0.00 2018−2019 234 110.56 2.134 52.523 ＜0.001 注：RR.相对危险度，LLR.对数似然比
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