Epidemiological characteristics of pulmonary tuberculosis in Nanshan district of Shenzhen, 2016−2020
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摘要:
目的 了解2016—2020年广东省深圳市南山区肺结核的流行特征,为制定防治措施提供科学依据。 方法 从中国疾病预防控制信息系统的传染病报告信息管理系统收集2016—2020年的深圳市南山区肺结核病例信息,采用描述性流行病学方法对肺结核发病的三间分布、疾病分类和耐药情况进行分析,SPSS 25.0软件用于数据统计分析,率的比较采用χ2检验。 结果 2016—2020年深圳市南山区共计报告肺结核病例3 565例,年均报告发病率为50.13/10万,报告发病率从2016年的60.88/10万下降至2020年的37.59/10万,差异有统计学意义(趋势χ2=130.399,P<0.01)。 报告发病数较多的月份集中在3、5和7月。 年均报告发病率位居前3位是蛇口街道(85.44/10万)、西丽街道(73.71/10万)和南山街道(62.79/10万)。 男性年均报告发病率(62.91/10万)高于女性(36.03/10万),差异有统计学意义(χ2=255.764,P<0.01); 25~34岁年龄组病例数最多(36.21%,1 291/3 565),45岁以上年龄组的病例构成比有所上升;职业以干部职员(33.38%,1 190/3 565)为主;非户籍人口年均报告发病率(105.34/10万)高于户籍人口(15.34/10万),差异有统计学意义(χ2=2 726.163,P<0.01)。 2016—2020年南山区肺结核患者的总耐药率为10.50%(109/1 038),耐多药率为4.05%(42/1 038)。 结论 2016—2020年深圳市南山区肺结核疫情呈逐年下降趋势,男性、青壮年、职员、非户籍人口和耐药肺结核患者是重点关注对象,中老年人结核病有所上升,应引起重视,需加强春夏季和重点区域结核病防控。 Abstract:Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (TB) in Nanshan district of Shenzhen from 2016 to 2020 and provide evidence for the prevention and control of pulmonary TB. Methods The data of pulmonary TB patient registration in Nanshan district from 2016 to 2020 were collected from China Information System for Disease Control and Prevention. Descriptive epidemiological analysis was conducted on the distribution of pulmonary TB incidence, disease classification, and drug resistance. Statistical analysis was conducted with software SPSS 25.0, and χ2 test was used to compare the rates. Results A total of 3565 pulmonary TB cases were reported in Nanshan district from 2016 to 2020, the average annual reported incidence rate was 50.13/100 000, the reported incidence rate decreased from 60.88/100 000 in 2016 to 37.59/100 000 in 2020 (trend χ2=130.399, P<0.01). Most cases were reported in March, May and July. The top three areas with high annual average reported incidence rates were Shekou street (85.44/100 000), Xili street (73.71/100 000) and Nanshan street (62.79/100 000). The average annual reported incidence was 62.91/100 000 in men and 36.03/100 000 in women, and the difference was significant (χ2=255.764, P<0.01). The cases in age group 25−34 years accounted for the highest proportion (36.21%, 1291/3565) , and the proportion of the cases aged 45 years or older increased. The cases in staff and employees accounted for the highest proportion (33.38%, 1190/3565). The average annual reported incidence rate in non-local residents (105.34/100 000) was higher than that in local residents (15.34/100 000), with statistically significant differences (χ2=2726.163, P<0.01). The overall drug resistance rate in pulmonary TB cases in Nanshan district during 2016−2020 was 10.50% (109/1038) and the multidrug resistance rate was 4.05% (42/1038). Conclusion The reported incidence rate of pulmonary TB showed a decline trend in Nanshan district from 2016 to 2020. It is necessary to strengthen the TB prevention and control in men, young adults, staff/employees, non-local population, drug-resistant patients and the elderly as well as in spring/summer and key areas. -
表 1 2016-2020年深圳市南山区肺结核报告发病情况
Table 1. Reported incidence of pulmonary TB in Nanshan district, Shenzhen, 2016−2020
年份 人口数 发病总数
(例)活动性肺结核报告
发病率(/10万)病原学阳性肺结核 病原学阴性肺结核 无病原学结果肺结核 病例数(例) 构成比(%) 病例数(例) 构成比(%) 病例数(例) 构成比(%) 2016 1 291 152 786 60.88 323 41.09 389 49.50 74 9.41 2017 1 356 307 879 64.81 328 37.32 462 52.55 89 10.13 2018 1 424 561 667 46.82 344 51.57 267 40.03 56 8.40 2019 1 493 631 652 43.65 399 61.20 215 32.97 38 5.83 2020 1 545 788 581 37.59 354 60.93 189 32.53 38 6.54 合计 7 111 439 3 565 50.13 1 748 49.03 1 522 42.70 295 8.27 表 2 2016-2020年深圳市南山区肺结核时间分布
Table 2. Monthly distribution of pulmonary TB cases in Nanshan district, Shenzhen, 2016−2020
月份 发病数(例) 构成比(%) 1 246 6.90 2 214 6.00 3 367 10.29 4 311 8.72 5 325 9.12 6 309 8.67 7 360 10.10 8 312 8.75 9 317 8.89 10 295 8.28 11 279 7.83 12 230 6.45 合计 3 565 100.00 表 3 2016-2020年深圳市南山区肺结核年龄分布
Table 3. Age distribution of pulmonary TB cases in Nanshan district, Shenzhen, 2016−2020
年龄组(岁) 2016年 2017年 2018年 2019年 2020年 总计 发病数(例) 构成比(%) 发病数(例) 构成比(%) 发病数(例) 构成比(%) 发病数(例) 构成比(%) 发病数(例) 构成比(%) 发病数(例) 构成比(%) < 15 3 0.38 2 0.23 5 0.75 4 0.61 4 0.69 18 0.50 15~ 195 24.81 201 22.87 119 17.84 110 16.87 112 19.28 737 20.67 25~ 284 36.13 314 35.72 267 40.03 233 35.74 193 33.22 1 291 36.21 35~ 108 13.74 105 11.94 99 14.84 102 15.65 79 13.60 493 13.83 45~ 91 11.58 100 11.38 81 12.14 105 16.10 92 15.83 469 13.16 55~ 56 7.13 77 8.76 47 7.05 56 8.59 44 7.57 280 7.86 65~ 31 3.94 37 4.21 32 4.80 26 3.99 35 6.02 161 4.52 75~ 18 2.29 43 4.89 17 2.55 16 2.45 22 3.79 116 3.25 合计 786 100.00 879 100.00 667 100.00 652 100.00 581 100.00 3 565 100.00 表 4 2016-2020年深圳市南山区肺结核户籍分布
Table 4. Population distribution of pulmonary TB cases in Nanshan district, Shenzhen, 2016−2020
年份 深圳户籍 非深圳户籍 病例数(例) 报告发病率(/10万) 病例数(例) 报告发病率(/10万) 2016 96 12.70 690 128.92 2017 130 16.05 749 137.15 2018 151 16.88 516 97.33 2019 146 15.84 506 88.45 2020 146 14.90 435 76.89 合计 669 15.34 2 896 105.34 表 5 2016-2020年深圳市南山区肺结核耐药筛查情况
Table 5. Drug-resistant pulmonary TB screening in Nanshan district, Shenzhen, 2016−2020
年份 耐药筛查
可疑者数
(例)总耐药 利福平耐药 异烟肼耐药
(不包含利福平耐药)发现患者数
(例)检出率
(%)发现患者数
(例)检出率
(%)其中耐多药 发现患者数
(例)检出率
(%)发现患者数(例) 检出率(%) 2016 214 23 10.75 15 7.01 12 5.61 8 3.74 2017 274 25 9.12 13 4.74 5 1.82 12 4.38 2018 215 27 12.56 10 4.65 10 4.65 17 7.91 2019 197 19 9.64 15 7.61 9 4.57 4 2.03 2020 138 15 10.87 7 5.07 6 4.35 8 5.80 合计 1 038 109 10.50 60 5.78 42 4.05 49 4.72 趋势χ2值 0.024 0.006 0.023 0.096 P值 0.876 0.939 0.881 0.757 -
[1] World Health Organization. Global tuberculosis report 2021[EB/OL].(2021-10-14) [2022-05-10]. https://www.who.int/publications/digital/global-tuberculosis-report-2021. [2] 沈鸿程, 杜雨华, 吴桂锋, 等. 2008-2018年广州市报告新发肺结核流行特征分析[J]. 中国防痨杂志,2020,42(4):322–326. DOI:10.3969/j.issn.1000−6621.2020.04.005.Shen HC, Du YH, Wu GF, et al. Epidemiological characteristics of newly reported pulmonary tuberculosis from 2008 to 2018 in Guangzhou[J]. Chin J Antituberc, 2020, 42(4): 322–326. DOI: 10.3969/j.issn.1000−6621.2020.04.005. [3] 谢锦哲. 2016年-2020年潮州市结核病疫情分析与评价[J]. 医药前沿,2021,11(30):195–196.Xie JZ. Analysis and evaluation of tuberculosis epidemic in Chaozhou city, 2016−2020[J]. Yiyao Qianyan, 2021, 11(30): 195–196. [4] Huang F, Xia YY, Chen H, et al. The impact of the COVID-19 epidemic on tuberculosis control in China[J]. Lancet Reg Health West Pac, 2020, 3: 100032. DOI: 10.1016/j.lanwpc.2020.100032. [5] 吕利平. 全国肺结核发病率分布特征的统计分析[D]. 兰州: 兰州财经大学, 2019.Lv LP. Statistical analysis of the distribution characteristics of the incidence of tuberculosis in China[D]. Lanzhou: Lanzhou University of Finance and Economics, 2019. [6] 杨天池, 洪航, 陈同, 等. 人口流入城市肺结核流行特征、时空分布及其社会影响因素分析[J]. 中国人兽共患病学报,2017,33(9):800–804. DOI:10.3969/j.issn.1002−2694.2017.09.009.Yang TC, Hong H, Chen T, et al. Epidemiological characteristics and temporal-spatial clustering of pulmonary tuberculosis and its social influence factors in immigration city[J]. Chin J Zoonoses, 2017, 33(9): 800–804. DOI: 10.3969/j.issn.1002−2694.2017.09.009. [7] 朱闵敏, 范玉铮, 郭旭君, 等. 基于社区水平的深圳市南山区2011-2015年肺结核疫情时空分析[J]. 热带医学杂志,2016,16(9):1194–1197. DOI:10.3969/j.issn.1672−3619.2016.09.030.Zhu MM, Fan YZ, Guo XJ, et al. Spatial-temporal analysis of community-level pulmonary tuberculosis at Nanshan district, Shenzhen city (2011−2015)[J]. J Trop Med, 2016, 16(9): 1194–1197. DOI: 10.3969/j.issn.1672−3619.2016.09.030. [8] 申晨, 申阿东. 结核病发病率的性别差异性研究现状[J]. 结核病与肺部健康杂志,2017,6(4):381–385. DOI:10.3969/j.issn.2095−3755.2017.04.018.Shen C, Shen AD. Study on gender differences in tuberculosis incidence[J]. J Tuberc Lung Health, 2017, 6(4): 381–385. DOI: 10.3969/j.issn.2095−3755.2017.04.018. [9] 国家卫生健康委员会. 中国卫生健康统计年鉴-2018[M]. 北京: 中国协和医科大学出版社, 2018: 72.National Health and Wellness Commission. China health care statistics yearbook-2018[M]. Beijing: China Union Medical University Press, 2018: 72. [10] 钟涛, 刘盛元, 詹广兴, 等. 2005-2016年深圳市南山区肺结核流行特征分析[J]. 疾病监测,2018,33(9):724–727. DOI:10.3784/j.issn.1003−9961.2018.09.006.Zhong T, Liu SY, Zhan GX, et al. Epidemiological characteristics of tuberculosis in Nanshan district of Shenzhen, 2005−2016[J]. Dis Surveill, 2018, 33(9): 724–727. DOI: 10.3784/j.issn.1003−9961.2018.09.006. [11] 左越, 李君, 窦克勤, 等. 国内高新区数字经济发展路径研究—以深圳市南山区为例[J]. 市场周刊,2019(9):45–49.Zuo Y, Li J, Dou KQ, et al. A study on the development path of digital economy in domestic high-tech zone: the case of Nanshan district, Shenzhen[J]. Mark Wkly, 2019(9): 45–49. [12] 王作飞. 2005-2015年济南市流动人口结核病患者的发病特点及流行趋势[D]. 济南: 山东大学, 2017.Wang ZF. Pathogenesis and epidemic trend of tuberculosis patients in floating population in Jinan from 2005 to 2015[D]. Jinan: Shandong University, 2017. [13] 深圳市南山区统计局. 南山区第七次全国人口普查公报(第六号)[Z/OL]. (2021-06-25)[2022-05-10]. http://www.szns.gov.cn/nsqtjj/gkmlpt/content/8/8900/post_8900208.html#15392.Shenzhen Nanshan District Bureau of Statistics. Nanshan District, the seventh national census announcement (No. 6)[Z/OL]. (2021-06-25)[2022-05-10]. http://www.szns.gov.cn/nsqtjj/gkmlpt/content/8/8900/post_8900208.html#15392. [14] 王云霞, 郑娟娟, 张娟娟, 等. 2011-2018年宝安区肺结核患者耐多药的影响因素分析[J]. 预防医学,2021,33(7):701–703. DOI:10.19485/j.cnki.issn2096−5087.2021.07.012.Wang YX, Zheng JJ, Zhang JJ, et al. Influencing factors for multidrug resistance of patients with tuberculosis in Baoan district from 2011 to 2018[J]. Prev Med, 2021, 33(7): 701–703. DOI: 10.19485/j.cnki.issn2096−5087.2021.07.012. [15] 全国第五次结核病流行病学抽样调查技术指导组, 全国第五次结核病流行病学抽样调查办公室. 2010年全国第五次结核病流行病学抽样调查报告[J]. 中国防痨杂志,2012,34(8):485–508.Technical Guidance Group of the Fifth National TB Epidemiological Survey, The Office of the Fifth National TB Epidemiological Survey. The fifth national tuberculosis epidemiological survey in 2010[J]. Chin J Antituberc, 2012, 34(8): 485–508. [16] World Health Organization. Global tuberculosis report 2017[R]. Geneva: World Health Organization, 2017. -