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. -
图 1 2016－2020年深圳市南山区肺结核地区分布
Figure 1. Area distribution of pulmonary TB cases in Nanshan district, Shenzhen, 2016−2020
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 
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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
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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
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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
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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
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