Epidemiological characteristics of tuberculosis in Yunnan, 2010−2021
-
摘要:
目的 分析2010—2021年云南省结核病流行病学基本特征,掌握结核病发病特点,为云南省结核病的防治提供参考建议。 方法 通过结核病监测信息报告管理系统下载2010—2021年云南省报告的结核病例数,使用地理信息系统(GIS)空间制图软件ArcGIS 10.7绘制云南省结核病报告发病率图示,对云南省结核病疫情概况进行描述性流行病学特征分析。 结果 云南省2010—2021年结核病疫情反复波动(χ2=858.570,P<0.001),累计报告病例数共333846例,年均发病率为57.58/10万,其中男性病例224397例(67.22%),女性病例109449例(32.78%),男女性别比例为2.05∶1。 发病时间上,以春季为主,主要集中在4—7月;发病地区上,怒江傈僳族自治州发病率明显高于其他州市;发病年龄主要集中在15~70岁;发病人群主要以农民(258509例,77.43%)为主,其次为学生(19454例,5.83%)。 结论 男性和农民已成为云南省结核病疫情的主要群体,且发病年龄多为中青年,应严格遵循“三位一体”的结核病防治服务模式加强对两类人群的管理和检测力度,组织基层医疗机构持续开展主动筛查和随访检查。 Abstract:Objective To analyze the epidemiological characteristics of tuberculosis (TB) in Yunnan province from 2010 to 2021 and provide reference for the prevention and treatment of TB in Yunnan. Methods The incidence data of TB in Yunnan from 2010 to 2021 were collected from Tuberculosis Surveillance Information System. Software Arcgis 10.7 was used for the visualization of the incidence of TB for a descriptive analysis on the epidemiological characteristics of TB in Yunnan. Results The incidence of TB fluctuated in Yunnan between 2010 and 2021 (χ2=858.570, P<0.001). A total of 333,846 TB cases were reported accumulatively with an annual average incidence rate of 57.58/100,000. In men, 224,397 TB cases were reported with an annual average incidence rate of 67.22%, while in women, 109,449 TB cases were reported with an annual average incidence rate of 32.78%. The male to female ratio of the cases was 2.05:1. In terms of temporal distribution, TB cases were mainly reported in during April-July. In terms of spatial distribution, the TB incidence rate was significantly higher in Nujiang prefecture than in other prefectures. In terms of age distribution, most TB cases were reported in people aged 15−70 years. In terms of occupation distribution, most cases were farmers (258,509, 77.43%), followed by students (19,454, 5.83%). Conclusions Men and farmers had become the main populations affected by TB in Yunnan, youth and middle-aged people accounted for high proportion in the TB cases. It is necessary to strengthen the prevention and treatment of TB at three levels, conduct active screening and organize follow up regularly. -
Key words:
- Yunnan province /
- Tuberculosis /
- Epidemiological characteristics
-
表 1 2010-2021年云南省结核病患者病原学结果
Table 1. Pathological results of TB patients in Yunnan province from 2010 to 2021
年份 利福平耐药(例) 病原学阳性(例) 病原学阴性(例) 无病原学结果(例) 2010 - 12308 8582 4527 2011 - 12405 10189 4071 2012 - 8694 15761 3137 2013 - 6962 16032 3476 2014 - 6160 16691 3400 2015 - 5891 17219 2541 2016 - 7035 16634 2635 2017 289 8109 16435 2615 2018 521 10646 15900 1551 2019 606 13331 14036 1869 2020 733 13652 13099 1698 2021 635 13565 10979 1303 表 2 2010-2021年云南省结核病性别构成情况
Table 2. Sex composition of TB in Yunnan province from 2010 to 2021
年份 总计 利福平耐药 病原学阳性 病原学阴性 无病原学结果 男性 女性 合计 男性 女性 男性 女性 男性 女性 男性 女性 2010 17340 8077 25417 - - 8538 3770 5701 2881 3101 1426 2011 18103 8562 26665 - - 8594 3811 6779 3410 2730 1341 2012 18693 8899 27592 - - 6091 2603 10512 5249 2090 1047 2013 17749 8721 26470 - - 4809 2153 10677 5355 2263 1213 2014 19854 9574 29428 - - 4820 2104 12384 6141 2650 1329 2015 17165 8486 25651 - - 4060 1831 11424 5795 1681 860 2016 19811 9556 29367 - - 5358 2467 12363 6099 2090 990 2017 18485 8963 27448 206 83 5584 2525 10966 5469 1729 886 2018 19181 9437 28618 380 141 7357 3289 10376 5524 1068 483 2019 19998 9844 29842 430 176 9274 4057 9049 4987 1245 624 2020 19413 9769 29182 546 187 9246 4406 8486 4613 1135 563 2021 18605 9561 28166 503 201 9822 4661 7338 4212 942 487 合计 224397 109449 333846 2065 788 83553 37677 116055 59735 22724 11249 表 3 2010-2021年云南省结核病人群职业分布情况
Table 3. Occupational distribution of TB population in Yunnan province from 2010 to 2021
职业 年 份 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 幼托儿童 27 15 5 8 9 11 14 7 14 13 17 8 散居儿童 115 98 86 78 88 62 57 43 37 41 34 34 学生 1294 1280 1166 1157 1279 1453 1361 1484 2329 2449 2139 2063 教师 257 205 177 182 184 201 180 165 207 186 218 240 保育员及保姆 1 1 1 2 1 - 2 3 - 4 1 3 餐饮食品业 41 34 34 29 36 32 29 29 49 37 53 60 公共场所服务员 16 15 13 16 19 16 17 19 15 8 15 16 商业服务 295 292 210 218 245 254 224 206 186 221 257 256 医务人员 81 97 95 119 112 112 110 113 125 159 185 178 工人 783 668 613 547 490 506 412 346 350 334 382 313 民工 742 552 507 394 300 350 299 150 150 145 142 122 农民 19120 20382 21733 20899 20907 22525 21011 22255 22477 23464 23169 20567 牧民 32 41 38 26 36 28 22 32 36 30 14 14 渔(船)民 2 3 2 1 5 4 8 3 8 15 2 – 海员及长途驾驶员 23 32 10 28 20 13 20 15 5 9 8 5 干部职员 314 290 287 297 283 298 307 271 278 285 327 273 离退人员 750 697 704 731 664 781 728 827 826 859 777 786 家务及待业 640 737 753 842 857 874 772 744 779 870 944 1032 不详 248 376 312 405 228 251 202 184 187 132 100 112 其他 636 850 846 491 488 556 529 552 560 581 398 400 -
[1] 卢春容, 房宏霞, 陆普选, 等. WHO2021年全球结核病报告: 全球与中国关键数据分析[J]. 新发传染病电子杂志,2021,6(4):368–372. DOI: 10.19871/j.cnki.xfcrbzz.2021.04.023.Lu CR, Fang HX, Lu PX, et al. The global tuberculosis report 2021: key data analysis for China and the global world[J]. Electron J Emerging Infect, 2021, 6(4): 368–372. DOI: 10.19871/j.cnki.xfcrbzz.2021.04.023. [2] 中国卫生部. 卫生部办公厅关于印发《中国结核病防治规划实施工作指南》的通知[J]. 中华人民共和国卫生部公报,2009(9):50.National Health and Family Planning Commission of PRC. Notice of the General Office of the Ministry of Health on the Issuance of the Guidelines for the Implementation of China's Tuberculosis Prevention and Control Plan[J]. Bull Minist Health PRC, 2009(9): 50. [3] 张舒惟. 云南省边境地区2009-2018年结核病例空间聚集性研究[D]. 昆明: 昆明医科大学, 2021. DOI: 10.27202/d.cnki.gkmyc.2021.000365.Zhang SW. Research on spatial clustering of tuberculosis cases from 2009 to 2018 in Border areas of Yunnan province[D]. Kunming: Kunming Medical University, 2021. DOI: 10.27202/d.cnki.gkmyc.2021.000365. [4] 唐南. 云南省肺结核病例地理分布及空间聚集性研究[D]. 昆明: 昆明医科大学, 2015.Tang N. Analysis on geographical distribution and spatial aggregation of tuberculosis cases in Yunnan[D]. Kunming: Kunming Medical University, 2015. [5] 王芸, 侯景龙, 杨蕊, 等. 云南省2010-2013年结核菌/艾滋病病毒双重感染者流行特征[J]. 公共卫生与预防医学,2015,26(3):8–11.Wang Y, Hou JL, Yang R, et al. Epidemiological characteristics of TB/HIV co-infection in Yunnan province (2010−2013)[J]. J Public Health Prev, 2015, 26(3): 8–11. [6] 韩笑颖. 肺结核与COVID-19传播的动力学模型及控制策略研究[D]. 北京: 北京建筑大学, 2021. DOI: 10.26943/d.cnki.gbjzc.2021.000299.Han XY. Study on the dynamic models and control strategy of tuberculosis and COVID-19 transmission[D]. Beijing: Beijing University of Civil Engineering and Architecture, 2021. DOI: 10.26943/d.cnki.gbjzc.2021.000299. [7] 王建娇, 刘小宁, 杨家外, 等. 2015-2019年云南省蒙自市肺结核流行特征及空间分布特征[J]. 中国预防医学杂志,2022,23(3):224–230. DOI:10.16506/j.1009−6639.2022.03.012.Wang JJ, Liu XN, Yang JW, et al. Epidemiological features and spatial distribution characteristics of tuberculosis in Mengzi city of Yunnan in 2015−2019[J]. Chin Prev Med, 2022, 23(3): 224–230. DOI: 10.16506/j.1009−6639.2022.03.012. [8] 杨胜雄, 潘春柳, 李军, 等. 2010-2019年贵阳市肺结核患者流行病学特征分析及趋势预测[J]. 疾病监测,2022,37(6):750–754. DOI: 10.3784/jbjc.202112090631.Yang SX, Pan CL, Li J, et al. Epidemiological characteristics of pulmonary tuberculosis cases and incidence trend in Guiyang, 2010−2019[J]. Dis Surveill, 2022, 37(6): 750–754. DOI: 10.3784/jbjc.202112090631. [9] 陈云鹏, 贺天锋. 2011-2020年宁波市肺结核流行特征分析[J]. 预防医学,2022,34(2):176–179. DOI:10.19485/j.cnki.issn2096−5087.2022.02.014.Chen YP, He TF. Epidemiological characteristics of pulmonary tuberculosis in Ningbo city from 2011 to 2020[J]. Prev Med, 2022, 34(2): 176–179. DOI: 10.19485/j.cnki.issn2096−5087.2022.02.014. [10] 陈伟, 王雪静, 王黎霞, 等. 全国五省结核病与性别关系的研究[J]. 中国防痨杂志,2010,32(9):534–539.Chen W, Wang XJ, Wang LX, et al. TB and gender in five provinces of China[J]. Chin J Antituberc, 2010, 32(9): 534–539. [11] 陈其琛, 刘国标, 李笑颜, 等. 广州市越秀区2013-2017年本地居民肺结核流行特征[J]. 实用预防医学,2019,26(9):1121–1125. DOI:10.3969/j.issn.1006−3110.2019.09.027.Chen QC, Liu GB, Li XY, et al. Epidemic characteristics of pulmonary tuberculosis among local residents in Yuexiu district of Guangzhou city, 2013−2017[J]. Pract Prev Med, 2019, 26(9): 1121–1125. DOI: 10.3969/j.issn.1006−3110.2019.09.027. [12] 赵秀娟, 刘琳, 吴兴勇, 等. 海南省369例耐多药肺结核患者流行病学特征分析[J]. 海南医学院学报,2022,28(3):166–170,180. DOI: 10.13210/j.cnki.jhmu.20210413.002.Zhao XJ, Liu L, Wu XY, et al. Epidemiological characteristics of 369 tuberculosis patients with multidrug resistance in Hainan island: A cross-sectional study[J]. J Hainan Med Univ, 2022, 28(3): 166–170,180. DOI: 10.13210/j.cnki.jhmu.20210413.002. [13] 陈玉萍, 戴碗琴, 马善源. 松江区1007例新发肺结核病患者调查分析[J]. 检验医学与临床,2020,17(19):2882–2884. DOI:10.3969/j.issn.1672−9455.2020.19.041.Cheng YP, Dai WQ, Ma SY. Investigation and analysis of 1007 new tuberculosis patients in Songjiang district[J]. Lab Med Clin, 2020, 17(19): 2882–2884. DOI: 10.3969/j.issn.1672−9455.2020.19.041. [14] 冉海良, 杨庆欢, 陈莹, 等. 2015年西双版纳州肺结核登记病例流行特征与空间聚集性[J]. 昆明医科大学学报,2020,41(6):46–50. DOI:10.3969/j.issn.1003−4706.2020.06.009.Ran HL, Yang QH, Chen Y, et al. Analysis on epidemiological characteristics and spatial clustering of registered pulmonary tuberculosis cases in Xishuangbanna prefecture in 2015[J]. J Kunming Med Univ, 2020, 41(6): 46–50. DOI: 10.3969/j.issn.1003−4706.2020.06.009. [15] 郑尔达, 杨传林, 李真晖, 等. 2016年昭通市昭阳区肺结核疫情与空间分布特征分析[J]. 应用预防医学,2017,23(3):221–223,226. DOI:10.3969/j.issn.1673−758X.2017.03.012.Zheng ED, Yang CL, Li ZH, et al. Analysis of tuberculosis epidemic situation and spatial distribution characteristics in Zhaoyang district, Zhaotong city in 2016[J]. J Appl Prev Med, 2017, 23(3): 221–223,226. DOI: 10.3969/j.issn.1673−758X.2017.03.012. [16] 王威, 叶一农, 吴智龙, 等. 2010-2020年广东省佛山市肺结核发病趋势及流行特征分析[J]. 疾病监测,2021,36(10):1039–1043. DOI: 10.3784/jbjc.202104160205.Wang W, Ye YN, Wu ZL, et al. Incidence trend and epidemiologieal characteristics of pulmonary tuberculosis in Foshan, 2010–2020[J]. Dis Surveill, 2021, 36(10): 1039–1043. DOI: 10.3784/jbjc.202104160205. [17] 于艳玲, 闫兴录, 王鑫, 等. 2011-2020年黑龙江省肺结核疫情特征分析[J]. 疾病监测,2021,36(10):1031–1034. DOI: 10.3784/jbjc.202106280369.Yu YL, Yan XL, Wang X, et al. Epidemiological characteristics of pulmonary tuberculosis in Heilongjiang, 2011−2020[J]. Dis Surveill, 2021, 36(10): 1031–1034. DOI: 10.3784/jbjc.202106280369. [18] 逯嘉, 李婷, 王丹霞, 等. “十三五”期间四川省肺结核流行病学特征分析[J]. 疾病监测,2021,36(11):1147–1151. DOI: 10.3784/jbjc.202106300376.Lu J, Li T, Wang DX, et al. Epidemiological characteristics of tuberculosis in Sichuan during the 13th five-year plan period[J]. Dis Surveill, 2021, 36(11): 1147–1151. DOI: 10.3784/jbjc.202106300376. -