2007-2021年四川省儿童肺结核登记情况及流行病学特征分析

Registration and epidemiological characteristics of pediatric pulmonary tuberculosis in Sichuan, 2007−2021

  • 摘要:
    目的 分析2007—2021年四川省0~14岁儿童肺结核登记变化趋势与流行病学特征,为儿童结核病防控提供参考依据。
    方法 从中国疾病预防控制信息系统的“监测报告管理”模块中收集四川省2007—2021年的肺结核患者登记个案资料,采用回顾性描述的方法和Joinpoint回归模型分析儿童肺结核登记率的三间分布和变化趋势以及儿童肺结核患者登记治疗特征。
    结果 四川省2007—2021年共登记儿童肺结核11709例,年均登记率5.61/10万,占全人群患者的1.40%。 登记率总体呈上升趋势,平均每年上升3.35%[95%置信区间(CI):0.78%~5.83%,P<0.05]。 第三季度登记率在全年中的占比最高(28.91%)。 10~岁组儿童肺结核登记率平均每年上升4.58%(95%CI:1.99%~7.08%,P<0.05),其他年龄段儿童的整体变化趋势不明显(均P>0.05)。 10~岁组登记率女性高于男性(χ2=55.122,P<0.001)。 与全人群相比,儿童女性(48.87%)、血型播散性肺结核(6.18%)的占比明显高于全人群(分别为29.71%、1.62%)(性别χ2=2019.501P<0.001;诊断分型χ2=36550.903P<0.001),而本地户籍(81.83%)、病原学阳性(23.75%)、汉族(62.53%)占比明显更低(户籍类别χ2=1312.728P<0.001;诊断结果χ2=4707.627P<0.001;民族χ2=9317.036P<0.001)。 儿童患者就诊延迟时间为23(9,52)d,确诊延迟时间为0(0,3) d,均明显低于全人群的29(10,62) d和1(0,4) d ,差异有统计学意义(就诊延迟Z=−14.160,P<0.001;就诊延迟Z=−17.625,P<0.001)。
    结论 近15年间四川省儿童肺结核登记率较高且呈上升趋势。 应关注流动就诊儿童肺结核患者并重视1岁以内婴儿和大龄女童肺结核发病。 加强儿童结核病的病原学检测,密切监控、预防重症发生。 加强肺结核患者家庭内密切接触者筛查。 通过加大投入、加强培训、强化宣教等一系列措施及时发现和治疗儿童肺结核患者。

     

    Abstract:
    Objective  To analyze the registration trend and epidemiological characteristics of pulmonary tuberculosis (TB) in children aged 0-14 years in Sichuan province in recent 15 years, and provide reference for the prevention and control of pulmonary TB in children.
    Methods  The registered data of pulmonary TB cases in Sichuan from 2007 to 2021 were collected from Surveillance Report Management System, a sub-system of China Disease Control and Prevention Information System. The retrospective description method and Joinpoint regression model were used to analyze the distributions and change trends of pediatric pulmonary TB registration rate and the treatment of pediatric pulmonary TB.
    Results  A total of 11,709 pediatric pulmonary TB cases were registered in Sichuan from 2007 to 2021, with an annual registration rate of 5.61/100,000 and a proportion of 1.40% of the total cases. The registration rate showed an overall upward trend, with an average annual increase of 3.35% 95%confidence interval(CI): 0.78%–5.83%, P<0.05. The annual cases registered in the third quarter accounted for the highest proportion (28.91%). The average annual registration rate of pulmonary TB in children aged ≥10 years increased by 4.58% (95%CI: 1.99%–7.08%, P<0.05), but the change trends in children in other age groups were not significant (all P>0.05). The registration rate in girls aged >190 years was higher than that in boys aged >10 years (χ2=55.122, P<0.001). The proportions of female cases (48.87%) and blood disseminated cases (6.18%) in children were significantly higher compared with the whole population (29.71% and 1.62%) (χ2=2019.501 and 365550.903, all P<0.001), but he proportions of the pediatric cases with local household registration (81.83%), with etiological positive results (23.75%) and in Han ethnic group (62.53%) were significantly lower (χ2=1312.728, χ2=4707.627, χ2=9317.036, all P<0.001). The delay for health care seeking was 23 days (9, 52) and the delay for diagnosis was 0 day (0, 3) in pediatric pulmonary TB cases, which were significantly lower than those in the whole population 29 days (10, 62) and 1 day (0, 4), the differences were significant (Z=−14.160, Z=−17.625, all P<0.001).
    Conclusion  In the past 15 years, the registration rate of pediatric pulmonary TB were high and showed an increasing trend in Sichuan. It is necessary to pay attention to pediatric pulmonary TB in floating population, pay attention to the incidence of pulmonary TB in infants under 1 year old and in girls, strengthen the etiological detection and surveillance for pediatric pulmonary TB to prevent the incidence of severe illness, increase investment and improve close contact screening in family and health education and training for the timely detection and treatment of pediatric pulmonary TB.

     

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