2010－2023年江西省65岁及以上老年人肺结核流行特征与发病趋势分析

胡嘉; 余丽辉; 张天琛; 何旺瑞; 黄钦

doi:10.3784/jbjc.202404150235

2010－2023年江西省65岁及以上老年人肺结核流行特征与发病趋势分析

Epidemiological characteristics and incidence trend of pulmonary tuberculosis in the elderly aged ≥65 years in Jiangxi, 2010−2023

摘要

摘要:
目的分析2010—2023年江西省≥65岁老年人肺结核流行及分布情况，为降低老年人肺结核发病率，制定防治策略提供科学依据。
方法通过中国疾病预防控制信息系统收集江西省2010—2023年≥65岁老年人肺结核患者病案信息，采用Joinpoint回归模型对老年人肺结核报告发病率进行趋势检验，在县（区）水平上采用ArcGIS 10.8进行全局及局部空间自相关分析。
结果 2010—2023年江西省共报告65岁及以上老年人肺结核患者122762例，年均报告发病率为203.32/10万。江西省老年人肺结核发病总体呈下降趋势［平均年度变化百分比（AAPC）=−5.55%，P＜0.05］。时间分布上江西省老年人肺结核发病呈年内季节性和年际周期性分布，3月春季高发，但2020年、2022年和2023年发病高峰和周期性不明显。全局自相关分析发现，2010—2023年江西省老年人发病存在空间聚集性（Moran's I=0.33，Z=6.173，P=0.001）。局部空间自相关分析发现，“高–高”聚集区主要分布在宜丰县、奉新县、高安市、上高县、渝水区。 “低–低”聚集区主要在赣西地区萍乡部分县（区）和赣南地区吉安、赣州部分县（区）。
结论 2010—2023年江西省≥65岁老年人肺结核发病率呈整体下降趋势，时间分布呈现周期性，每年3月是发病高峰期。江西省在县级水平上老年人肺结核呈现空间聚集性，应制定相应防治策略有效控制高峰时段和高发地区老年人肺结核流行。

Abstract:
Objective To analyze the prevalence and distribution of pulmonary tuberculosis (TB) in the elderly aged ≥65 years in Jiangxi province from 2010 to 2023 and provide evidence for the reduction of pulmonary TB incidence in the elderly and the development of prevention and treatment strategies.
Methods The information of pulmonary TB cases aged ≥65 years in Jiangxi from 2010 to 2023 were collected through China Disease Control and Prevention Information System. Joinpoint regression model was used for trend tests for reported incidences of pulmonary TB in the elderly. Global and local spatial autocorrelation analyses at county level were carried out by using ArcGIS 10.8.
Results A total of 122 762 pulmonary TB cases aged ≥65 years were reported in Jiangxi from 2010 to 2023, with an average annual reported incidence of 203.32/100,000. The overall incidence of pulmonary TB showed a decreasing trend in the elderly in Jiangxi average annual percent change (AAPC)=−5.55%, P<0.05. The temporal distribution of pulmonary TB incidence of pulmonary TB in the elderly showed seasonality and periodicity, with annual high incidence in March, but the incidence peak and periodicity in 2020, 2022, and 2023 were not obvious. Global autocorrelation analysis found that there was spatial clustering of incidence of pulmonary TB in the elderly from 2010 to 2023 (Moran's I=0.33, Z=6.173, P=0.001). Local spatial autocorrelation analysis revealed that the “high-high” clustering areas were mainly distributed in Yifeng, Fengxin, Gao'an, Shanggao, and Yushui. The “low-low” clustering areas were mainly distributed in some counties (districts) of Pingxiang in western Jiangxi and some counties (districts) of Ji'an and Ganzhou in southern Jiangxi.
Conclusion The overall incidence of pulmonary TB in the elderly aged ≥65 years showed an downward trend in Jiangxi from 2010 to 2023. The incidence showed periodicity, the annual incidence peaked in March and the reported incidence had spatial clustering at county level. Effective prevention and treatment strategies should be developed to control the prevalence of pulmonary TB in the elderly in periods and areas with high-incidence.

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