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

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.