Epidemiological characteristics of pulmonary tuberculosis in children aged 0–14 years in Xinjiang, 2010–2019

  Objective   To analyze the epidemiological characteristics of pulmonary tuberculosis (TB) in children aged 0–14 years in Xinjiang from 2010 to 2019, and provide scientific evidence for the improvement of the prevention and control of pulmonary TB in children.

  Methods   Based on the reported incidence data and population data of pulmonary TB in children aged 0–14 years in Xinjiang from during 2010–2019 from the Infectious Disease Reporting Information Management System and basic information system of China Disease Prevention and Control , the trend analysis was conducted by using Joinpoint regression model.

  Results  From 2010 to 2018, a total of 3632 pulmonary TB cases were reported in children aged 0–14 years in Xinjiang, accounting for 0.58% (3632/477 136) of the total reported pulmonary TB cases in the whole population. The actual reported incidence rate of pulmonary TB in children decreased from 10.65/100 000 (496/4 656 826) in 2010 to 5.08/100 000 (296/5 827 122) in 2019, with an average annual drop rate of 8.57%. Joinpoint regression analysis showed that the standardized reported incidence of childhood pulmonary TB showed a periodic change during 2010–2015 ［annual percentage change (APC)=−5.6%, P=0.095］ and during 2015–2018 (APC=−10.9%, P=0.034), indicating a downward trend. A total of 1 362 pulmonary TB cases were reported in boys, with an average reported incidence rate of 5.48/100 000 (1362/24 862 789), and 2270 pulmonary TB cases were reported in girls with an average reported incidence rate of 9.49/100 000 (2270/23 927 224). The incidence rate of pulmonary TB in girls was higher than that in boys (χ²=224.626, P<0.001). Among different age groups, there were significant differences in the incidence rate of pulmonary TB (χ²=2921.08, P＜0.001). The reported incidence rate of pulmonary TB was higher in children aged 10–14 years (17.51/100 000, 2604/14 872 187) than in age groups 0 years old (4.34/100 000, 150/3 456 347), 5–9 years (3.05/100 000, 510/16 748 835) and 1–4 years (2.68/100 000, 368/13 712 644). Joinpoint regression analysis revealed that the reported incidence rate of pulmonary TB in age group 0–8 years decreased from 4.34/100 000 (150/3 456 347) to 2.72/100 000 (108/3 975 844), showing a gradual decline trend with age (APC=−6.9%, P=0.028, P<0.001) , but the incidence rate increased obviously after age 8 years (APC=414.2%, P<0.001) . The reported incidence rate of pulmonary TB in age group 10–14 years rapidly decreased after 2014 from 21.81/100 000 (286/1 311 592) to 12.48/100 000 (234/1 875 722) (APC=−10.0%, P=0.005).

  Conclusion   Although the overall incidence of pulmonary TB in children in Xinjiang showed a downward trend in recent years, it is still necessary to strengthen the screening of close contacts of pulmonary TB patients in children in families and improve the surveillance and reporting system of pulmonary TB in children on the basis of the BCG vaccination of newborns and the prevention and control of TB in students.