2011―2023年我国0～14岁儿童肺结核报告发病趋势和空间聚集性分析

李玉红; 梅金周; 李雪; 杜昕; 李涛; 张慧; 赵雁林; 刘小秋

doi:10.3784/jbjc.202505190160

2011―2023年我国0～14岁儿童肺结核报告发病趋势和空间聚集性分析

Trends and spatial clustering of reported pulmonary tuberculosis incidence in children aged 0−14 years in China, 2011–2023

摘要

摘要:
目的分析 我国0～14岁儿童肺结核报告发病的流行趋势及其空间分布特征。
方法从中国疾病预防控制信息系统中获取2011―2023年全国0～14岁儿童肺结核报告发病数据，采用Joinpoint 5.1.0软件对报告发病率进行趋势分析，运用Arcgis 10.8和SaTScan 10.2.5软件对报告发病率进行空间自相关分析和时空扫描分析。
结果 2011―2023年全国共报告0～14岁儿童肺结核病例102131例，报告发病率从2011年的3.96/10万下降至2024年的2.97/10万平均年度变化百分比（AAPC）＝ −2.76%，95%CI：−3.56%～−2.06%，P<0.001。全局自相关分析结果显示，2011―2023年全国各年儿童肺结核报告发病率的全局Moran's I 指数在0.27～0.46，均存在全局自相关（均P＜0.001）。局部自相关分析结果显示，2011―2023年全国儿童肺结核报告发病率均有热点区域（高−高聚集），且主要在青海、四川、云南、西藏和新疆5个省（自治区）。 2011―2023年共有5个聚集区，其中一类聚集区分布在西藏、青海、新疆、甘肃、四川、云南、宁夏、重庆、贵州等省（自治区和直辖市），聚集时段为2017―2022年。
结论 2011―2023年我国0～14儿童肺结核报告发病率呈下降趋势，呈现显著的空间聚集性分布，热点区域主要集中于我国西北和西南区域，需加强发病持续上升省份和聚集区的肺结核联合防控工作。

Abstract:
Objective To understand the epidemiological trends, and spatial distribution characteristics of reported pulmonary tuberculosis among children aged 0−14 years in China.
Methods Reported incidence data of pulmonary tuberculosis among children aged 0−14 years across the nation from 2011 to 2023 were retrieved from the China Information System for Disease Control and Prevention. The Joinpoint 5.1.0 software was employed to conduct a trend analysis of the reported incidence rate. The ArcGIS 10.8 and SaTScan 10.2.5 software were utilized to perform spatial autocorrelation analysis and spatiotemporal scan analysis on the reported incidence rate.
Results A total of 102131 cases of pulmonary tuberculosis among children aged 0−14 years were reported nationwide from 2011 to 2023. The reported incidence rate declined from 3.96 per 100 000 population in 2011 to 2.97 per 100000 population in 2024 average annual percentage change (AAPC) = −2.76%, 95% confidence interval(CI) : −3.56%~−2.06%, P<0.001. The results of global autocorrelation analysis indicated that the global Moran's I index of the reported incidence rate of pulmonary tuberculosis among children across the country each year from 2011 to 2023 ranged between 0.27 and 0.46, demonstrating significant global autocorrelation (all P < 0.001). The results of local autocorrelation analysis revealed that there were hotspots (characterized by high - high clustering) in the reported incidence rate of pulmonary tuberculosis among children across the country from 2011 to 2023, primarily concentrated in five provinces, namely Qinghai, Sichuan, Yunnan, Xizang, and Xinjiang. From 2011 to 2023, a total of 5 clusters were identified. Among them, the first class clusters were distributed in Xizang, Qinghai, Xinjiang, Gansu, Sichuan, Yunnan, Ningxia, Chongqing, and Guizhou, with the clustering period spanning from 2017 to 2022.
Conclusion From 2011 to 2023, the reported incidence rate of pulmonary tuberculosis among children aged 0-14 years in China exhibited a downward trend, presenting a distinct spatial clustering distribution. The hotspot areas were mainly centered in the northwestern and southwestern regions of China. It is imperative to reinforce the joint prevention and control of pulmonary tuberculosis in provinces with a continuously increasing incidence and in clustering areas.

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