摘要
目的 分析2010—2024年陕西省0~14岁儿童肺结核的流行特征和发病趋势,为优化儿童结核病防控策略提供参考依据。方法 从“全民健康保障信息化工程疾病预防控制信息系统”中的“监测报告管理系统”和“疾病预防控制信息管理系统”导出2010—2024年陕西省0~14岁儿童肺结核病例数据和人口学资料,建立Joinpoint回归模型分析儿童肺结核发病的时间、空间、人群分布趋势特征。结果 2010—2024年陕西省0~14岁儿童肺结核累计报告2 954例,儿童报告发病人数占全人群的0.97%,儿童年均报告发病率为3.32/10万。0~14岁儿童肺结核累计报告病原学阳性804例,呈逐年上升趋势(χ^(2)_(趋势)=420.94,P<0.01)。陕西省0~14岁儿童肺结核报告发病率总体呈下降趋势,从2010年的5.35/10万下降到2024年的2.41/10万。Joinpiont回归分析显示,2010—2013年儿童肺结核报告发病率快速下降(APC=-20.02%,95%CI=-33.64%~-10.42%),2013—2017年缓慢上升(APC=11.18%,95%CI=3.07%~24.17%),2017—2024年又缓慢下降(APC=-7.27%,95%CI=-12.73%~-4.30%)(P值均<0.01)。0~14岁儿童中,年均报告发病率最高为10~14岁儿童(8.02/10万),其次是5~9岁儿童(1.44/10万),0~4岁儿童报告发病率最低(0.95/10万),3个年龄段的儿童报告发病率差异有统计学意义(χ^(2)=51.91,P<0.01)。男童肺结核年均报告发病率为3.25/10万,女童年均报告发病率为3.39/10万,差异无统计学意义(χ^(2)=2.01,P>0.05)。每年的病例报告情况无明显周期性变化。陕西省各地市中,年均报告发病率最高的为安康市(5.16/10万)。结论 2010—2024年陕西省0~14岁儿童肺结核报告发病率整体呈下降趋势,但仍需加强主动监测,对于安康市等疫情高发地区要因地施策,持续关注。
Objective To analyze the epidemiological characteristics and incidence trends of pulmonary tuberculosis(TB)in children aged 0-14 years in Shaanxi Province from 2010 to 2024,so as to provide a reference for optimizing child TB prevention and control strategies.Methods Data on pulmonary TB cases in children aged 0-14 years and demographic information in Shaanxi Province from 2010 to 2024 were collected from Surveillance and Reporting Management System with Disease Prevention and Control Information Management System under the National Health Security Informatization Project Disease Prevention and Control Information System.A Joinpoint regression model was established to analyze the temporal,spatial,and population distribution trends of child pulmonary TB incidence.Results A total of 2954 cases of pulmonary TB in children aged 0-14 years were reported in Shaanxi Province from 2010 to 2024,accounting for 0.97%of all TB cases in the general population.The average annual reported incidence rate in children was 3.32 per 100000.Among these cases,804 were pathogenetically positive,showing a increasing trend(χ^(2)_(trend)=420.94,P<0.01).The overall reported incidence rate of pulmonary TB in children aged 0-14 years in Shaanxi Province showed a decreasing trend,dropping from 5.35 per 100000 in 2010 to 2.41 per 100000 in 2024.Joinpoint regression analysis identified three distinct phases for the reported incidence rate of TB:a rapid decline from 2010 to 2013(APC=-20.02%,95%CI=-33.64%to-10.42%),a slight increase from 2013 to 2017(APC=11.18%,95%CI=3.07%-24.17%)and a slight decline again from 2017 to 2024(APC=-7.27%,95%CI=-12.73%to-4.30%)(all P<0.01).Among children aged 0-14 years,the age group with the highest average annual reported incidence rate was 10-14 years(8.02 per 100000),followed by 5-9 years(1.44 per 100000),and 0-4 years had the lowest rate(0.95 per 100000).The difference in reported incidence rates among the three age groups was statistically significant(χ^(2)=51.91,P<0.01).The average annual reported incidence rate of TB was 3.25 per 100000 in boys and 3.39 per 100000 in girls,with no statistically significant difference(χ^(2)=2.01,P>0.05).There was no obvious periodic variation in the annual case reporting.Among all cities in Shaanxi Province,Ankang City had the highest average annual reported incidence rate(5.16 per 100000).Conclusions From 2010 to 2024,the reported incidence rate of pulmonary TB in children aged 0-14 years in Shaanxi Province showed an overall decreasing trend.However,it is still necessary to strengthen active surveillance,implement targeted measures in high-incidence areas such as Ankang City,and maintain continuous attention to child TB prevention and control.
作者
贺志强
赵燕
李凯凯
张宏伟
HE Zhiqiang;ZHAO Yan;LI Kaikai;ZHANG Hongwei(Institute for Tuberculosis and Leprosy Control and Prevention,Shaanxi Provincial Center for Disease Control and Prevention,Xi'an 710054,Shaanxi Province,China)
出处
《中国学校卫生》
北大核心
2025年第9期1346-1350,共5页
Chinese Journal of School Health
基金
陕西省卫生健康科研基金项目(2022B007)。
关键词
结核
肺
流行病学研究
发病率
回归分析
儿童
Tuberculosis
pulmonary
Epidemiologic studies
Incidence
Regression analysis
Child
