贵州省2015—2018年涂阳肺结核流行及空间分布特征分析

目的 分析2015—2018年贵州省涂阳肺结核发病的流行及空间分布特征，为全省传染性肺结核防治工作提供依据。方法 数据来源于结核病管理信息系统，整理2015—2018年贵州省88个县（市、区）涂阳肺结核患者登记信息和人口数据，采用ArcGIS 10.0软件构建地理信息数据库、结果可视化、空间自相关分析。结果 2015—2018年贵州省共报告涂阳肺结核45 560例，年均发病率为31.93/10万，总体呈下降趋势，居前3位地区为:安顺、毕节、铜仁市，最低为六盘水市；冬、夏季（1—2月、5—8月）为疫情高发时间，男性发病数均高于女性（发病数比为2.01∶1），农民、年龄≥60岁人群发病数最多；涂阳肺结核报告发病率全局空间自相关Moran’s I介于0.069～0.254之间（2016、2017年P＜0.05），热点主要在望谟县，冷点地区主要在花溪、观山湖、万山区。结论 贵州省涂阳肺结核发病存在空间聚集，应对农民、男性、老年患者等高风险人群和高发病率及热点地区给予重点关注和政策倾斜，增加肺结核专项经费和人力资源等的投入，加大宣传教育，开展创新模式有效发现和管理患者，从而降低涂阳肺结核发病率。

Prevalence and spatial distribution characteristics of smear-positive pulmonary tuberculosis in Guizhou Province from 2015 to 2018

To analyze the epidemiological and spatial characteristics of the incidence of smear-positive pulmonary tuberculosis in Guizhou Province from 2015 to 2018, and provide reference for the prevention and control of infectious tuberculosis. Methods Data were obtained from the tuberculosis management information system, and the registration information and population data of patients with smear-positive tuberculosis in 88 counties(cities and districts) in Guizhou Province from 2015-2018 were collated, and ArcGIS 10.0 software was used to construct a geographic information database,visualize the results, and analyze spatial autocorrelation. Results A total of 45 560 cases of smear-positive TB were reported in Guizhou Province from 2015 to 2018, with an average annual incidence rate of 31.93/100 000 and an overall decreasing trend, with the top 3 regions being Anshun, Bijie, and Tongren city and the lowest being Liupanshui city; winter and summer(January, February, and May to August) were the high incidence months, and the number of incidences was higher in males than females(incidence ratio of 2.01:1), with the highest number of incidences among farmers and people aged ≥60 years;the global spatial autocorrelation Moran’s I for the reported incidence of smear-positive TB ranged from 0.069 to 0.254(P<0.05 in 2016 and 2017), with hot spots mainly in Wangmo County and cold spots mainly in Huaxi, Guanshan Lake, and Wanshan District. Conclusion The incidence of smear-positive pulmonary tuberculosis in Guizhou Province has spatial clustering. Attention and policy should be given to high-risk groups such as farmers, men, elderly patients and high incidence and hotspot areas, the investment in special funding and human resources for TB should be increased, publicity and education should be enhanced, and innovative models to effectively detect and manage patients should be carried out, so as to reduce the incidence of smear-positive TB.