2005—2017年新疆14个地州市基于传染病动力学结核病流行状况定量研究

目的对新疆 14个地（州、市）结核病发病数据进行建模分析，定量给出新疆各地（州、市）结核病的流行状况，并对新疆各地（州、市）结核病新发病数进行预测。方法采用动力学模型对新疆14个地（州、市）2005—2014年的结核病数据进行拟合，利用2015—2017年结核病数据进行验证，对验证结果进行评价，得到各地区参数的估计值和基本再生数（R0），并对各地（州、市）2018—2022年新发结核病数据进行预测。结果2015—2017年结核病数据验证结果显示，实际值均落在预测值曲线95%置信区间内，模型拟合效果良好。南疆喀什地区R0为11.38 (95%CI:11.33～11.50)，东疆地区乌鲁木齐市和北疆地区的伊犁哈萨克自治州R0分别为5.46 (95%CI:5.28～5.50)、2.22 (95%CI:2.18～2.28)，南疆地区结核病疫情远高于北疆和东疆地区，尤其是喀什地区结核病疫情最严重。2018—2022年预测结果显示，大部分地区结核病新发病数在波动中呈缓慢增长趋势。结论此结核病动力学模型拟合良好，具有可行性，可以用来预测结核病新发病数，同时应采取干预措施，加强对南疆地区的管理，控制结核病的流行。

A quantitative study on the epidemic situation of tuberculosis based on the transmission disease dynamics in 14 prefectures of Xinjiang from 2005 to 2017

ObjectiveTo quantitatively analyze the epidemic situation of tuberculosis(TB) by modeling the data of tuberculosis in prefectures of Xinjiang, and predict the new cases of tuberculosis in prefectures of Xinjiang.MethodsA dynamic model was used to fit the data of TB in 14 prefectures in Xinjiang from 2005 to 2014, the results of the fitting were verified by tuberculosis data in 2015-2017, verified results were evaluated, estimated values and basic reproductive numbers (R0) of parameters in each region were obtained, data of new TB in 2018-2022 were predicted.ResultsThe verification of TB data in 2015-2017 showed that the actual values fell within the 95% confidence interval of the predictive value curve, model was fit well. R0 in Southern Kashgar was 11.38 (95%CI:11.33-11.50), R0 in Urumqi City in Eastern Xinjiang and Ili Kazak Autonomous Prefecture in Northern Xinjiang were 5.46 (95% CI: 5.28-5.50) and 2.22 (95% CI: 2.18-2.28) respectively. The epidemic situation of TB in Southern Xinjiang was more serious than that in Northern and Eastern Xinjiang, epidemic situation of TB in Kashgar Prefecture was most serious. The predicted results showed that the number of new TB from 2018 to 2022 will slowly grow in most prefectures.ConclusionThe dynamical model of TB fits well and is feasible in this study, it can be used for prediction of new TB cases, intervention and management in Southern Xinjiang should be strengthened to control the prevalence of TB.