2011―2020年全国65岁及以上老年人肺结核报告发病情况分析

目的  分析2011―2020年全国≥65岁老年人(简称老年人)肺结核报告发病特征。方法  利用中国2011―2020年肺结核发病监测数据，分析老年人肺结核报告发病率及分布特征，计算年均变化趋势。结果  全国老年人肺结核报告发病率从2011年的158.7/10万下降至2020年的98.3/10万。老年人肺结核的发病风险是＜65岁人群的2.4~2.9倍，其中以70~＜75岁和75~＜80岁年龄组的发病率最高。老年人中，男性的发病风险是女性的2.5~3.1倍，1月和3月的报告发病数最高，其中2020年1月―2020年4月的报告发病数较既往同期出现了大幅下降。中国东、中、西部老年人肺结核报告发病率分别为95.9/10万、159.0/10万和184.4/10万，中、西部地区分别是东部地区的1.7倍和1.9倍。2011―2019年，老年人肺结核报告发病率的年均递降率为3.5%，东、中、西部分别为4.9%、4.5%和1.5%，推算获得的2020年报告发病率高于实际的报告发病率。结论  2011―2020年，中国老年人肺结核防治工作取得了显著成效，但总体负担依然很重，应重点关注西部的重点地区，并强化老年肺结核患者的发现等工作。

Analysis of the reported incidence of pulmonary tuberculosis in the elderly aged 65 and over in China, 2011-2020

  Objective  To analyze the characteristics of pulmonary tuberculosis (PTB) among the elderly aged 65 and over nationwide from 2011 to 2020.  Methods  Using nationwide surveillance data of PTB from 2011 to 2020, to analyze the reported incidence of PTB in the elderly.The distribution characteristic and the average annual change trends were calculated.  Results  The reported incidence of PTB in the elderly decreased from 158.7/100 000 in 2011 to 98.3/100 000 in 2020. The risk of developing PTB in the elderly aged 65 and over was 2.4-2.9 times that of those under the age of 65, and the 70- < 75 and 75- < 80 age groups had the highest incidences. Among the elderly, the risk of developing PTB in men was 2.5-3.1 times than that of women. The numbers of reported cases were the highest in January and March, which belong to winter and spring. From January to April 2020, the number of reported cases decreased significantly compared with that of the same period in previous years. The reported incidences of PTB among the elderly in eastern, central, and western China were 95.9/100 000, 159.0/100 000 and 184.4/100 000, respectively, and the incidences in central and western China were 1.7 and 1.9 times higher than that of eastern China, respectively. From 2011 to 2019, the average annual decline rate of the reported incidence of PTB in the elderly aged 65 and over was 3.5%, and the rates in eastern, central and western China were 4.9%, 4.5% and 1.5%, respectively. The estimated reported incidences were higher than the actual reported incidences in 2020.  Conclusions  From 2011 to 2020, China has remarkable achievements in the prevention and control of PTB in the elderly, but the overall burden is still heavy. We should focus on key provinces in western China, and strengthen the detection of PTB among the elderly.