2011—2020年贵州省黔南州肺外结核流行病学特征分析

目的 了解黔南州2011—2020年肺外结核流行特征,为制定防控措施提供依据。方法 收集结核病管理信息系统登记的黔南州2011— 2020年肺外结核病例资料,采用描述流行病学方法进行分析。结果 2011—2020年黔南州肺外结核发病9 397例,年均报告发病率为28.12/10万,占全人群结核病的平均比例为19.12%（9 397/49 138）,其发病率呈缓慢上升趋势;男性5 037例,占53.60%（5 037/9 397）;女性4 360例,占46.40%（4 360/9 397）。男女比例为1.16:1;全年均有病例,主要集中在第一季度和第二季度;黔南州12县（市）肺外结核患者发病数前三位分别是三都县12.60%（1 184/9 397）、罗甸县10.57%（993/9 397）和长顺县10.38%（975/9 397）。按民族分析,肺外结核中病例数前三位分别是苗族25.28%（2 376/9 397）、布依族21.68%（2 037/9 397）和水族15.56%（1 462/9 397）;10年间发病农民病例数占总发病数的63.50 %（5 967/9 397）;总体发病年龄46～60岁发病数最多。男性16～30岁和46～60岁发病数较多,呈“M”型双波峰形。女性发病数集中在31～60岁呈单波形;肺外结核以结核性淋巴腺炎最多,占全部肺外结核20.77%（1 952/9 397）,其次是泌尿生殖系统结核病17.41%（1 636/9 397）和骨关节结核病13.86%（1 302/ 9 397）;发现方式以因有症状就诊和转诊为主,占83.25%（7 823/9 397）;肺外结核初治成功率96.92%（9 108/9 397）,复治成功率73.36%（212/289）。结论 2011—2020年黔南州肺外结核病呈缓慢上升趋势,男性、农民、布依族、年龄46～60岁是肺外结核防治的重点人群。

Epidemiological characteristics of extrapulmonary tuberculosis in Qiannan of Guizhou Province from 2011 to 2020

Objective To understand the epidemiological characteristics of extrapulmonary tuberculosis in Qiannan from 2011 to 2020, so as to provide a basis for the development of prevention and control measures. Methods Information on extrapulmonary tuberculosis cases registered in the Tuberculosis Management Information System in Qiannan Prefecture from 2011 to 2020 was collected and analyzed by descriptive epidemiological methods. Results There were 9 397 cases of extrapulmonary tuberculosis in Qiannan Prefecture from 2011 to 2020, with an average annual reported incidence rate of 28.12/100 000, accounting for an average proportion of 19.12% (9 397/49 138) of the whole population with tuberculosis, and its incidence rate was slowly increasing. Male cases accouted for 5.60% (5 037/9397) and female cases accouted for 46.40% (4 360/9 397). The ratio of males to females was 1.16:1. There were cases throughout the year, mainly concentrated in the first and second quarters; the top three counties (cities) in Qiannan with the number of extrapulmonary TB cases were 12.60% (1 184/9 397) in Sandu County, 10.57% (993/9 397) in Luodian, and 10.38% (975/9 397) in Changshun County. Analyzed by ethnicity, the top three cases of extrapulmonary TB were 25.28% (2 376/9 397) among Miao, 21.68% (2 037/9 397) among Buyi, and 15.56% (1 462/9 397) among Shui; the number of cases among farmers accounted for 63.50% (5 967/9 397) of the total number of cases during the 10-year period; the overall age of incidence was 46-60 years old. The number of cases was the highest in the age group of 46-60 years. The number of cases in males aged 16-30 and 46-60 years was higher, with an “M”-shaped double-wave pattern. In females, the incidence was concentrated at the age range of 31-60 years in a single waveform; extrapulmonary tuberculosis was most most frequent in tuberculous lymphadenitis, accounting for 20.77% (1 952/9 397) of all extrapulmonary tuberculosis, followed by 17.41% (1 636/9 397) of genitourinary tuberculosis and 13.86% (1 302/9 397) of osteoarticular tuberculosis; the mode of detection was mainly symptomatic consultation and referral, accounting for 83.25% (7 823/9 397) of all cases. The detection mode was mainly due to symptomatic consultation and referral, accounting for 83.25% (7 823/9 397); the success rate of initial treatment of extrapulmonary TB was 96.92% (9 108/9 397) and 73.36% (212/289) of retreatment. Conclusion Extrapulmonary tuberculosis is slowly increasing in Qiannan State from 2011 to 2020, and men, farmers, Buyi ethnic group, and age of 46-60 years are the key population for the prevention and treatment of extrapulmonary tuberculosis.