2011—2015年上海市崇明区肺结核疫情分析

2011—2015年国家结核病信息管理系统中登记的上海市崇明区肺结核患者878例,涂阳患者337例,涂阴患者515例;涂阳登记发病率、涂阴登记发病率分别为9.57/10万(337/3 519 800)、14.63/10万(515/3 519 800),5年间肺结核的发病率差异无统计学意义(χ ²=4.58,P=0.330)。登记死亡率为1.11/10万(39/3 519 800),登记病死率为0.44/10万(39/878)。男662例,女216例;构成比分别为75.40%(662/878)和24.60%(216/878)。肺结核患者发现方式构成比差异有统计学意义(χ ²=38.54,P=0.001),以“因症就诊”和“转诊”为主,各占77.22%(678/878)、21.07%(185/878)。878例患者中发病时间以6月份最多,占10.36%(91/878);2月份最少,占5.92%(52/878)。5年流动人口和户籍人口发病率分别为13.57/10万(105/773 700),28.15/10万(773/2 746 100), 差异有统计学意义(χ ²=51.44,P<0.01)。肺结核发病例数在各年龄段构成比差异无统计学意义(χ ²=26.84,P=0.310);发病例数较高的年龄段是≥65岁和55~65岁,各占29.84%(262/878)和20.27%(178/878)。职业分布以农民(27.90%,245/878)和离退休人员(21.07%,185/878)为主;涂阳337例,治愈297例,治愈率为88.13%;涂阴肺结核541例,治疗成功496例,治疗成功率为91.68%。2011—2015年崇明区肺结核防治效果略显成效;男性、户籍人口、中老年人发病率较高,为高危人群,应重点予以关注。

Analysis of pulmonary tuberculosis epidemics in Chongming District of Shanghai from 2011 to 2015

There were 878 cases of pulmonary tuberculosis (PTB) patients in Chongming District registered in the National Tuberculosis Information Management System from 2011 to 2015, including 337 cases of smear-positive patients and 515 cases of smear-negative patients. The incidence rates of smear-positive and smear-negative cases were 9.57/100 000 (337/3 519 800) and 14.63/100 000 (515/3 519 800) respectively, and there was no statistically significant difference in the incidence of PTB in 5 years (χ ²=4.58, P=0.330). The registered death rate was 1.11/100 000 (39/3 519 800) and the registered mortality rate was 0.44/100 000 (39/878). There were 662 men and 216 women, constituted 75.40% (662/878) and 24.60% (216/878). There was statistically significant difference in the sources of PTB patients (χ ²=38.54, P=0.001). The main sources of PTB were “Symptomatic visit” and “Referral”, which accounted for 77.22% (678/878) and 21.07% (185/878) respectively. Among the 878 patients, the most frequent time of onset was in June, accounting for 10.36% (91/878), while the lowest incidence was observed in February, accounting for 5.92% (52/878). The incidence rates of PTB among floating population and household population in 5 years were 13.57/100000 (105/773 700) and 28.15/100000 (773/2 746 100) respectively, with statistically difference (χ ²=51.44, P<0.01). There was no statistically significant difference in the proportion of TB cases in all age groups (χ ²=26.84, P=0.310), and the higher number of cases was over 65 years and 55-65 years, which accounted for 29.84% (262/878) and 20.27% (178/878). Farmers (27.90%, 245/878) and retired (21.07%, 185/878)were main occupations. Among 337 smear positive cases, 297were cured, and the cure rate was 88.13%. Among 541 smear-negative patients, 496 were successfully treated, and the treatment success rate was 91.68%. In 2011-2015, the TB control in chongming district was slightly effective, and the incidences of male, household and middle aged people were higher, which should be paid more attention to.