陕西省2010—2024年0~14岁儿童肺结核流行特征分析

贺志强; 赵燕; 李凯凯; 张宏伟

doi:10.16835/j.cnki.1000-9817.2025276

陕西省2010—2024年0~14岁儿童肺结核流行特征分析

doi: 10.16835/j.cnki.1000-9817.2025276

陕西省疾病预防控制中心结核病麻风病预防控制所，西安 710054

基金项目:

陕西省卫生健康科研基金项目 2022B007

详细信息

作者简介:
贺志强(1993-)，男，甘肃平凉人，硕士，主管医师，主要研究方向为结核病流行病学

通讯作者:
赵燕，E-mail：zyfzhk@126.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R181.3⁺² R521
计量
- 文章访问数: 6
- HTML全文浏览量: 3
- PDF下载量: 0
- 被引次数: 0
出版历程
- 收稿日期: 2025-05-23
- 修回日期: 2025-07-08
- 网络出版日期: 2025-10-10
- 刊出日期: 2025-09-25

Epidemiological characteristics analysis of pulmonary tuberculosis among children aged 0-14 in Shaanxi Province from 2010 to 2024

Institute for Tuberculosis and Leprosy Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, Shaanxi Province, China

摘要

摘要: 目的分析2010—2024年陕西省0~14岁儿童肺结核的流行特征和发病趋势，为优化儿童结核病防控策略提供参考依据。方法从“全民健康保障信息化工程疾病预防控制信息系统”中的“监测报告管理系统”和“疾病预防控制信息管理系统”导出2010—2024年陕西省0~14岁儿童肺结核病例数据和人口学资料，建立Joinpoint回归模型分析儿童肺结核发病的时间、空间、人群分布趋势特征。结果 2010—2024年陕西省0~14岁儿童肺结核累计报告2 954例，儿童报告发病人数占全人群的0.97%，儿童年均报告发病率为3.32/10万。0~14岁儿童肺结核累计报告病原学阳性804例，呈逐年上升趋势(χ_趋势²=420.94，P < 0.01)。陕西省0~14岁儿童肺结核报告发病率总体呈下降趋势，从2010年的5.35/10万下降到2024年的2.41/10万。Joinpiont回归分析显示，2010—2013年儿童肺结核报告发病率快速下降(APC=-20.02%，95%CI=-33.64%~-10.42%)，2013—2017年缓慢上升(APC=11.18%，95%CI=3.07%~24.17%)，2017—2024年又缓慢下降(APC=-7.27%，95%CI=-12.73%~-4.30%)(P值均 < 0.01)。0~14岁儿童中，年均报告发病率最高为10~14岁儿童(8.02/10万)，其次是5~9岁儿童(1.44/10万)，0~4岁儿童报告发病率最低(0.95/10万)，3个年龄段的儿童报告发病率差异有统计学意义(χ²=51.91，P < 0.01)。男童肺结核年均报告发病率为3.25/10万，女童年均报告发病率为3.39/10万，差异无统计学意义(χ²=2.01，P>0.05)。每年的病例报告情况无明显周期性变化。陕西省各地市中，年均报告发病率最高的为安康市(5.16/10万)。结论 2010—2024年陕西省0~14岁儿童肺结核报告发病率整体呈下降趋势，但仍需加强主动监测，对于安康市等疫情高发地区要因地施策，持续关注。
- 结核，肺 /
- 流行病学研究 /
- 发病率 /
- 回归分析 /
- 儿童
Abstract: Objective To analyze the epidemiological characteristics and incidence trends of pulmonary tuberculosis (TB) in children aged 0-14 years in Shaanxi Province from 2010 to 2024, so as to provide a reference for optimizing child TB prevention and control strategies. Methods Data on pulmonary TB cases in children aged 0-14 years and demographic information in Shaanxi Province from 2010 to 2024 were collected from Surveillance and Reporting Management System with Disease Prevention and Control Information Management System under the National Health Security Informatization Project Disease Prevention and Control Information System. A Joinpoint regression model was established to analyze the temporal, spatial, and population distribution trends of child pulmonary TB incidence. Results A total of 2 954 cases of pulmonary TB in children aged 0-14 years were reported in Shaanxi Province from 2010 to 2024, accounting for 0.97% of all TB cases in the general population. The average annual reported incidence rate in children was 3.32 per 100 000. Among these cases, 804 were pathogenetically positive, showing a increasing trend (χ_trend²=420.94, P < 0.01). The overall reported incidence rate of pulmonary TB in children aged 0-14 years in Shaanxi Province showed a decreasing trend, dropping from 5.35 per 100 000 in 2010 to 2.41 per 100 000 in 2024. Joinpoint regression analysis identified three distinct phases for the reported incidence rate of TB: a rapid decline from 2010 to 2013 (APC=-20.02%, 95%CI=-33.64% to -10.42%), a slight increase from 2013 to 2017 (APC=11.18%, 95%CI=3.07%-24.17%) and a slight decline again from 2017 to 2024 (APC=-7.27%, 95%CI=-12.73% to -4.30%) (all P < 0.01). Among children aged 0-14 years, the age group with the highest average annual reported incidence rate was 10-14 years (8.02 per 100 000), followed by 5-9 years (1.44 per 100 000), and 0-4 years had the lowest rate (0.95 per 100 000). The difference in reported incidence rates among the three age groups was statistically significant (χ²=51.91, P < 0.01). The average annual reported incidence rate of TB was 3.25 per 100 000 in boys and 3.39 per 100 000 in girls, with no statistically significant difference (χ²=2.01, P>0.05). There was no obvious periodic variation in the annual case reporting. Among all cities in Shaanxi Province, Ankang City had the highest average annual reported incidence rate (5.16 per 100 000). Conclusions From 2010 to 2024, the reported incidence rate of pulmonary TB in children aged 0-14 years in Shaanxi Province showed an overall decreasing trend. However, it is still necessary to strengthen active surveillance, implement targeted measures in high-incidence areas such as Ankang City, and maintain continuous attention to child TB prevention and control.
- Tuberculosis, pulmonary /
- Epidemiologic studies /
- Incidence /
- Regression analysis /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

图 1 陕西省2010—2024年0~14岁儿童肺结核报告发病数时间序列

Figure 1. Time series of reported tuberculosis cases among children aged 0-14 in Shaanxi Province from 2010 to 2024

下载: 全尺寸图片幻灯片

表 1 陕西省2010—2024年0~14岁儿童肺结核报告发病率和变化趋势

Table 1. Reported incidence rate and changing trends of pulmonary tuberculosis among children aged 0-14 in Shaanxi Province from 2010 to 2024

年份	0~4岁		5~9岁		10~14岁		合计
年份	人口数/10⁵	报告发病人数	人口数/10⁵	报告发病人数	人口数/10⁵	报告发病人数	人口数/10⁵	报告发病人数
2010	24.66	39(1.58)	20.68	64(3.09)	20.24	248(12.25)	65.59	351(5.35)
2011	20.74	32(1.54)	17.40	34(1.95)	16.99	141(8.30)	55.13	207(3.75)
2012	18.63	24(1.29)	17.98	28(1.56)	17.95	132(7.35)	54.56	184(3.37)
2013	19.11	18(0.94)	19.64	23(1.17)	15.97	96(6.01)	54.73	137(2.50)
2014	19.96	15(0.75)	19.88	31(1.56)	15.42	126(8.17)	55.26	172(3.11)
2015	20.01	18(0.90)	19.94	28(1.40)	15.49	147(9.49)	55.43	193(3.48)
2016	19.97	17(0.85)	19.83	19(0.96)	15.43	135(8.75)	55.23	171(3.10)
2017	19.44	21(1.08)	19.34	29(1.50)	15.02	164(10.92)	53.80	214(3.98)
2018	21.68	18(0.83)	21.55	48(2.23)	16.73	142(8.49)	59.96	208(3.47)
2019	20.91	16(0.77)	17.70	32(1.81)	17.79	167(9.39)	56.40	215(3.81)
2020	21.08	15(0.71)	18.19	17(0.93)	17.71	187(10.56)	56.97	219(3.84)
2021	22.34	18(0.81)	23.84	24(1.01)	22.35	160(7.16)	68.52	202(2.95)
2022	20.27	12(0.59)	25.08	23(0.92)	22.19	109(4.91)	67.54	144(2.13)
2023	18.26	11(0.60)	24.85	27(1.09)	23.37	143(6.12)	66.48	181(2.72)
2024	16.54	14(0.85)	24.31	19(0.78)	23.99	123(5.13)	64.84	156(2.41)
合计	303.59	288(0.95)	310.22	446(1.44)	276.64	2 220(8.02)	890.45	2 954(3.32)
注： ()内数字为报告发病率/10^-5。

下载: 导出CSV

表 2 陕西省2010—2024年0~14岁儿童不同性别间肺结核报告发病率

Table 2. Reported incidence of pulmonary tuberculosis among chi-ldren aged 0-14 by gender in Shaanxi Province from 2010 to 2024

年份	男生		女生
年份	人数/10⁵	报告发病率	人数/10⁵	报告发病率
2010	34.98	199(5.69)	30.61	152(4.97)
2011	29.46	120(4.07)	25.66	87(3.39)
2012	29.47	107(3.63)	25.09	77(3.07)
2013	29.39	74(2.52)	25.34	63(2.49)
2014	29.68	92(3.10)	25.58	80(3.13)
2015	29.82	106(3.55)	25.62	87(3.40)
2016	29.54	88(2.98)	25.69	83(3.23)
2017	28.87	128(4.43)	24.93	86(3.45)
2018	32.16	111(3.45)	27.79	97(3.49)
2019	30.04	100(3.33)	26.36	115(4.36)
2020	30.42	102(3.35)	26.56	117(4.41)
2021	36.38	89(2.45)	32.14	113(3.52)
2022	35.31	70(1.98)	32.22	74(2.30)
2023	34.73	95(2.74)	31.75	86(2.71)
2024	33.90	60(1.77)	30.95	96(3.10)
合计	474.15	1 541(3.25)	416.30	1 413(3.39)
注： ()内数字为报告发病率/10^-5。

下载: 导出CSV

表 3 陕西省2010—2024年不同年龄段儿童肺结核报告发病率分阶段变化

Table 3. Stage-specific changes in reported incidence of pulmonary tuberculosis among children of different age groups in Shaanxi Province from 2010 to 2024

年龄组/岁	第一阶段			第二阶段			第三阶段
年龄组/岁	年份	APC值(95%CI)	P值	年份	APC值(95%CI)	P值	年份	APC值(95%CI)	P值
0~4	2010—2014	-15.43%(-32.00%~-5.40%)	< 0.01	2014—2024	-0.75%(-3.77%~11.20%)	0.91	—	—	—
5~9	2010—2024	-5.80%(-9.62%~-1.90%)	< 0.01	—	—	—	—	—	—
10~14	2010—2013	-17.27%(-35.38%~-1.88%)	0.04	2013—2017	15.04%(1.92%~34.48%)	0.04	2017—2024	-10.55%(-19.10%~-6.09%)	0.02

下载: 导出CSV

参考文献(22)

[1]	胡鑫洋, 高静韬. 世界卫生组织《2024年全球结核病报告》解读[J]. 结核与肺部疾病杂志, 2024, 5(6): 500-504. HU X Y, GAO J T. Interpretation of WHO Global Tuberculosis Report 2024[J]. J Tuberc Lung Dis, 2024, 5(6): 500-504. (in Chinese)
[2]	舒薇, 刘宇红. 矢志革新履践致远: 《2024年全球结核病报告》结核病科学研究章节解读[J]. 中国防痨杂志, 2025, 47(2): 137-141. SHU W, LIU Y H. Committed to innovation and striving for long-term progress: interpretation of research and innovation chapter in the Global Tuberculosis Report 2024[J]. Chin J Antituberc, 2025, 47(2): 137-141. (in Chinese)
[3]	World Health Organization. Global tuberculosis report 2024[R]. Geneva: World Health Organization, 2025.
[4]	李媛媛, 谢晶晶, 李树涛, 等. 2024年WHO全球结核病报告: 全球与中国关键数据分析[J]. 新发传染病电子杂志, 2024, 9(6): 92-98. LI Y Y, XIE J J, LI S T, et al. 2024 WHO tuberculosis report: key data analysis for China and the global world[J]. Electron J Emerg Infect Dis, 2024, 9(6): 92-98. (in Chinese)
[5]	王前, 王嘉, 李玉红, 等. 重视儿童结核病防治关爱儿童健康[J]. 中国防痨杂志, 2023, 45(1): 1-5. WANG Q, WANG J, LI Y H, et al. Attach importance to childhood tuberculosis and care for children's health[J]. Chin J Antituberc, 2023, 45(1): 1-5. (in Chinese)
[6]	邓亚丽, 刘卫平, 张天华, 等. 陕西省结核病防治"十二五"规划实施效果[J]. 职业与健康, 2017, 33(16): 2210-2214. DENG Y L, LIU W P, ZHANG T H, et al. Effects of "12th Five-year" plan for tuberculosis prevention and control in Shaanxi Province[J]. Occup Health, 2017, 33(16): 2210-2214. (in Chinese)
[7]	陕西省结核病防治研究所. 陕西省《"十三五"结核病防治规划》终期评估报告[R]. 西安: 陕西省结核病防治研究所, 2021. Shaanxi Provincial Institute for Tuberculosis Prevention and Treatment. Final evaluation report on the "13th Five-year" Tuberculosis Prevention and Treatment Plan in Shaanxi Province[R]. Xi'an: Shaanxi Provincial Institute for Tuberculosis Prevention and Treatment, 2021. (in Chinese)
[8]	赵琰枫, 屠霞, 王嫩寒, 等. 三种病原学检测方法对肺结核患者阳性检出贡献的比较及应用分析[J/OL]. 中国防痨杂志, 2025: 1-12. https://link.cnki.net/doi/10.19982/j.issn.1000-6621.20250005. ZHAO Y F, TU X, WANG N H, et al. Comparison and application analysis of positive detection contributions of three etiological detection methods for pulmonary tuberculosis patients[J/OL]. Chin J Antituberc, 2025: 1-12. https://link.cnki.net/doi/10.19982/j.issn.1000-6621.20250005. (in Chinese)
[9]	孔雯, 丁晓艳, 竺丽梅, 等. 儿童接种卡介苗3~6年后PPD结果及其对结核潜伏感染的影响[J]. 中国学校卫生, 2019, 40(9): 1366-1368. doi: 10.16835/j.cnki.1000-9817.2019.09.024 KONG W, DING X Y, ZHU L M, et al. PPD results after 3-6 years of BCG vaccination and its effect on latent tuberculosis infection in children[J]. Chin J Sch Health, 2019, 40(9): 1366-1368. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.09.024
[10]	YANG R, LIU M, JIANG H, et al. The epidemiology of pulmonary tuberculosis in children in China's Mainland, 2009-2015[J]. Arch Dis Child, 2020, 105(4): 319-325. doi: 10.1136/archdischild-2019-317635
[11]	单志力, 毛玲琼, 朱小梅, 等. 温州市2008—2017年学生肺结核病时空流行病学分析[J]. 中国学校卫生, 2018, 39(7): 1066-1068, 1072. doi: 10.16835/j.cnki.1000-9817.2018.07.031 SHAN Z L, MAO L Q, ZHU X M, et al. Epidemiological analysis on the spatiotemporal clustering of students' pulmonary tuberculosis in Wenzhou from 2008 to 2017[J]. Chin J Sch Health, 2018, 39(7): 1066-1068, 1072. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2018.07.031
[12]	中华人民共和国卫生部办公厅, 中华人民共和国教育部办公厅. 关于印发《学校结核病防控工作规范(试行)》的通知[J]. 中华人民共和国国家卫生健康委员会公报, 2010(10): 40-43. General Office of the Ministry of Health of the PRC, General Office of the Ministry of Education of the PRC. Notice on issuing the Regulations on Tuberculosis Prevention and Control in Schools (Trial)[J]. Gaz Nation Health Comm PRC, 2010(10): 40-43. (in Chinese)
[13]	焦伟伟, 孙琳, 肖婧, 等. 国家结核病规划指南—儿童结核病管理(第2版)[J]. 中国循证儿科杂志, 2016, 11(1): 65-74. JIAO W W, SUN L, XIAO J, et al. National tuberculosis program guidelines: management of childhood tuberculosis (2nd edition)[J]. Chin J Evid Based Pediatr, 2016, 11(1): 65-74. (in Chinese)
[14]	邓亚丽, 张宏伟, 张天华, 等. 陕西省新型结核病防治管理模式实施前后能力建设与诊治效果分析[J]. 中国防痨杂志, 2018, 40(12): 1341-1345. DENG Y L, ZHANG H W, ZHANG T H, et al. Analysis on the capacity building and diagnosis and treatment effect of implementation of new tuberculosis prevention and management mode in Shaanxi Province[J]. Chin J Antituberc, 2018, 40(12): 1341-1345. (in Chinese)
[15]	邓亚丽, 张天华, 刘卫平, 等. 2014—2018年陕西省肺结核发病的时空聚集性分析[J]. 中国防痨杂志, 2020, 42(9): 948-955. DENG Y L, ZHANG T H, LIU W P, et al. Temporal and spatial clustering analysis of pulmonary tuberculosis incidence in Shaanxi Province from 2014 to 2018[J]. Chin J Antituberc, 2020, 42(9): 948-955. (in Chinese)
[16]	何树梅, 梁贵年, 马丽霞, 等. 西藏民族大学新生2016—2017年结核菌素试验结果分析[J]. 中国学校卫生, 2018, 39(4): 627-629. HE S M, LIANG G N, MA L X, et al. Analysis of tuberculin test results of freshmen in Xizang Minzu University in 2016-2017[J]. Chin J Sch Health, 2018, 39(4): 627-629. (in Chinese)
[17]	李彤欣, 周吉坤, 朱建良, 等. 石家庄市2011—2020年学校结核病疫情特征分析[J]. 中国学校卫生, 2023, 44(6): 897-899, 905. doi: 10.16835/j.cnki.1000-9817.2023.06.023 LI T X, ZHOU J K, ZHU J L, et al. Analysis of epidemic characteristics of tuberculosis in schools in Shijiazhuang during 2011-2020[J]. Chin J Sch Health, 2023, 44(6): 897-899, 905. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.06.023
[18]	JAGANATH D, WOBUDEYA E, SEKADDE M P, et al. Seasonality of childhood tuberculosis cases in Kampala, Uganda, 2010-2015[J]. PLoS One, 2019, 14(4): e0214555. doi: 10.1371/journal.pone.0214555
[19]	张宏伟, 邓亚丽, 张天华, 等. 陕西省2005—2016年肺结核流行病学特征[J]. 中国热带医学, 2018, 18(6): 547-550. ZHANG H W, DENG Y L, ZHANG T H, et al. Epidemiological characteristics of pulmonary tuberculosis in Shaanxi, 2005-2016[J]. China Trop Med, 2018, 18(6): 547-550. (in Chinese)
[20]	张琳, 杜昕, 马煜, 等. 2016—2021年陕西省肺结核流行特征分析[J]. 预防医学, 2024, 36(8): 706-709. ZHANG L, DU X, MA Y, et al. Epidemiological characteristics of pulmonary tuberculosis in Shaanxi Province from 2016 to 2021[J]. China Prev Med J, 2024, 36(8): 706-709. (in Chinese)
[21]	胡轶君, 徐怡婷, 蹇荣华, 等. 2014—2019年广东省耐多药结核病时空分布特征与风险评估[J]. 中国防痨杂志, 2025, 47(5): 639-646. HU Y J, XU Y T, JIAN R H, et al. Spatio-temporal analysis and risk assessment of multidrug-resistant tuberculosis in Guangdong Province, 2014-2019[J]. Chin J Antituberc, 2025, 47(5): 639-646. (in Chinese)
[22]	陈伟, 陈秋兰, 夏愔愔, 等. 2008—2012年全国学生结核病疫情特征分析[J]. 中国防痨杂志, 2013, 35(12): 949-954. CHEN W, CHEN Q L, XIA Y Y, et al. Analysis of the characteristics of national TB epidemic situation in schools from 2008 to 2012[J]. Chin J Antituberc, 2013, 35(12): 949-954. (in Chinese)