甘肃省2018—2022年高中生肺结核时空流行状况

王铂; 何爱伟; 赵剑喜; 白玉娥; 郭强; 马玉宝; 杨枢敏

doi:10.16835/j.cnki.1000-9817.2023.12.027

甘肃省2018—2022年高中生肺结核时空流行状况

doi: 10.16835/j.cnki.1000-9817.2023.12.027

甘肃省疾病预防控制中心结核病防制科，兰州 730000

基金项目:

甘肃省卫生健康行业科研计划项目 GSWSKY2022-30

详细信息

作者简介:
王铂(1978-)，男，宁夏回族自治区石嘴山市人，硕士，副主任医师，主要从事学校肺结核防治方面工作

通讯作者:
杨枢敏，E-mail: 791253252@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R521 R181.3⁺² G478
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- 被引次数: 0
出版历程
- 收稿日期: 2023-10-07
- 修回日期: 2023-10-30
- 网络出版日期: 2023-12-26
- 刊出日期: 2023-12-25

Spatial-temporal feature of tuberculosis among high school students in Gansu Province from 2018 to 2022

Gansu Provincial Center for Disease Control and Prevention, Lanzhou (730000), Gansu Province, China

摘要

摘要: 目的分析2018—2022年甘肃省(县)区高中生肺结核时空分布特点，为全省学校结核病防控工作提供科学依据。方法收集中国疾病预防控制信息管理系统子系统结核信息管理系统和传染病信息报告系统中2018—2022年甘肃省报告的分县(区)高中生肺结核患者数据，从中国疾病预防控制信息管理系统子系统疾病综合管理系统收集分县(区)高中生人口学数据，运用全局空间自相关(Moran's I)和局部空间自相关方法(LISA)，分析5年间高中生肺结核空间聚集状况。结果 2018—2022年甘肃省各县(区)报告肺结核患者41 885例，平均报告发病率32.81/10万；报告高中生肺结核患者1 170例，平均报告发病率13.72/10万。除2020年，其余4年间甘肃省高中生肺结核报告发病率均为非随机分布，总体呈现出中等强度的空间聚集性。2018—2022年甘肃省大部分县(区)高中生肺结核报告发病率在10.00/10万及以下，报告发病率>40.00/10万的县(区)主要分布在甘肃省甘南州碌曲县、玛曲县、迭部县、合作市、夏河县，天水市甘谷县、武山县，陇南市文县、康县以及平凉市华池县、庆阳市环县。2018—2022年高中生肺结核报告发病率>30.00/10万的县(区)逐渐减少。5年间，甘南州各县(区)高中生肺结核报告发病率多持续在40.00/10万以上。LISA分析结果显示，5年间甘肃省各县(区)高中生肺结核报告发病率高-高发病区主要集中在甘南州的各县(区)。结论 2018—2022年甘肃省高中生肺结核疫情依然严峻，表现出地区分布不平衡，发病率呈较强的空间聚集性，发病热点区集中在甘南州各县(区)。
- 结核，肺 /
- 发病率 /
- 时空聚类分析 /
- 流行病学研究 /
- 学生
Abstract: Objective To analyze the spatial-temporal distribution characteristics of tuberculosis among high school students at county levels in Gansu Province from 2018 to 2022, so as to provide a scientific basis for tuberculosis prevention and control in schools. Methods Tuberculosis data from high school students in counties (districts) reported in Gansu Province from 2018 to 2022 was collected from the Tuberculosis Information Management System and Infectious Disease Information Reporting System of the Chinese Disease Prevention and Control Information Management System. Demographic data of high school students in counties (districts) came from the General Management System of the Chinese Disease Prevention and Control Information Management System, and the spatial clustering of the reported incidence rate of pulmonary tuberculosis among high school students in Gansu Province in the past five years was analyzed using the methods of global spatial autocorrelation (Moran's I) and local indicators of spatial audocorrelation(LISA). Results A total of 41 885 pulmonary tuberculosis cases were reported in various counties of Gansu Province From 2018 to 2022, with an average reported incidence rate of 32.81/100 000. During the same period, 1 170 high school students cases were reported, with an average reported incidence rate of 13.72/100 000. With the exception of 2020, the reported incidence rate of pulmonary tuberculosis among high school students was non random distribution in other 4 years, showed a moderate intensity of spatial clustering. From 2018 to 2022, most counties in Gansu Province reported that the incidence rate of pulmonary tuberculosis among high school students was 10.00/100 000 or below, the counties with reported incidence rate >40.00/100 000 were mainly distributed in Luqu County, Maqu County, Diebu County, Hezuo City, Xiahe County of Gannan Prefecture, Gangu County and Wushan County of Tianshui Prefecture, Wenxian County and Kangxian County of Longnan Prefecture, Huachi County of Pingliang Prefecture, Huanxian County of Qingyang Prefecture. The number of counties where the reported incidence rate of tuberculosis among high school students more than 30.00/100 000 gradually decreased from 2018 to 2022. In the past five years, the reported incidence rate of tuberculosis among high school students in all counties of Gannan Prefecture remained above 40.00/100 000. The LISA analysis results showed that the high incidence areas were mainly concentrated in Gannan Prefecture. Conclusions The epidemic situation of pulmonary tuberculosis among high-school students in Gansu province from 2018 to 2022 is still a serious condition, showing the characteristics of unbalanced regional distribution. The reported incidence rate shows a strong spatial clustering, and the hot spots are concentrated in the counties (districts) of Gannan prefecture in Gansu Province.
- Tuberculosis, pulmonary /
- Incidence /
- Space-time clustering /
- Epidemiologic studies /
- Students
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图 1 甘肃省2018—2022年各县(区)高中学生肺结核报告发病率

Figure 1. Reported incidence rate of pulmonary tuberculosis among senior high school students in all county of Gansu Province from 2018 to 2022

下载: 全尺寸图片幻灯片

图 2 甘肃省2018—2022年各县(区)高中生肺结核报告发病率LISA局部自相关分析

Figure 2. LISA local autocorrelation analysis of the reported incidence rate of pulmonary tuberculosis among high school students in county of Gansu Province from 2018 to 2022

下载: 全尺寸图片幻灯片

表 1 甘肃省2018—2022年高中学生肺结核报告发病情况

Table 1. Reported incidence of pulmonary tuberculosis among high school students in Gansu Province from 2018 to 2022

年份	常住人口		高中生		高中生患者在全部肺结核患者中占比/%
年份	人数/万	报告发病人数	人数/万	报告发病人数	高中生患者在全部肺结核患者中占比/%
2018	2 637.26	10 163(38.54)	179.09	270(15.08)	2.66
2019	2 647.43	9 542(36.04)	177.54	248(13.97)	2.60
2020	2 501.98	8 119(32.45)	166.13	334(20.10)	4.11
2021	2 490.02	7 642(30.69)	164.99	193(11.70)	2.53
2022	2 490.02	6 419(25.78)	164.99	125(7.58)	1.95
合计	12 766.71	41 885(32.81)	852.74	1 170(13.72)	2.79
注：()内数字为报告发病率/10万。2022年未能获得准确人口数据，用2021年人口数代替。

下载: 导出CSV

表 2 甘肃省2018—2022年各县(区)高中生肺结核报告发病率全局自相关情况

Table 2. Global autocorrelation of reported incidence rate of tuberculosis among high school students in county level of Gansu Province from 2018 to 2022

年份	Moran's I值	Var(I)	Z值	P值	标准差
2018	0.27	-0.01	4.31	＜0.01	0.07
2019	0.24	-0.01	4.15	＜0.01	0.06
2020	0.09	-0.01	1.94	0.05	0.04
2021	0.18	-0.01	2.69	0.01	0.07
2022	0.11	-0.01	2.04	0.04	0.06

下载: 导出CSV

参考文献(23)

[1]	俞社根, 贾忠伟. 动力学模型在天津市肺结核发病率预测及防控策略效果评估中的应用[J]. 中国防痨杂志, 2021, 43(10): 1039-1045. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFLZ202110012.htm YU S G, JIA Z W. Application of a dynamic model on the prediction of pulmonary tuberculosis incidence and control strategy evaluation in Tian jin, China[J]. Chin J Antituberc, 2021, 43(10): 1039-1045. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZFLZ202110012.htm
[2]	WHO. Global tuberculosis report 2022[R]. Geneva: World Health Organization, 2022.
[3]	陈亮, 周琳. 新型冠状病毒肺炎大流行对结核病控制的启示[J]. 实用医学杂志, 2022, 38(13): 1578-1581. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ202213002.htm CHEN L, ZHOU L. Impact and implications of the COVID-19 pandemic on tuberculosis control[J]. J Pract Med, 2022, 38(13): 1578-1581. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ202213002.htm
[4]	倪妮, 黄飞, 王倪, 等. 2016—2020年全国流动人口肺结核流行特征分析[J]. 疾病监测, 2023, 38(7): 819-824. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC202307011.htm NI N, HUANG F, WANG N, et al. Epidemic characteristics of pulmonary tuberculosis in migrants in China, 2016-2020[J]. Dis Surveill, 2023, 38(7): 819-824. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBJC202307011.htm
[5]	王胜芬, 周杨, 欧喜超, 等. 我国结核病耐药状况: 2018年全国结核病耐药监测数据分析[J]. 中国防痨杂志, 2022, 44(11): 1141-1147. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFLZ202211005.htm WANG F S, ZHOU Y, OU X C, et al. Prevalence of drug resistant tuberculosis in China: data from national drug resistant tuberculosis survey in 2018[J]. Chin J Antituberc, 2022, 44(11): 1141-1147. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZFLZ202211005.htm
[6]	楚男, 高倩倩, 周成超. 2004—2018年中国肺结核病时间及空间变动趋势分析[J]. 中国公共卫生, 2022, 38(7): 887-890. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202207012.htm CHU N, GAO Q Q, ZHOU C C. Trends in spatiotemporal distribution of pulmonary tuberculosis morbidity and mortality in China: 2004-2018[J]. Chin J Public Health, 2022, 38(7): 887-890. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGGW202207012.htm
[7]	中华人民共和国国家卫生健康委员会办公厅. 关于调整肺结核传染病报告分类的通知(国卫办疾控函[2019]296号)[EB/OL]. (2019-03-21)[2023-09-17]. http://www.nhc.gov.cn.jkj/s3589/201903/d779ae48db6446c28d1f537ef09f5ab.shtml. General Office of the National Health Commission of the PRC. Adjustification of reporting for pulmonary tuberculosis[EB/OL]. (2019-03-21)[2023-09-17]. http://www.nhc.gov.cn.jkj/s3589/201903/d779ae48db6446c28d1f537ef09f5ab.shtml. (in Chinese)
[8]	殷小晴. 2015-2019年吉林省涂阳肺结核流行特征和空间聚集性研究[D]. 长春: 吉林大学, 2021. YIN X Q. Epidemiological characteristics and spatial aggregation of smear positive pulmonary tuberculosis in Jilin Province during 2015-2019[D]. Changchun: Jilin University, 2021. (in Chinese)
[9]	黄小婵. 贵州省2006—2019年肺结核流行及时空分布特征分析[D]. 贵阳: 贵州医科大学, 2022. HUANG X C. Analysis of pulmonary tuberculosis prevalence and spatio-temporal distribution characteristics in Guizhou Province from 2006 to 2019[D]. Guiyang: Guizhou Medical University, 2022. (in Chinese)
[10]	吴倩, 张钰, 刘魁, 等. 2016—2020年浙江省肺结核流行特征分析[J]. 预防医学, 2022, 34(5): 487-491. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202205013.htm WU Q, ZHANG Y, LIU K, et al. Epidemiological characteristics of pulmonary tuberculosis in Zhejiang Province from 2016 to 2020[J]. J Prev Med, 2022, 34(5): 487-491. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZYFX202205013.htm
[11]	刘东鹏, 苟发香, 刘新凤, 等. 甘肃省2013年肺结核发病空间分布研究[J]. 中华预防医学, 2015, 16(10): 761-764. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYC201510006.htm LIU D P, GOU F X, LIU X F, et al. The spatial pattern of pulmonary tuberculosis in Gansu in 2013[J]. Chin J Prev Med, 2015, 16(10): 761-764. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYC201510006.htm
[12]	艾克旦, 商越, 王兆芬, 等. 青海省南部2009—2019年肺结核时空分布特征演变研究[J]. 中国预防医学杂志, 2021, 22(8): 582-586. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYC202108004.htm AI K D, SHANG Y, WANG Z F, et al. The dynamic change of spatial-temporal distribution of pulmonary tuberculosis in in southern Qing hai, 2009-2019[J]. Chin J Prev Med, 2021, 22(8): 582-586. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYC202108004.htm
[13]	商越, 艾克旦, 张甜甜, 等. 青海省2016—2019年学生肺结核病流行特征分析[J]. 中国学校卫生, 2021, 42(9): 1373-1375. doi: 10.16835/j.cnki.1000-9817.2021.09.023 SHAN Y, AI K D, ZHANG T T, et al. Epidemiological characteristics of pulmonary tuberculosis among students in Qinghai Province from 2016 to 2019[J]. Chin J Sch Health, 2021, 42(9): 1373-1375. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.09.023
[14]	王明哲, 王乐, 艾尔肯, 等. 2011—2020年新疆普通肺结核患者流行病学特征分析[J]. 预防医学情报杂志, 2022, 38(10): 1334-1339. https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202210003.htm WANG M Z, WANG L, AI E K, et al. Epidemiological characteristics of common patients with pulmonary tuberculosis in Xinjiang from 2011 to 2020[J]. J Prev Med Inf, 2022, 38(10): 1334-1339. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YFYX202210003.htm
[15]	李佳琛, 赵剑喜, 白玉娥, 等. 2016—2020年甘肃省肺结核患者流行特征分析[J]. 疾病预防控制通报, 2023, 34(4): 44-48. https://www.cnki.com.cn/Article/CJFDTOTAL-DFBT202304010.htm LI J C, ZHAO J X, BAI Y E, et al. Epidemiological characteristics of pulmonary tuberculosis in Gansu Province from 2016 to 2020[J]. Bull Dis Control Prev, 2023, 34(4): 44-48. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-DFBT202304010.htm
[16]	李江红, 王军元, 雷彩英, 等. 《天水市结核病防治十三五规划》防治措施评估结果分析[J]. 医学动物防制, 2022, 38(10): 932-935. https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ202210004.htm LI J H, WANG Y J, LEI C Y, et al. Analysis on evaluation results of prevention and treatment measures in the 13th Five-Year Plan for Tuberculosis Prevention and Control in Tianshui[J]. J Med Pest Control, 2022, 38(10): 932-935. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXDZ202210004.htm
[17]	许玲, 满世军, 肖生顺, 等. 2016—2021年武威市凉州区肺结核流行病学特征分析[J]. 疾病预防控制通报, 2022, 37(4): 47-49. https://www.cnki.com.cn/Article/CJFDTOTAL-DFBT202204012.htm XU L, MAN S J, XIAO S S, et al. Epidemiological characteristics of pulmonary tuberculosis in Liangzhou District of Wuwei City, Gansu Province from 2016 to 2021[J]. Bull Dis Control Prev, 2022, 37(4): 47-49. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-DFBT202204012.htm
[18]	陈卉, 张灿有, 张慧, 等. 2004—2021年全国学校肺结核疫情分析[J]. 中国防痨杂志, 2022, 44(8): 768-776. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFLZ202208003.htm CHEN H, ZHANG C Y, ZHANG H, et al. Analysis on the epidemic situation of pulmonary tuberculosis in schools in China from 2004 to 2021[J]. Chin J Antituberc, 2022, 44(8): 768-776. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZFLZ202208003.htm
[19]	郭强, 马玲, 李江红, 等. 2015—2020年甘肃省学校肺结核防控措施实施情况分析[J]. 结核与肺部疾病杂志, 2021, 2(4): 322-325. https://www.cnki.com.cn/Article/CJFDTOTAL-FBJK202104005.htm GUO Q, MA L, LI J H, et al. Investigation and analysis of the implementation status of tuberculosis prevention and control in schools in Gansu Province during 2015 to 2020[J]. J Tuberc Lung Dis, 2021, 2(4): 322-325. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-FBJK202104005.htm
[20]	FEI H, YINYIN X, HUI C, et al. The impact of the COVID-19 epidemic on tuberculosis control in China[J]. Lancet Reg Health West Pac, 2020. DOI: 10.1016/j.lanwpc.2020.100032.
[21]	王铂. 甘肃省2007—2017年学校肺结核流行状况分析及趋势预测[D]. 兰州: 兰州大学, 2018. WANG B. Analysis and trend forecast of the prevalence of tuberculosis in schools from 2007 to 2017 in Gansu Province[D]. Lanzhou: Lanzhou University, 2018. (in Chinese)
[22]	芦娟, 陈庆荣, 周伟忠. 2010—2016年甘南藏族自治州法定传染病流行特征分析[J]. 疾病预防控制通报, 2018, 33(5): 45-48. https://www.cnki.com.cn/Article/CJFDTOTAL-DFBT201805014.htm LU J, CHEN Q R, ZHOU W Z, et al. Epidemiological characteristics of notifiable infectious diseases in Gannan Tibetan autonomous prefecture, 2010-2016[J]. Bull Dis Control Prev, 2018, 33(5): 45-48. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-DFBT201805014.htm
[23]	成君, 赵雁林. 学校结核病防控工作中的问题与对策[J]. 中国学校卫生, 2021, 42(12): 1761-1767. doi: 10.16835/j.cnki.1000-9817.2021.12.001 CHEN J, ZHAO Y L. Problem and solution of tuberculosis prevention and control in schools[J]. Chin J Sch Health, 2021, 42(12): 1761-1767. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.12.001