2013-2018年中国结核病空间聚集性分析

杨丽佳; 李涛; 陈伟

Abstract

杨丽佳,李涛,陈伟.2013-2018年中国结核病空间聚集性分析[J].Chinese journal of Epidemiology,2020,41(11):1843-1847

2013-2018年中国结核病空间聚集性分析

Study on spatial clustering characteristics of tuberculosis in China, 2013-2018

Received:January 14, 2020

DOI：10.3760/cma.j.cn112338-20200114-00029

KeyWord: 结核病空间聚集性分析

English Key Word: Tuberculosis Spatial cluster Analysis

FundProject:国家科技重大专项（2017ZX10201302-007）

Author Name	Affiliation	E-mail
Yang Lijia	National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Li Tao	National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Chen Wei	National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China	chenwei@chinacdc.cn

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Abstract:

目的分析2013-2018年中国结核病以县（区）为单位的空间聚集性特征及其变化趋势。方法数据来源于中国疾病预防控制信息系统结核病信息管理系统，以2013-2018年全国各县（区）结核病登记数据和同期人口数据为基础，描述2013-2018年结核病疫情的空间分布特征，采用SaTScan 9.6软件对2013-2018年以县（区）为单位的结核病登记率进行空间扫描，通过扫描窗口下的对数似然比（LLR）和P值判断结核病聚集区的位置和范围，在此基础上分析聚集区结核病发病的RR值。结果 2013-2018年，全国结核病登记率基本呈缓慢下降趋势。全国范围内存在多个空间高值聚集区，主要位于西部的新疆维吾尔自治区（新疆）、西藏自治区（西藏）、陕西省、四川省、重庆市、云南省、贵州省、广西壮族自治区（广西），中东部的内蒙古自治区、湖北省、湖南省、江西省、广东省、海南省。结核病空间聚集区覆盖的县（区）数量呈缓慢下降趋势，从2013年的1 112个下降到2018年的806个。新疆南疆地区、西藏西部地区的结核病聚集区相比于其他地区，结核病发病的RR值始终维持在较高水平（RR>3.0）。结论 2013-2018年我国结核病聚集区域覆盖的县（区）数量逐渐减少，聚集区主要分布于西部、中部的多个省份，应加强结核病聚集区的结核病患者健康教育和早期发现等防控工作，防止结核病疫情的扩散。西部地区不仅存在结核病聚集性，且结核病发病RR值较高，应加强结核病患者的治疗管理等工作。

English Abstract:

Objective To explore the tuberculosis (TB) clustering areas and changing tendency in China from 2013 to 2018, so as to provide evidence for improving the control and prevention programs on TB. Methods Spatial distribution of TB in China from 2013 to 2018 was studied using data from TB information management system of Chinese disease prevention and control information system. The SaTScan 9.6 software was used to detect and analyze the TB clusters and relative risks. Likelihood ratio and P value under the scan windows were used as the main index to define the clusters. Results The TB registration rate declined in China from 2013 to 2018. High-risk clusters were mainly located in western regions of Xinjiang, Tibet, Shaanxi, Sichuan, Chongqing, Yunnan, Guizhou, Guangxi provinces and central and eastern regions of Inner Mongolia, Hubei, Hunan, Jiangxi, Guangdong and Hainan provinces. The number of counties with TB clusters declined slowly, from 1 112 in 2013 to 806 in 2018. In comparison with areas other than the clusters, the RR of TB in the clusters remained at high levels in southern Xinjiang and western Tibet from 2013 to 2018 (RR>3.0). Conclusions The number of the counties with TB clustering declined slowly from 2013 to 2018, and most of them were located in western and central China. Early detection and health education should be focused on TB patients to prevent the spread of TB. Management programs set for TB patients should be strengthened, especially in the western parts of the country where TB clusters and high relative risks existed.

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