Article(id=1241065992894337604, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202410212, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729008000000, receivedDateStr=2024-10-16, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773822790597, onlineDateStr=2026-03-18, pubDate=1740412800000, pubDateStr=2025-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773822790597, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773822790597, creator=13701087609, updateTime=1773822790597, updator=13701087609, issue=Issue{id=1241065978004557893, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='4', pageStart='577', pageEnd='768', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773822787047, creator=13701087609, updateTime=1773823194927, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241067688831808347, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241067688831808348, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241065978004557893, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=597, endPage=602, ext={EN=ArticleExt(id=1241065993288602209, articleId=1241065992894337604, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Epidemiological characteristics and spatial clustering analysis of pulmonary tuberculosis, Guizhou Province, 2016-2023, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the prevalence and spatial clustering characteristics of tuberculosis in Guizhou Province, and provide scientific basis for further reducing the prevalence of tuberculosis.

Methods

Based on the incidence monitoring data of tuberculosis in Guizhou Province in the tuberculosis information management system from 2016 to 2023, this study described and analyzed the distribution characteristics of tuberculosis incidence in the whole province in time, population and region, and used spatial clustering to analyze the key regions and types of incidence rate clustering in the province.

Results

From 2016 to 2023, the annual average reported incidence rate of tuberculosis in Guizhou Province was 100.28/100 000, and the reported incidence rate declined at an average annual rate of 6.82%, from 130.66/100 000 in 2016 to 82.90/100 000 (trend χ2=9 647.38, P<0.001). From 2016 to 2023, the reported incidence rate of men and women will decrease from 165.18/100 000, 93.89/100 000 to 102.32/100 000 and 62.58/100 000 respectively (trend χ2=6 968.96, 2 828.21,all P<0.001). The reported incidence rates in the age groups of <20 years old, 20-39 years old, 40-59 years old and ≥60 years old all showed a downward trend (trend χ2=3 021.42, 3 563.78, 2 477.46, 1 184.20,all P<0.001). The average annual reported incidence rate of men and age groups ≥60 years old were higher than others (χ2=18 845.45, 65 957.05, all P<0.001) and the proportion of farmers was 69.46% higher than that of other occupations (χ2=732 538.16, P<0.001). At the same time, the proportion of medical staff and teachers increased (trend χ2=61.54, 45.87, all P<0.001). Spatial clustering analysis showed that tuberculosis in the province presented a clustered distribution (Moran I=0.293, Z=4.607, P<0.001), with high-high clustered areas mainly concentrated in Wangmo County, Ceheng County and other areas in Qiannan Prefecture.

Conclusion

In recent years, the prevention and control of tuberculosis in Guizhou Province has achieved certain results, but the current situation of prevention and control is still quite severe. Males, age groups ≥60 years old, farmers, medical personnel and teachers are the key population affected by the disease. Areas with relatively backward economic and living standards, such as Wangmo and Ceheng in Qiannan Prefecture, are the key areas affected by the disease.

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目的

了解贵州省肺结核流行特征和空间聚集性,为进一步降低肺结核流行提供科学依据。

方法

以2016—2023年结核病信息管理系统中贵州省的肺结核发病监测数据为依据,描述和分析全省肺结核发病在时间、人群和地区中的分布特征,并采用全局和局部自相关分析探测全省发病聚集重点地区和聚集类型。

结果

2016—2023年贵州省肺结核年均报告发病率为100.28/10万,报告发病率以年均6.82%的下降速率,从130.66/10万降至82.90/10万(趋势χ2=9 647.375,P<0.001)。2016—2023年男女报告发病率分别从165.18/10万、93.89/10万下降至102.32/10万和62.58/10万(趋势χ2=6 968.956、2 656.114,P均<0.001);<20岁、20~39岁、40~59岁和≥60岁年龄组的报告发病均呈下降趋势(趋势χ2=3 021.424、3 563.783、2 477.462、1 184.117,P均<0.001);年均报告发病率男性、≥60岁年龄组分别高于其他分组(χ2=18 845.452、65 957.048,P均<0.001),农民占比69.46%高于其他职业(χ2=732 538.160,P<0.001),同时医务人员和教师人群发病占比升高(趋势χ2=61.539、45.872,P均<0.001)。空间相关分析显示,全省肺结核发病呈现聚集分布(Moran I=0.293,Z=4.607,P<0.001),高-高聚集地区整体集中在黔西南州的望谟县、册亨县等地。

结论

近年贵州省肺结核防治工作取得一定的成效,但目前防控形势仍较严峻。男性、≥60岁、农民、医务人员和教师等是重点发病人群,黔西南州的望谟、册亨等经济和生活水平较落后是发病重点地区。

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李进岚,E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点,除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=Nrl+q83/eDYSy+agkqSDyA==, magXml=lTZu4+IN5A5jMzmcnQ/55Q==, pdfUrl=null, pdf=1nP2i6krZC/kWG2w378W+A==, pdfFileSize=1100645, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=seA5hsVvTILlxhHeGKh4Mg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=2hIOI477jmD/juX2lp0xHw==, mapNumber=null, authorCompany=null, fund=null, authors=

马晓雪(1996—),女,硕士,主管医师,研究方向:疾病预防与控制

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马晓雪(1996—),女,硕士,主管医师,研究方向:疾病预防与控制

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(In Chinese), articleTitle=Spatial distribution of pulmonary tuberculosis in the elderly in Inner Mongolia Autonomous Region,2016-2020, refAbstract=null)], funds=[Fund(id=1241066005682770038, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, awardId=2020-181-131, language=CN, fundingSource=贵州省发改委省级基本建设前期工作项目(2020-181-131), fundOrder=null, country=null), Fund(id=1241066005783433338, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, awardId=2024-E-7, language=CN, fundingSource=贵州省疾病预防控制中心2024年青年科学基金项目(2024-E-7), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241065995981345494, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, xref=1., ext=[AuthorCompanyExt(id=1241065995989734103, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, companyId=1241065995981345494, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Tuberculosis Prevention and Control Institute of Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou 550004, China), AuthorCompanyExt(id=1241065995998122712, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, companyId=1241065995981345494, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.贵州省疾病预防控制中心结核病防治研究所,贵州 贵阳 550004)]), AuthorCompany(id=1241065996102980325, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, xref=2., ext=[AuthorCompanyExt(id=1241065996111368935, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, companyId=1241065996102980325, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.贵州医科大学公共卫生与健康学院)])], figs=[ArticleFig(id=1241066002050502672, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Fig.1, caption=Reported incidence of pulmonary tuberculosis at different ages in Guizhou Province from 2016 to 2023, figureFileSmall=67a/uBaKw/2DXP/bGLolJQ==, figureFileBig=seA5hsVvTILlxhHeGKh4Mg==, tableContent=null), ArticleFig(id=1241066002155360279, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=图1, caption=2016—2023年贵州省不同年龄肺结核报告发病情况, figureFileSmall=67a/uBaKw/2DXP/bGLolJQ==, figureFileBig=seA5hsVvTILlxhHeGKh4Mg==, tableContent=null), ArticleFig(id=1241066002419601440, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Fig.2, caption=Regional distribution of annual average reported incidence rate of tuberculosis in Guizhou Province from 2016 to 2023, figureFileSmall=b6M9ILkbWGb1/TctLOn65g==, figureFileBig=+7JMwDqMpiWSADyFaSrYqw==, tableContent=null), ArticleFig(id=1241066002545430565, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=图2, caption=2016—2023年贵州省肺结核年均报告发病率的地区分布[标准地图审图号:黔 S(2020)007 号], figureFileSmall=b6M9ILkbWGb1/TctLOn65g==, figureFileBig=+7JMwDqMpiWSADyFaSrYqw==, tableContent=null), ArticleFig(id=1241066004017631274, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Fig.3, caption=Local spatial autocorrelation analysis of reported tuberculosis incidence in Guizhou Province from 2016 to 2023, figureFileSmall=jWjQKxRpslYkFmlg9bbS4Q==, figureFileBig=N8f8oQhNZLwJMK/ZPkvMfg==, tableContent=null), ArticleFig(id=1241066004109905968, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=图3, caption=2016—2023年贵州省肺结核报告发病局部自相关分析[标准地图审图号:黔 S(2020)007 号], figureFileSmall=jWjQKxRpslYkFmlg9bbS4Q==, figureFileBig=N8f8oQhNZLwJMK/ZPkvMfg==, tableContent=null), ArticleFig(id=1241066004193792053, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Table 1, caption=

Reported incidence of pulmonary tuberculosis in Guizhou Province from 2016 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份肺结核病原学阳性
发病数发病率(/10万)发病数发病率(/10万)
201646 117130.6611 46232.47
201743 426122.1511 25431.66
201840 833114.0611 92633.31
201936 904102.5116 12648.56
202034 97696.5417 75249.00
202131 74982.3317 50845.40
202229 36976.2417 36645.08
202331 96782.9021 18554.94
合计295 341100.28124 57942.70
), ArticleFig(id=1241066004361564219, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=表1, caption=

2016—2023年贵州省肺结核报告发病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份肺结核病原学阳性
发病数发病率(/10万)发病数发病率(/10万)
201646 117130.6611 46232.47
201743 426122.1511 25431.66
201840 833114.0611 92633.31
201936 904102.5116 12648.56
202034 97696.5417 75249.00
202131 74982.3317 50845.40
202229 36976.2417 36645.08
202331 96782.9021 18554.94
合计295 341100.28124 57942.70
), ArticleFig(id=1241066004487393343, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Table 2, caption=

Reported incidence of pulmonary tuberculosis by gender in Guizhou Province from 2016 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份男性女性
发病数发病率(/10万)发病数发病率(/10万)
201630 073165.1816 04493.89
201728 359154.7715 06787.46
201826 455143.3214 37882.91
201923 422125.9213 48277.48
202022 139119.2612 83772.66
202119 952101.2511 79762.56
202218 38393.2710 98658.41
202320 169102.3211 79862.58
合计188 952124.90106 38974.27
), ArticleFig(id=1241066004642582598, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=表2, caption=

2016—2023年贵州省不同性别肺结核报告发病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份男性女性
发病数发病率(/10万)发病数发病率(/10万)
201630 073165.1816 04493.89
201728 359154.7715 06787.46
201826 455143.3214 37882.91
201923 422125.9213 48277.48
202022 139119.2612 83772.66
202119 952101.2511 79762.56
202218 38393.2710 98658.41
202320 169102.3211 79862.58
合计188 952124.90106 38974.27
), ArticleFig(id=1241066004755828812, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Table 3, caption=

Reported incidence of pulmonary tuberculosis at different ages in Guizhou Province from 2016 to 2023

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年份<20岁20~39岁40~59岁≥60岁
发病数发病率
(/10万)
发病数发病率
(/10万)
发病数发病率
(/10万)
发病数发病率
(/10万)
20165 60153.5814 097144.5014 040144.8812 379229.42
20175 75254.2513 005131.4212 839130.6011 830226.62
20185 63052.4312 393125.1012 014122.1010 796203.05
20194 88243.3811 586124.4610 811110.269 625170.87
20204 84142.4311 207122.8310 115100.598 813156.24
20213 49027.709 469100.749 96593.758 825148.79
20222 83724.268 06479.989 57587.878 893152.16
20232 92425.277 48374.4310 16993.0411 391189.64
合计35 95739.8187 304112.6189 528109.6182 552183.49
), ArticleFig(id=1241066004860686417, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=表3, caption=

2016—2023年贵州省不同年龄肺结核报告发病情况

, figureFileSmall=null, figureFileBig=null, tableContent=
年份<20岁20~39岁40~59岁≥60岁
发病数发病率
(/10万)
发病数发病率
(/10万)
发病数发病率
(/10万)
发病数发病率
(/10万)
20165 60153.5814 097144.5014 040144.8812 379229.42
20175 75254.2513 005131.4212 839130.6011 830226.62
20185 63052.4312 393125.1012 014122.1010 796203.05
20194 88243.3811 586124.4610 811110.269 625170.87
20204 84142.4311 207122.8310 115100.598 813156.24
20213 49027.709 469100.749 96593.758 825148.79
20222 83724.268 06479.989 57587.878 893152.16
20232 92425.277 48374.4310 16993.0411 391189.64
合计35 95739.8187 304112.6189 528109.6182 552183.49
), ArticleFig(id=1241066004952961113, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Table 4, caption=

Reported incidence of pulmonary tuberculosis in different professions in Guizhou Province from 2016 to 2023

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年份农民学生家务及待业教师医务人员其他
201634 649(75.13)3 528( 7.65)3 166( 6.87)295(0.64)155(0.34)4 324( 9.38)
201731 895(73.45)4 077( 9.39)3 090( 7.12)281(0.65)169(0.39)3 914( 9.01)
201828 608(70.06)4 894(11.99)3 302( 8.09)250(0.61)174(0.43)3 605( 8.83)
201925 709(69.66)4 475(12.13)3 327( 9.02)277(0.75)201(0.54)2 915( 7.90)
202022 986(65.72)4 674(13.36)3 582(10.24)340(0.97)243(0.69)3 151( 9.01)
202121 268(66.99)3 584(11.29)3 591(11.31)341(1.07)179(0.56)2 786( 8.78)
202219 176(65.29)2 792( 9.51)3 835(13.06)275(0.94)202(0.69)3 089(10.52)
202320 851(65.23)2 756( 8.62)4 812(15.05)275(0.86)152(0.48)3 121( 9.76)
合计205 142(69.46)30 780(10.42)28 705( 9.72)2 334(0.79)1 475(0.50)26 905( 9.11)
), ArticleFig(id=1241066005066207324, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=表4, caption=

2016—2023年贵州省不同职业肺结核报告发病情况[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
年份农民学生家务及待业教师医务人员其他
201634 649(75.13)3 528( 7.65)3 166( 6.87)295(0.64)155(0.34)4 324( 9.38)
201731 895(73.45)4 077( 9.39)3 090( 7.12)281(0.65)169(0.39)3 914( 9.01)
201828 608(70.06)4 894(11.99)3 302( 8.09)250(0.61)174(0.43)3 605( 8.83)
201925 709(69.66)4 475(12.13)3 327( 9.02)277(0.75)201(0.54)2 915( 7.90)
202022 986(65.72)4 674(13.36)3 582(10.24)340(0.97)243(0.69)3 151( 9.01)
202121 268(66.99)3 584(11.29)3 591(11.31)341(1.07)179(0.56)2 786( 8.78)
202219 176(65.29)2 792( 9.51)3 835(13.06)275(0.94)202(0.69)3 089(10.52)
202320 851(65.23)2 756( 8.62)4 812(15.05)275(0.86)152(0.48)3 121( 9.76)
合计205 142(69.46)30 780(10.42)28 705( 9.72)2 334(0.79)1 475(0.50)26 905( 9.11)
), ArticleFig(id=1241066005162676321, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Table 5, caption=

Global spatial autocorrelation analysis of reported tuberculosis incidence in Guizhou Province from 2016 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年度Moran IZP
20160.1081.8190.069
20170.0771.3490.177
20180.1632.6310.003
20190.2894.523<0.001
20200.2944.607<0.001
20210.3815.952<0.001
20220.3645.672<0.001
20230.3245.100<0.001
合计0.2934.607<0.001
), ArticleFig(id=1241066005267533927, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=表5, caption=

2016—2023年贵州省肺结核报告发病全局自相关分析

, figureFileSmall=null, figureFileBig=null, tableContent=
年度Moran IZP
20160.1081.8190.069
20170.0771.3490.177
20180.1632.6310.003
20190.2894.523<0.001
20200.2944.607<0.001
20210.3815.952<0.001
20220.3645.672<0.001
20230.3245.100<0.001
合计0.2934.607<0.001
), ArticleFig(id=1241066005401751662, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=EN, label=Table 6, caption=

Local spatial autocorrelation analysis of reported tuberculosis incidence in Guizhou Province from 2016 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
年份高-高高-低低-高低-低
2016望谟、务川清镇-观山湖、云岩、南明
2017望谟、册亨平坝-观山湖
2018望谟、册亨、贞丰、镇宁龙里钟山观山湖、云岩、南明、白云
2019望谟、册亨、贞丰、镇宁、紫云-钟山观山湖、云岩、南明、花溪、白云、乌当、平坝
2020望谟、册亨、紫云岑巩、龙里-观山湖、云岩、南明、花溪、白云、乌当、平坝、碧江、万山、盘州
2021望谟、册亨、贞丰、紫云、罗甸--观山湖、云岩、南明、花溪、白云、乌当、清镇、碧江、万山、盘州
2022望谟、册亨、贞丰、镇宁、紫云--观山湖、云岩、南明、花溪、白云、平坝、碧江、万山、盘州
2023望谟、册亨、贞丰、紫云、罗甸--观山湖、云岩、南明、花溪、白云、乌当、碧江、万山、盘州、玉屏
), ArticleFig(id=1241066005540163695, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241065992894337604, language=CN, label=表6, caption=

2016—2023年贵州省肺结核报告发病局部自相关分析

, figureFileSmall=null, figureFileBig=null, tableContent=
年份高-高高-低低-高低-低
2016望谟、务川清镇-观山湖、云岩、南明
2017望谟、册亨平坝-观山湖
2018望谟、册亨、贞丰、镇宁龙里钟山观山湖、云岩、南明、白云
2019望谟、册亨、贞丰、镇宁、紫云-钟山观山湖、云岩、南明、花溪、白云、乌当、平坝
2020望谟、册亨、紫云岑巩、龙里-观山湖、云岩、南明、花溪、白云、乌当、平坝、碧江、万山、盘州
2021望谟、册亨、贞丰、紫云、罗甸--观山湖、云岩、南明、花溪、白云、乌当、清镇、碧江、万山、盘州
2022望谟、册亨、贞丰、镇宁、紫云--观山湖、云岩、南明、花溪、白云、平坝、碧江、万山、盘州
2023望谟、册亨、贞丰、紫云、罗甸--观山湖、云岩、南明、花溪、白云、乌当、碧江、万山、盘州、玉屏
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2016—2023年贵州省肺结核流行特征及空间聚集分析
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马晓雪 1 , 周建 1 , 王大福 2 , 李福栋 2 , 郭生琼 1 , 罗珑 1 , 陈再平 1 , 刘益宁 1 , 陈美 1 , 李进岚 1
现代预防医学 | 流行病与统计方法 2025,52(4): 597-602
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现代预防医学 | 流行病与统计方法 2025, 52(4): 597-602
2016—2023年贵州省肺结核流行特征及空间聚集分析
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马晓雪1, 周建1, 王大福2, 李福栋2, 郭生琼1, 罗珑1, 陈再平1, 刘益宁1, 陈美1, 李进岚1
作者信息
  • 1.贵州省疾病预防控制中心结核病防治研究所,贵州 贵阳 550004
  • 2.贵州医科大学公共卫生与健康学院
  • 马晓雪(1996—),女,硕士,主管医师,研究方向:疾病预防与控制

通讯作者:

李进岚,E-mail:
Epidemiological characteristics and spatial clustering analysis of pulmonary tuberculosis, Guizhou Province, 2016-2023
Xiao-xue MA1, Jian ZHOU1, Da-fu WANG2, Fu-dong LI2, Sheng-qiong GUO1, Long LUO1, Zai-ping CHEN1, Yi-ning LIU1, Mei CHEN1, Jin-lan LI1
Affiliations
  • Tuberculosis Prevention and Control Institute of Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou 550004, China
出版时间: 2025-02-25 doi: 10.20043/j.cnki.MPM.202410212
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目的

了解贵州省肺结核流行特征和空间聚集性,为进一步降低肺结核流行提供科学依据。

方法

以2016—2023年结核病信息管理系统中贵州省的肺结核发病监测数据为依据,描述和分析全省肺结核发病在时间、人群和地区中的分布特征,并采用全局和局部自相关分析探测全省发病聚集重点地区和聚集类型。

结果

2016—2023年贵州省肺结核年均报告发病率为100.28/10万,报告发病率以年均6.82%的下降速率,从130.66/10万降至82.90/10万(趋势χ2=9 647.375,P<0.001)。2016—2023年男女报告发病率分别从165.18/10万、93.89/10万下降至102.32/10万和62.58/10万(趋势χ2=6 968.956、2 656.114,P均<0.001);<20岁、20~39岁、40~59岁和≥60岁年龄组的报告发病均呈下降趋势(趋势χ2=3 021.424、3 563.783、2 477.462、1 184.117,P均<0.001);年均报告发病率男性、≥60岁年龄组分别高于其他分组(χ2=18 845.452、65 957.048,P均<0.001),农民占比69.46%高于其他职业(χ2=732 538.160,P<0.001),同时医务人员和教师人群发病占比升高(趋势χ2=61.539、45.872,P均<0.001)。空间相关分析显示,全省肺结核发病呈现聚集分布(Moran I=0.293,Z=4.607,P<0.001),高-高聚集地区整体集中在黔西南州的望谟县、册亨县等地。

结论

近年贵州省肺结核防治工作取得一定的成效,但目前防控形势仍较严峻。男性、≥60岁、农民、医务人员和教师等是重点发病人群,黔西南州的望谟、册亨等经济和生活水平较落后是发病重点地区。

肺结核  /  流行  /  空间聚集
Objective

To understand the prevalence and spatial clustering characteristics of tuberculosis in Guizhou Province, and provide scientific basis for further reducing the prevalence of tuberculosis.

Methods

Based on the incidence monitoring data of tuberculosis in Guizhou Province in the tuberculosis information management system from 2016 to 2023, this study described and analyzed the distribution characteristics of tuberculosis incidence in the whole province in time, population and region, and used spatial clustering to analyze the key regions and types of incidence rate clustering in the province.

Results

From 2016 to 2023, the annual average reported incidence rate of tuberculosis in Guizhou Province was 100.28/100 000, and the reported incidence rate declined at an average annual rate of 6.82%, from 130.66/100 000 in 2016 to 82.90/100 000 (trend χ2=9 647.38, P<0.001). From 2016 to 2023, the reported incidence rate of men and women will decrease from 165.18/100 000, 93.89/100 000 to 102.32/100 000 and 62.58/100 000 respectively (trend χ2=6 968.96, 2 828.21,all P<0.001). The reported incidence rates in the age groups of <20 years old, 20-39 years old, 40-59 years old and ≥60 years old all showed a downward trend (trend χ2=3 021.42, 3 563.78, 2 477.46, 1 184.20,all P<0.001). The average annual reported incidence rate of men and age groups ≥60 years old were higher than others (χ2=18 845.45, 65 957.05, all P<0.001) and the proportion of farmers was 69.46% higher than that of other occupations (χ2=732 538.16, P<0.001). At the same time, the proportion of medical staff and teachers increased (trend χ2=61.54, 45.87, all P<0.001). Spatial clustering analysis showed that tuberculosis in the province presented a clustered distribution (Moran I=0.293, Z=4.607, P<0.001), with high-high clustered areas mainly concentrated in Wangmo County, Ceheng County and other areas in Qiannan Prefecture.

Conclusion

In recent years, the prevention and control of tuberculosis in Guizhou Province has achieved certain results, but the current situation of prevention and control is still quite severe. Males, age groups ≥60 years old, farmers, medical personnel and teachers are the key population affected by the disease. Areas with relatively backward economic and living standards, such as Wangmo and Ceheng in Qiannan Prefecture, are the key areas affected by the disease.

Pulmonary tuberculosis  /  Epidemic  /  Spatial clustering
马晓雪, 周建, 王大福, 李福栋, 郭生琼, 罗珑, 陈再平, 刘益宁, 陈美, 李进岚. 2016—2023年贵州省肺结核流行特征及空间聚集分析. 现代预防医学, 2025 , 52 (4) : 597 -602 . DOI: 10.20043/j.cnki.MPM.202410212
Xiao-xue MA, Jian ZHOU, Da-fu WANG, Fu-dong LI, Sheng-qiong GUO, Long LUO, Zai-ping CHEN, Yi-ning LIU, Mei CHEN, Jin-lan LI. Epidemiological characteristics and spatial clustering analysis of pulmonary tuberculosis, Guizhou Province, 2016-2023[J]. Modern Preventive Medicine, 2025 , 52 (4) : 597 -602 . DOI: 10.20043/j.cnki.MPM.202410212
肺结核是严重的公共卫生问题。世界卫生组织在2014年的世界卫生大会上通过支持了“终止结核病策略”,其愿景是创建一个没有结核病的世界[1]。贵州省长期以来是全国结核病防控的重点地区,结核病防控形势刻不容缓[2-3]。为进一步了解全省肺结核发病趋势和重点人群,为全省终止结核病流行提供科学依据,本研究收集了2016—2023年报告发病情况,探讨不同时间、人群肺结核发病及空间聚集情况。
2016—2023年贵州省肺结核发病资料来源于“中国疾病预防控制中心信息系统—结核病信息管理系统”中的统计表,人口资料来源于该系统常住人口。贵州省矢量化地图来源于贵州省疾病预防控制中心(底图无修改)。
从“中国疾病预防控制中心信息系统—结核病信息管理系统”按发病日期分年度导出贵州省2016—2023年分年龄、人群、地区年统计表。
采用WPS软件整理数据库,采用率(1/10万)或构成比(%)对2016—2023年贵州省肺结核患者发病时间、人群分布进行描述,采用SPSS 22.0软件进行(趋势)χ2检验,检验水准α为0.05。
采用WPS将全省88个行政县(市、区)的发病率分年度整理汇总。通过各行政区划代码为关联字段将发病率与导入ArcGIS软件中的全省矢量化电子地图连接,建立2016—2023年贵州省肺结核发病率地理信息数据库。以县(市、区)为单位对全省2016—2023年肺结核发病率进行全局和局部空间自相关分析。全局自相关以Moran I指数判断肺结核发病在全省范围内是否具有空间聚集性,根据Z检验对Moran I显著性进行检验;局部自相关分析通过ArcGIS软件计算局部空间自相关指标(local indicators of spatial association, LISA),识别空间聚集类型,包括“高-高”、“高-低”、“低-高”和“低-低”4种聚集类型[4]
2016—2023年贵州省累计报告肺结核患者295 341例,年均报告发病率为100.28/10万,报告发病率以年均6.82%的下降速率从130.66/10万下降至82.90/10万(趋势χ2=9 647.375,P<0.001)。其中,病原学阳性肺结核共124 579例,年均报告发病率为42.70/10万,报告发病率从32.47/10万上升至54.94/10万(趋势χ2=3 485.425,P<0.001)。见表1
295 341例肺结核患者中,男性188 952例,女性106 389例,男性年均报告发病率124.90/10万高于女性74.27/10万(χ2=18 845.452,P<0.001);2016—2023年男女报告发病率均呈下降趋势(趋势χ2=6 968.956、2 656.114,P均<0.001)。见表2
2016—2023年贵州省的<20岁、20~39岁、40~59岁及≥60岁年龄组的肺结核年均发病率分别为39.81/10万、112.61/10万、109.61/10万和183.49/10万,不同年龄组的发病率差异有统计学意义(χ2=65 957.048,P<0.001);不同年龄组的发病均呈现下降趋势(趋势χ2=3 021.424、3 563.783、2 477.462、1 184.117,P均<0.001)。见表3图1
295 341例肺结核患者中,农民占绝大多数69.46%,其次为学生群体8.62%,不同职业的占比差异有统计学意义(χ2=732 538.160,P<0.001)。2016—2023年家务及待业、教师、医务人员占比呈上升趋势(趋势χ2=2 323.742、61.539、45.872,P均<0.001)。见表4
2016—2023年贵州省88个县(市、区)肺结核年均报告发病率为43.53/10万~218.93/10万。其中,疫情较高的为罗甸县218.93/10万、望谟县196.83/10万和册亨县176.94/10万,较低的为观山湖区43.53/10万、云岩区50.04/10万和花溪区50.54/10万,不同地区的发病率差异有统计学意义(χ2=28 189.42,P<0.001)。见图2
通过ArcGIS 10.2软件对2016—2023年贵州省各年度肺结核报告发病率的全局自相关分析显示,2016—2023年贵州省报告发病率Moran I值均>0,除2016年、2017年外其余年份P值均小于0.05,提示2018—2023年贵州省肺结核报告发病率呈空间聚集性分布,Moran I值总体呈上升趋势,提示聚集程度亦上升。见表5
对各县(市、区)的报告发病率进行局部自相关分析发现,“高-高”聚集区2016—2023年主要分布在贵州省西南部的黔西南州望谟县、册亨县、贞丰县,安顺市紫云县,南部的黔南州的罗甸县、镇宁县。“低-低”聚集区主要分布在贵州省中部的贵阳市的县(市、区)。详见图3表6
结核病发病是反映各地疫情水平和防治工作成效的重要指标,其通常表现出一定的时间、人群和空间等分布特征。贵州省肺结核报告发病率从2016年的130.66/10万下降至2023年的82.90/10万,年均下降速率6.82%高于国内新疆[5]、内蒙古[6]、河北[7]等地。与贵州省近年一系列防控政策与措施密切相关,一是严格贯彻落实国家关于“十二五”、“十三五”期间结核病防治规划等策略;二是逐步建立健全疾控中心、定点医院、基层医疗机构“防治管三位一体”模式和制度;三是逐步提高全省肺结核检测发现能力,全省所有县区陆续实现快速检测的分子生物学设备的配备和应用,与本研究中病原学阳性率逐步升高结果相符;四是在全省推广传染性肺结核及重症肺结核集中住院治疗策略,早期发现患者阻断疫情进一步传播;五是贵州省关于肺结核医疗政策的改革突破,减轻了患者经济负担,确保患者全疗程规范治疗进一步提升成功治疗水平等。但全省报告发病率长期位居全国前列,年均发病率仍高于国内大部分地区,同时与国家在《遏制结核病行动计划2019—2022年》中提出到2022年全国肺结核发病降至55/10万的目标相差甚远[8],提示全省肺结核防控形势仍需重点关注。
研究发现,不同性别和年龄组人群发病呈下降趋势,与全省总体发病一致,但男性、≥60岁、农民仍是全省肺结核发病重点人群。这与男性社交范围广导致感染机会增大,以及男性吸烟饮酒等不良生活习性易影响机体免疫力导致发病有关[9-10]。贵州省由于欠发达的经济和独特的山区地理特征,导致农民基数大,且绝大部分为留守老人,同时这部分群体经济、生活、健康素养和自身机体等条件欠佳,与肺结核的感染、发生和传播均密切相关[11-12],导致≥60岁、农民成为全省肺结核重点发病人群。全省已从2022年起,将老年人结核病筛查纳入“政府民生实事”,每年在全省各县区/乡镇开展老年人免费筛查252万余人,力争更大力度发现和控制老年肺结核疫情。另外,在职业分布中,医务人员和教师群体构成不断增加。有学者认为,由于医务人员与(疑似)结核病患者大量接触,较普通人群更易感染结核[13],而教师作为学校特殊群体,学校是疫情暴发的潜在威胁[14]。建议进一步加强职工定期体检工作,杜绝学校和医院等特殊群体聚集性疫情发生。
从空间分布上看,地区分布、空间聚集分析结果均显示,全省各县(市、区)发病分布不均匀,相关研究认为[15-18]这与各地不同的经济、居民生活与文化、医疗水平和地理等特征相关。高发病和聚集地区整体集中在黔西南州的望谟县、册亨县、贞丰县,安顺市的紫云县和黔南州的罗甸县、镇宁县等地,这些县区大部分经济、医疗和居民生活等水平较落后,且处于省界边界,不利于结核病的防治。与此相反,贵州省省会城市贵阳市的县区经济水平、发展速度、居民生活和医疗水平等条件相对较高,是全省肺结核低流行和低聚集地区。
综上,贵州省肺结核发病率总体呈下降趋势,但当前防控形势依然严峻。其中,男性、≥60岁和农民是重点发病人群,医务人员和教师患者不断增多,肺结核发病的高聚集区为经济和医疗水平普遍较落后的望谟、册亨等县区。为此,建议提升对以上重点人群和地区的重视,对经济和医疗落后的地区和人群,加大防治经费的投入提升防治工作效力;结合“政府民生实事”老年人免费结核病筛查和基本公共卫生服务工作,进一步提升老年人群肺结核筛查和管理工作;加强职工定期体检,充分发现医务人员和教师病例,降低聚集性疫情发生风险。充分利用全省肺结核发病的特征,继续深入探索其影响因素,制定更有针对性的防控措施,降低全省肺结核发病风险。
  • 贵州省发改委省级基本建设前期工作项目(2020-181-131)
  • 贵州省疾病预防控制中心2024年青年科学基金项目(2024-E-7)
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2025年第52卷第4期
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doi: 10.20043/j.cnki.MPM.202410212
  • 接收时间:2024-10-16
  • 首发时间:2026-03-18
  • 出版时间:2025-02-25
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  • 收稿日期:2024-10-16
基金
贵州省发改委省级基本建设前期工作项目(2020-181-131)
贵州省疾病预防控制中心2024年青年科学基金项目(2024-E-7)
作者信息
    1.贵州省疾病预防控制中心结核病防治研究所,贵州 贵阳 550004
    2.贵州医科大学公共卫生与健康学院

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李进岚,E-mail:
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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