To retrospectively analyze the epidemiological characteristics and treatment outcomes of patients with recurrent pulmonary tuberculosis in Shaanxi Province from 2011 to 2024, so as to provide a scientific basis for the prevention and control of recurrent pulmonary tuberculosis and the formulation of relevant strategies in Shaanxi Province.

The medical records of all patients with recurrent pulmonary tuberculosis registered in the Tuberculosis Information Management System (TIMS) of Shaanxi Province from 2011 to 2024 were collected. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of the subjects, chi-square test was used for inter-group comparison, and Joinpoint regression model was applied for time trend analysis.

A total of 11 715 patients with recurrent pulmonary tuberculosis were cumulatively reported in Shaanxi Province from 2011 to 2024. The registration rate of recurrent pulmonary tuberculosis in the province decreased from 3.94/100 000 population in 2011 to 1.46/100 000 population in 2024, showing an overall significant downward trend (AAPC=-8.6%, P<0.05). The composition of patient detection sources underwent a fundamental shift: the dominant detection route changed from “direct consultation” (accounting for 52.45% in 2011) to “referral”(with the proportion peaking at 73.13% in 2020). During the study period, the cumulative etiologically positive rate of recurrent patients was 56.18%, which was significantly higher than 35.91% of all notified pulmonary tuberculosis patients in the general population, with a statistically significant difference (χ²=1 983.846, P<0.05). The demographic characteristics showed that patients with recurrent pulmonary tuberculosis were predominantly concentrated in male farmers aged 40-64 years, accounting for a cumulative 36.46% of all enrolled subjects. Meanwhile, although the average annual consultation delay rate of recurrent patients was 56.93%, it showed a significant continuous downward trend during the study period (AAPC=-2.50%, P<0.05). Treatment outcome analysis showed that the cumulative treatment success rate of patients with recurrent pulmonary tuberculosis from 2011 to 2024 was 82.41%, while Joinpoint regression indicated a significant downward trend of this rate (AAPC=-1.43%, P<0.05).

The epidemic of recurrent pulmonary tuberculosis in Shaanxi Province has shown an overall downward trend, but the etiologically positive rate is significantly higher than that of all notified pulmonary tuberculosis patients, and the composition of patient detection sources has changed dramatically. Recurrent patients are concentrated in middle-aged and elderly male farmers, and the treatment success rate is on a downward trend, suggesting that there are still weak links in the treatment and management of recurrent patients. It is recommended to strengthen active screening and health management for high-risk groups such as farmers, optimize the referral network to reduce consultation delay, and improve the quality of treatment and management for recurrent patients to increase the treatment success rate.