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Article(id=1325530200049730060, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325530078536553117, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025276, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1747929600000, receivedDateStr=2025-05-23, revisedDate=1751904000000, revisedDateStr=2025-07-08, acceptedDate=null, acceptedDateStr=null, onlineDate=1793960626852, onlineDateStr=2026-11-06, pubDate=1758729600000, pubDateStr=2025-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793960626852, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793960626852, creator=13701087609, updateTime=1793960626852, updator=13701087609, issue=Issue{id=1325530078536553117, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='9', pageStart='1217', pageEnd='1368', issueExtLink='null', onlineDate='null', pubDate='1758729600000', pubDateStr='2025-09-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793960597879, creator='13701087609', updateTime=1793960597879, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1346, endPage=1350, ext={EN=ArticleExt(id=1325530200288805389, articleId=1325530200049730060, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Epidemiological characteristics analysis of pulmonary tuberculosis among children aged 0-14 in Shaanxi Province from 2010 to 2024, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
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 (χtrend2=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.

, authors=Zhiqiang HE, Yan ZHAO*, Kaikai LI, Hongwei ZHANG, authorsList=Zhiqiang HE, Yan ZHAO, Kaikai LI, Hongwei ZHANG, authorCompany=null, correspAuthors=Yan ZHAO, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325530201010225680, articleId=1325530200049730060, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=陕西省2010—2024年0~14岁儿童肺结核流行特征分析, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
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。

, authors=贺志强, 赵燕*, 李凯凯, 张宏伟, authorsList=贺志强, 赵燕, 李凯凯, 张宏伟, authorCompany=null, correspAuthors=赵燕, authorNote=

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

, correspAuthorsNote=
赵燕，E-mail：
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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

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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

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(in Chinese), articleTitle=null, refAbstract=null), Reference(id=1325530213756715618, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=22, rfOrder=39, authorNames=null, journalName=null, refType=null, unstructuredReference=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., articleTitle=null, refAbstract=null), Reference(id=1325530213828018787, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=22, rfOrder=40, authorNames=null, journalName=null, refType=null, unstructuredReference=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), articleTitle=null, refAbstract=null)], funds=[Fund(id=1325530205682680378, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, awardId=null, language=CN, fundingSource=陕西省卫生健康科研基金项目(2022B007), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325530201341575697, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, xref=null, ext=[AuthorCompanyExt(id=1325530201358352914, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, companyId=1325530201341575697, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Institute for Tuberculosis and Leprosy Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, Shaanxi Province, China), AuthorCompanyExt(id=1325530201370935827, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, companyId=1325530201341575697, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=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)])], figs=[ArticleFig(id=1325530204902539826, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, language=EN, label=Fig.1, caption=Time series of reported tuberculosis cases among children aged 0-14 in Shaanxi Province from 2010 to 2024, figureFileSmall=ZahEJn7XJNe+0dsUH8rFDA==, figureFileBig=OlZzg5OS0EFYQG/I79AglA==, tableContent=null), ArticleFig(id=1325530204994814515, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, language=CN, label=图1, caption=陕西省2010—2024年0~14岁儿童肺结核报告发病数时间序列, figureFileSmall=ZahEJn7XJNe+0dsUH8rFDA==, figureFileBig=OlZzg5OS0EFYQG/I79AglA==, tableContent=null), ArticleFig(id=1325530205204529716, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, language=EN, label=Tab.1, caption=

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

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年份0~4岁5~9岁10~14岁合计
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
201024.6639(1.58)20.6864(3.09)20.24248(12.25)65.59351(5.35)
201120.7432(1.54)17.4034(1.95)16.99141(8.30)55.13207(3.75)
201218.6324(1.29)17.9828(1.56)17.95132(7.35)54.56184(3.37)
201319.1118(0.94)19.6423(1.17)15.9796(6.01)54.73137(2.50)
201419.9615(0.75)19.8831(1.56)15.42126(8.17)55.26172(3.11)
201520.0118(0.90)19.9428(1.40)15.49147(9.49)55.43193(3.48)
201619.9717(0.85)19.8319(0.96)15.43135(8.75)55.23171(3.10)
201719.4421(1.08)19.3429(1.50)15.02164(10.92)53.80214(3.98)
201821.6818(0.83)21.5548(2.23)16.73142(8.49)59.96208(3.47)
201920.9116(0.77)17.7032(1.81)17.79167(9.39)56.40215(3.81)
202021.0815(0.71)18.1917(0.93)17.71187(10.56)56.97219(3.84)
202122.3418(0.81)23.8424(1.01)22.35160(7.16)68.52202(2.95)
202220.2712(0.59)25.0823(0.92)22.19109(4.91)67.54144(2.13)
202318.2611(0.60)24.8527(1.09)23.37143(6.12)66.48181(2.72)
202416.5414(0.85)24.3119(0.78)23.99123(5.13)64.84156(2.41)
合计303.59288(0.95)310.22446(1.44)276.642 220(8.02)890.452 954(3.32)
), ArticleFig(id=1325530205280027189, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, language=CN, label=表1, caption=

陕西省2010—2024年0~14岁儿童肺结核报告发病率和变化趋势

, figureFileSmall=null, figureFileBig=null, tableContent=
年份0~4岁5~9岁10~14岁合计
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
201024.6639(1.58)20.6864(3.09)20.24248(12.25)65.59351(5.35)
201120.7432(1.54)17.4034(1.95)16.99141(8.30)55.13207(3.75)
201218.6324(1.29)17.9828(1.56)17.95132(7.35)54.56184(3.37)
201319.1118(0.94)19.6423(1.17)15.9796(6.01)54.73137(2.50)
201419.9615(0.75)19.8831(1.56)15.42126(8.17)55.26172(3.11)
201520.0118(0.90)19.9428(1.40)15.49147(9.49)55.43193(3.48)
201619.9717(0.85)19.8319(0.96)15.43135(8.75)55.23171(3.10)
201719.4421(1.08)19.3429(1.50)15.02164(10.92)53.80214(3.98)
201821.6818(0.83)21.5548(2.23)16.73142(8.49)59.96208(3.47)
201920.9116(0.77)17.7032(1.81)17.79167(9.39)56.40215(3.81)
202021.0815(0.71)18.1917(0.93)17.71187(10.56)56.97219(3.84)
202122.3418(0.81)23.8424(1.01)22.35160(7.16)68.52202(2.95)
202220.2712(0.59)25.0823(0.92)22.19109(4.91)67.54144(2.13)
202318.2611(0.60)24.8527(1.09)23.37143(6.12)66.48181(2.72)
202416.5414(0.85)24.3119(0.78)23.99123(5.13)64.84156(2.41)
合计303.59288(0.95)310.22446(1.44)276.642 220(8.02)890.452 954(3.32)
), ArticleFig(id=1325530205355524662, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, language=EN, label=Tab.2, caption=

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

, figureFileSmall=null, figureFileBig=null, tableContent=
年份男生女生
人数/105报告发病率人数/105报告发病率
201034.98199(5.69)30.61152(4.97)
201129.46120(4.07)25.6687(3.39)
201229.47107(3.63)25.0977(3.07)
201329.3974(2.52)25.3463(2.49)
201429.6892(3.10)25.5880(3.13)
201529.82106(3.55)25.6287(3.40)
201629.5488(2.98)25.6983(3.23)
201728.87128(4.43)24.9386(3.45)
201832.16111(3.45)27.7997(3.49)
201930.04100(3.33)26.36115(4.36)
202030.42102(3.35)26.56117(4.41)
202136.3889(2.45)32.14113(3.52)
202235.3170(1.98)32.2274(2.30)
202334.7395(2.74)31.7586(2.71)
202433.9060(1.77)30.9596(3.10)
合计474.151 541(3.25)416.301 413(3.39)
), ArticleFig(id=1325530205431022135, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, language=CN, label=表2, caption=

陕西省2010—2024年0~14岁儿童不同性别间肺结核报告发病率

, figureFileSmall=null, figureFileBig=null, tableContent=
年份男生女生
人数/105报告发病率人数/105报告发病率
201034.98199(5.69)30.61152(4.97)
201129.46120(4.07)25.6687(3.39)
201229.47107(3.63)25.0977(3.07)
201329.3974(2.52)25.3463(2.49)
201429.6892(3.10)25.5880(3.13)
201529.82106(3.55)25.6287(3.40)
201629.5488(2.98)25.6983(3.23)
201728.87128(4.43)24.9386(3.45)
201832.16111(3.45)27.7997(3.49)
201930.04100(3.33)26.36115(4.36)
202030.42102(3.35)26.56117(4.41)
202136.3889(2.45)32.14113(3.52)
202235.3170(1.98)32.2274(2.30)
202334.7395(2.74)31.7586(2.71)
202433.9060(1.77)30.9596(3.10)
合计474.151 541(3.25)416.301 413(3.39)
), ArticleFig(id=1325530205506519608, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, language=EN, label=Tab.3, caption=

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

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组/岁第一阶段第二阶段第三阶段
年份APC值(95%CI)P值年份APC值(95%CI)P值年份APC值(95%CI)P值
0~42010—2014-15.43%(-32.00%~-5.40%)< 0.012014—2024-0.75%(-3.77%~11.20%)0.91———
5~92010—2024-5.80%(-9.62%~-1.90%)< 0.01——————
10~142010—2013-17.27%(-35.38%~-1.88%)0.042013—201715.04%(1.92%~34.48%)0.042017—2024-10.55%(-19.10%~-6.09%)0.02
), ArticleFig(id=1325530205590405689, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325530200049730060, language=CN, label=表3, caption=

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

, figureFileSmall=null, figureFileBig=null, tableContent=
年龄组/岁第一阶段第二阶段第三阶段
年份APC值(95%CI)P值年份APC值(95%CI)P值年份APC值(95%CI)P值
0~42010—2014-15.43%(-32.00%~-5.40%)< 0.012014—2024-0.75%(-3.77%~11.20%)0.91———
5~92010—2024-5.80%(-9.62%~-1.90%)< 0.01——————
10~142010—2013-17.27%(-35.38%~-1.88%)0.042013—201715.04%(1.92%~34.48%)0.042017—2024-10.55%(-19.10%~-6.09%)0.02
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陕西省2010—2024年0~14岁儿童肺结核流行特征分析
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贺志强 , 赵燕 * , 李凯凯 , 张宏伟
中国学校卫生 | 疾病控制 2025,46(9): 1346-1350
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中国学校卫生 |疾病控制 2025 , 46 (9) : 1346 -1350
陕西省2010—2024年0~14岁儿童肺结核流行特征分析
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贺志强, 赵燕* , 李凯凯, 张宏伟
作者信息
  • 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
通讯作者:
赵燕，E-mail：
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

Epidemiological characteristics analysis of pulmonary tuberculosis among children aged 0-14 in Shaanxi Province from 2010 to 2024
Zhiqiang HE, Yan ZHAO* , Kaikai LI, Hongwei ZHANG
Affiliations
  • Institute for Tuberculosis and Leprosy Control and Prevention, Shaanxi Provincial Center for Disease Control and Prevention, Xi'an 710054, Shaanxi Province, China
出版时间: 2025-09-25 doi: 10.16835/j.cnki.1000-9817.2025276
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摘要
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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
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 (χtrend2=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
贺志强, 赵燕, 李凯凯, 张宏伟. 陕西省2010—2024年0~14岁儿童肺结核流行特征分析. 中国学校卫生, 2025 , 46 (9) : 1346 -1350 . DOI: 10.16835/j.cnki.1000-9817.2025276
Zhiqiang HE, Yan ZHAO, Kaikai LI, Hongwei ZHANG. Epidemiological characteristics analysis of pulmonary tuberculosis among children aged 0-14 in Shaanxi Province from 2010 to 2024[J]. Chinese Journal of School Health, 2025 , 46 (9) : 1346 -1350 . DOI: 10.16835/j.cnki.1000-9817.2025276
正文
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《2024年全球结核病报告》显示，2023年全球结核病估算发病数为1 080万例，全球结核病估算死亡数为125万例，0~14岁儿童发病数占全人群的12%[1-2]。我国2023年估算的结核病新发病例数为74.1万例，在结核病高负担国家中排第3位[3]。2023年我国报告结核病例数为572 812例，0~14岁儿童发病数仅占2%，远低于全球估算的儿童发病数的12%[4]。目前，我国儿童结核病防治工作还存在诸多挑战，提高公众对儿童结核病的关注度，加大儿童结核病防治投入，对儿童结核病控制意义深远。本研究旨在通过分析2010—2024年陕西省0~14岁儿童肺结核的流行特征和发病趋势，为优化全国儿童肺结核防控策略提供参考依据。
1　资料来源与方法
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1.1　资料来源
陕西省2010—2024年登记的0~14岁儿童肺结核病例数据和人口学资料来自“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”，导出发病日期为2010年1月1日至2024年12月31日、现住址为陕西省辖区内0~14岁的儿童肺结核患者报告发病数报表信息。
1.2　方法
采用WPS 2024软件对数据进行整理分析，计数资料用频数和率描述，组间差异比较用χ2检验，用SPSS 25.0软件做时间序列分析。利用Joinpoint Regression Program 5.4.3软件建立Joinpoint回归模型，用于分析儿童肺结核发病变化趋势，计算年度变化百分比(annual percent change, APC)及其95%置信区间(CI)，评价分段函数各独立区间的内部趋势；APC>0，表示发病率逐年递增，APC < 0，提示发病率逐年递减。检验水准α=0.05。
2　结果
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2.1　陕西省2010—2024年0~14岁儿童肺结核人群分布特征
见表1，2。
2010—2024年陕西省累计报告肺结核患者305 647例，其中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，占报告儿童患者数的27.22%(804/2 954)。病原学检查阳性患者占比从2010年的13.68%(48/351)上升到2024年的59.62%(93/156)，病原学阳性患者报告占比逐年上升(χ趋势2=420.94，P < 0.01)。男童年均报告发病率为3.25/10万，女童为3.39/10万，差异无统计学意义(χ2=2.01，P=1.00)。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5.35/10万下降到2024年的2.41/10万，Joinpiont回归模型分析结果显示，2010—2013年儿童报告发病率快速下降(APC=-20.02%，95%CI=-33.64%~-10.42%)，2013—2017年又缓慢上升(APC=11.18%，95%CI=3.07%~24.17%)，2017—2024年再缓慢下降(APC=-7.27%，95%CI=-12.73%~-4.30%)(P值均 < 0.01)。0~14岁男童报告发病率变化分3个阶段，2010—2013年快速下降，2013—2017年缓慢上升，2017—2024年又持续下降；0~14岁女童报告发病率总体呈持续下降趋势。
0~14岁儿童中，年均报告发病率最高年龄段为10~14岁(8.02/10万)，其次是5~9岁(1.44/10万)，0~4岁报告发病率最低(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)。Joinpiont回归模型分析结果显示，0~4岁儿童报告发病率整体呈下降趋势，2010—2014年下降较为明显，而2014—2024年下降较为缓慢；5~9岁儿童报告发病率年均下降5.80%，整体呈明显下降趋势；10~14岁儿童报告发病率变化趋势分3个阶段，2010—2013，2013—2017和2017—2024年呈先下降后上升，然后再下降的趋势。见表1，3。
2.2　陕西省2010—2024年0~14岁儿童肺结核发病时间分布
2010—2024年陕西省0~14岁2 954例儿童肺结核累计报告发病数比例最高的为9月(9.38%，277例)，其次是4月(9.24%，273例)，6月(9.04%，267例)，5月(8.84%，261例)，2月比例最低(6.13%，181例)，1，3，7，8，10—12月份登记比例相对稳定。见图1。
2.3　陕西省2010—2024年0~14岁儿童肺结核发病地区分布
陕西省2010—2024年0~14岁儿童肺结核累计发病数由高到低依次是西安市(678例)、榆林市(456例)、安康市(344例)、延安市(299例)、汉中市(287例)、渭南市(236例)、咸阳市(235例)、商洛市(209例)、宝鸡市(167例)和铜川市(43例)。年均报告发病率由高到低依次是安康市(5.16/10万)、延安市(4.97/10万)、榆林市(4.87/10万)、汉中市(3.69/10万)、商洛市(3.66/10万)、西安市(3.22/10万)、铜川市(2.74/10万)、咸阳市(2.07/10万)、渭南市(2.06/10万)和宝鸡市(2.05/10万)。总体来看，儿童结核病疫情的地区特点为陕北地区(榆林市，延安市)和陕南地区(汉中、安康市和商洛市)高于关中地区(西安市、咸阳市、宝鸡市、渭南市、铜川市)。
3　讨论
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本调查结果显示，2010—2024年陕西省儿童肺结核年均报告发病率为3.32/10万，与全国报告水平基本一致[5]；2010—2024年陕西省儿童肺结核报告发病率整体呈下降趋势，与陕西省对结核病防治工作的不断重视有关。陕西省先后实施了《陕西省“十二五”结核病防治规划》和陕西省《“十三五”结核病防治规划》，通过完善体系建设、理顺“防、诊、治、管、保、教”工作机制、提高病例发现水平、规范诊疗流程和推动信息化建设等措施，进一步优化防控措施[6-7]。研究期间，儿童报告病原学阳性病例逐年上升，可能与分子生物学检测技术的不断普及和改进密切相关[8]。
分性别和年龄看，男、女童报告发病率差异无统计学意义。在不同年龄组儿童中，报告发病率最高的为10~14岁，最低的是0~4岁。低龄儿童受卡介苗保护力作用较好、活动范围有限、感染机会少，而学龄儿童尤其中学生受疫苗保护力减弱、学业压力大、缺乏锻炼、社会面接触增多，使得发病风险升高[9-11]。10~14岁儿童报告发病率情况和0~14岁儿童的报告发病趋势呈一致的阶段性变化。分析2013—2017阶段，其报告发病率上升的可能原因为国家加强学校结核病防治工作，10~14岁儿童是小学高年级和中学学生群体，国家出台了一系列学校结核病防治规划和方案，加大学校结核病主动筛查工作[12-13]；陕西省也出台相应的政策规划，针对中学新生入学体检和日常健康体检中结核病的主动筛查工作和登记管理，使得此群体病例检出和登记情况上升[14]。
从病例报告时间看，儿童肺结核病例报告最多的为9月，病例最少的为2月，各年的报告发病情况无明显的周期性，与陕西省全人群发病时间的季节性不同[15]，可能与儿童每月病例数较少有关。9月报告病例多，可能与中学生入学结核病筛查工作的开展有关[16-17]。儿童作为结核发病特殊人群，临床表现不典型且儿童对疾病的感受和描述能力有限，病情大多由家长代述，报告发病时间可能滞后。而本研究发现，儿童肺结核报告发病率整体变化趋势在2020—2023年特殊时期并未受到很大影响，可能与儿童发病数本身就少有关[18]。
从病例报告地区分布看，儿童年均报告发病率最高的地区是安康市，最低的是渭南市和宝鸡市，整体疫情特点为陕北地区和陕南地区高于关中地区，与目前的研究结果一致[19-20]。陕北地区为黄土高原，冬春寒冷多风沙、经济状况差、居住场所简陋，结核杆菌的暴露风险大大增加[21]；陕南地处秦岭以南的秦巴山区，交通不便、医疗服务不均衡、就诊困难，延迟就诊的情况多见，结核病传播风险增大[22]；而关中地区地形相对平坦、交通便利、医疗资源丰富，疫情相对较低。提示要重点关注安康市等结核病高疫情地区，加强主动监测和主动筛查工作，将防治工作关口前移，减少肺结核疫情进一步传播。
综上所述，2010—2024年陕西省儿童肺结核报告发病率呈下降趋势，反映出陕西省结核病防治策略和措施效果显著。但儿童报告发病率和世界卫生组织估算的中国儿童发病率还相差甚远，所以针对不同地区和不同年龄段儿童的疫情特点，要分类施策，精准防控，加强主动监测和筛查工作以及儿童潜伏感染者的预防性治疗，多项举措齐头并进，以减少儿童肺结核的发病率。
基金
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  • 陕西省卫生健康科研基金项目(2022B007)
文献
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2025年第46卷第9期
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doi: 10.16835/j.cnki.1000-9817.2025276
  • 接收时间：2025-05-23
  • 首发时间：2026-11-06
  • 出版时间：2025-09-25
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  • 收稿日期：2025-05-23
  • 修回日期：2025-07-08
基金
陕西省卫生健康科研基金项目(2022B007)
作者信息
    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

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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
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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
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