The incidence and risk factors of tuberculosis in Mianyang in Sichuan Province_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Xuan ¹ , ZHU Xia ² , SUN Hongying ³ , WANG Xiaoli ⁴ , WANG Liping ⁵ , WANG Ting ¹ , HUANG Weiwei ¹ , LIANG Zongan ¹ , WANG Gang ¹ ,  JI Yulin ¹

1. Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. Center of Infectious Disease, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
3. Center for Disease Control and Prevention of Mianyang, Mianyang 621000, P.R.China;
4. Center for Disease Control and Prevention of Fucheng, Mianyang 621000, P.R.China;
5. Center for Disease Control and Prevention of Jiangyou, Jiangyou 621700, P.R.China;

Corresponding author：

JI Yulin, Email: 790754788@qq.com

Keywords：

Active case finding; Tuberculosis; Incidence; Risk factor

DOI：

10.7507/1672-2531.202101013

Video：

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Objective To analyze the incidence and risk factors of tuberculosis in the city of Mianyang based on data from active cases.Methods From March 2018 to April 2019, 199 182 residents were selected for the study. Data were collected using a questionnaire, digital radiography (DR), physical examination and laboratory tests. The incidence of tuberculosis was estimated, and multivariate logistic regression was used to identify factors associated with the disease.Results Throughout the process, 103 residents were diagnosed with active tuberculosis, corresponding to an incidence of 51.71 per 100 000. Risk of tuberculosis was significantly higher among individuals who were over age 60 (OR=1.74, 95%CI 1.11 to 2.73, P=0.02), males (OR=4.39, 95%CI 2.74 to 7.04, P<0.001), medical workers (OR=11.18, 95%CI 2.99 to 41.84, P<0.001), and those with a history of tuberculosis (OR=16.43, 95%CI 8.10 to 33.33, P<0.001). Conversely, individuals with higher levels of education were associated with lower risk of tuberculosis: compared to those with primary school or less, those with a junior high school education had an OR of 0.53 (95%CI 0.30 to 0.88, P=0.02); high school/technical school had an OR of 0.36 (95%CI 0.15 to 0.92, P=0.03); junior college or above had an OR of 0.23 (95%CI 0.06 to 0.88, P=0.04).Conclusions Analyzing tuberculosis epidemiology based on active cases can help detect the disease as well as control or even prevent epidemics. Individuals who are more senior, males, medical workers, with a history of tuberculosis, and those with lower levels of education may be at higher risk of the disease. These results may improve screening efforts and allow timely intervention.

Citation： ZHANG Xuan, ZHU Xia, SUN Hongying, WANG Xiaoli, WANG Liping, WANG Ting, HUANG Weiwei, LIANG Zongan, WANG Gang, JI Yulin. The incidence and risk factors of tuberculosis in Mianyang in Sichuan Province. Chinese Journal of Evidence-Based Medicine, 2021, 21(6): 642-647. doi: 10.7507/1672-2531.202101013 Copy

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2.	国家统计局. 2019年度甲乙类传染病报告发病人数和死亡人数. Available from: https://data.stats.gov.cn/easyquery.htm?cn=C01.
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7.	瞿媛, 普丽, 苏丽敏, 等. 玉溪市红塔区重点人群肺结核主动筛查模式探究. 实用预防医学, 2017, 24(8): 971-973.
8.	Lönnroth K, Castro KG, Chakaya JM, et al. Tuberculosis control and elimination 2010-50: cure, care, and social development. Lancet, 2010, 375(9728): 1814-1829.
9.	WHO Policy on Collaborative TB/HIV. Activities: guidelines for national programmes and other stakeholders. Geneva: World Health Organization, 2012.
10.	彭红, 许卫国, 翟祥军, 等. 江苏农村社区一般人群胸部X线摄片主动筛查肺结核的效果评估. 中国防痨杂志, 2014, 36(12): 1029-1035.
11.	张伟. DR系统胸部摄影在肺结核病筛查中的应用价值分析. 心理医生, 2018, 24(1): 45-46.
12.	黄维维, 孙宏英, 陈建, 等. 四川省绵阳市肺结核流行现状及危险因素研究. 中国呼吸与危重监护杂志, 2015, 14(4): 354-357.
13.	Holmes CB, Hausler H, Nunn P. A review of sex differences in the epidemiology of tuberculosis. Int J Tuberc Lung Dis, 1998, 2(2): 96-104.
14.	Diwan VK, Thorson A. Sex, gender, and tuberculosis. Lancet, 1999, 353(9157): 1000-1001.
15.	Wang J, Fei Y, Shen H, et al. Gender difference in knowledge of tuberculosis and associated health-care seeking behaviors: a cross-sectional study in a rural area of China. BMC Public Health, 2008, 8: 354.
16.	王永坡. 唐河县肺结核病流行病学特征调查及发病的危险因素分析. 中国初级卫生保健, 2020, 34(12): 53-55.
17.	吴纪明, 曹蕾, 陈敬义, 等. 湖北省鄂州市2011-2017年肺结核发病情况流行病学特征. 中国热带医学, 2019, 19(5): 454-458.
18.	Yan F, Thomson R, Tang S, et al. Multiple perspectives on diagnosis delay for tuberculosis from key stakeholders in poor rural China: case study in four provinces. Health Policy, 2007, 82(2): 186-199.
19.	Odone A, Tillmann T, Sandgren A, et al. Tuberculosis among migrant populations in the European Union and the European Economic Area. Eur J Public Health, 2015, 25(3): 506-512.
20.	Rhines AS. The role of sex differences in the prevalence and transmission of tuberculosis. Tuberculosis (Edinb), 2013, 93(1): 104-107.
21.	谭卫国, 管红云, 吴清芳, 等. 流动人口结核病防控创新策略与实施效果. 新发传染病电子杂志, 2020, 5(3): 145-149.
22.	Lienhardt C, Fielding K, Sillah JS, et al. Investigation of the risk factors for tuberculosis: a case-control study in three countries in West Africa. Int J Epidemiol, 2005, 34(4): 914-923.
23.	杨凯璇, 费丽萍, 寇新荣, 等. 中国15岁以上人群结核病发病危险因素meta分析. 实用预防医学, 2018, 25(1): 3-6.
24.	Karolemeas K, McKinley TJ, Clifton-Hadley RS, et al. Recurrence of bovine tuberculosis breakdowns in Great Britain: risk factors and prediction. Prev Vet Med, 2011, 102(1): 22-29.
25.	邓敏. 浙江省结核病防治示范区规模化现场流行病学调查及发病危险因素分析. 杭州: 浙江大学, 2014.
26.	Joshi R, Narang U, Zwerling A, et al. Predictive value of latent tuberculosis tests in Indian healthcare workers: a cohort study. Eur Respir J, 2011, 38(6): 1475-1477.
27.	Mathew A, David T, Thomas K, et al. Risk factors for tuberculosis among health care workers in South India: a nested case-control study. J Clin Epidemiol, 2013, 66(1): 67-74.
28.	张思潮, 王伟洪, 钟剑峰, 等. 湖州市结核病防治医务人员结核病感染现状调查研究. 中华预防医学杂志, 2017, 12(18): 902-905.

1. World Health Organization. Global tuberculosis report 2020. Available from: https://apps.who.int/iris/handle/10665/336069.
2. 国家统计局. 2019年度甲乙类传染病报告发病人数和死亡人数. Available from: https://data.stats.gov.cn/easyquery.htm?cn=C01.
3. World Health Organization. Find, Treat, All, #End TB. Available at: https://www.who.int/initiatives/find-treat-all-endtb/immediate-next-steps.
4. 全国第五次结核病流行病学抽样调查技术指导组, 全国第五次结核病流行病学抽样调查办公室. 2010年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34(8): 485-508.
5. 中华人民共和国国家卫生健康委员会. 中华人民共和国卫生行业标准-肺结核诊断(WS 288-2017). Available at: http://www.nhc.gov.cn/wjw/s9491/201712/a452586fd21d4018b0ebc00b89c06254.shtml.
6. 国家统计局. 中国2010年人口普查资料. Available at: http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
7. 瞿媛, 普丽, 苏丽敏, 等. 玉溪市红塔区重点人群肺结核主动筛查模式探究. 实用预防医学, 2017, 24(8): 971-973.
8. Lönnroth K, Castro KG, Chakaya JM, et al. Tuberculosis control and elimination 2010-50: cure, care, and social development. Lancet, 2010, 375(9728): 1814-1829.
9. WHO Policy on Collaborative TB/HIV. Activities: guidelines for national programmes and other stakeholders. Geneva: World Health Organization, 2012.
10. 彭红, 许卫国, 翟祥军, 等. 江苏农村社区一般人群胸部X线摄片主动筛查肺结核的效果评估. 中国防痨杂志, 2014, 36(12): 1029-1035.
11. 张伟. DR系统胸部摄影在肺结核病筛查中的应用价值分析. 心理医生, 2018, 24(1): 45-46.
12. 黄维维, 孙宏英, 陈建, 等. 四川省绵阳市肺结核流行现状及危险因素研究. 中国呼吸与危重监护杂志, 2015, 14(4): 354-357.
13. Holmes CB, Hausler H, Nunn P. A review of sex differences in the epidemiology of tuberculosis. Int J Tuberc Lung Dis, 1998, 2(2): 96-104.
14. Diwan VK, Thorson A. Sex, gender, and tuberculosis. Lancet, 1999, 353(9157): 1000-1001.
15. Wang J, Fei Y, Shen H, et al. Gender difference in knowledge of tuberculosis and associated health-care seeking behaviors: a cross-sectional study in a rural area of China. BMC Public Health, 2008, 8: 354.
16. 王永坡. 唐河县肺结核病流行病学特征调查及发病的危险因素分析. 中国初级卫生保健, 2020, 34(12): 53-55.
17. 吴纪明, 曹蕾, 陈敬义, 等. 湖北省鄂州市2011-2017年肺结核发病情况流行病学特征. 中国热带医学, 2019, 19(5): 454-458.
18. Yan F, Thomson R, Tang S, et al. Multiple perspectives on diagnosis delay for tuberculosis from key stakeholders in poor rural China: case study in four provinces. Health Policy, 2007, 82(2): 186-199.
19. Odone A, Tillmann T, Sandgren A, et al. Tuberculosis among migrant populations in the European Union and the European Economic Area. Eur J Public Health, 2015, 25(3): 506-512.
20. Rhines AS. The role of sex differences in the prevalence and transmission of tuberculosis. Tuberculosis (Edinb), 2013, 93(1): 104-107.
21. 谭卫国, 管红云, 吴清芳, 等. 流动人口结核病防控创新策略与实施效果. 新发传染病电子杂志, 2020, 5(3): 145-149.
22. Lienhardt C, Fielding K, Sillah JS, et al. Investigation of the risk factors for tuberculosis: a case-control study in three countries in West Africa. Int J Epidemiol, 2005, 34(4): 914-923.
23. 杨凯璇, 费丽萍, 寇新荣, 等. 中国15岁以上人群结核病发病危险因素meta分析. 实用预防医学, 2018, 25(1): 3-6.
24. Karolemeas K, McKinley TJ, Clifton-Hadley RS, et al. Recurrence of bovine tuberculosis breakdowns in Great Britain: risk factors and prediction. Prev Vet Med, 2011, 102(1): 22-29.
25. 邓敏. 浙江省结核病防治示范区规模化现场流行病学调查及发病危险因素分析. 杭州: 浙江大学, 2014.
26. Joshi R, Narang U, Zwerling A, et al. Predictive value of latent tuberculosis tests in Indian healthcare workers: a cohort study. Eur Respir J, 2011, 38(6): 1475-1477.
27. Mathew A, David T, Thomas K, et al. Risk factors for tuberculosis among health care workers in South India: a nested case-control study. J Clin Epidemiol, 2013, 66(1): 67-74.
28. 张思潮, 王伟洪, 钟剑峰, 等. 湖州市结核病防治医务人员结核病感染现状调查研究. 中华预防医学杂志, 2017, 12(18): 902-905.

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