Analysis of the reported epidemic situation of pulmonary tuberculosis in the elderly patients at West China Hospital of Sichuan University_West China Medical Journal

Authors：

ZENG Qinghui ^1,2 , HUANG Wenzhi ^1,2 , PENG Yalan ^1,2 , WANG Yantong ^1,2 , ZONG Zhiyong ¹ , CHEN Yi ² , HU Ti ³ ,  QIAO Fu ^1,2

1. Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Infection Control, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. West China School of Nursing, Sichuan University / Department of Intensive Care Unit, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

QIAO Fu, Email: 114558366@qq.com

Keywords：

Pulmonary tuberculosis; epidemic analysis; elderly

DOI：

10.7507/1002-0179.202401134

Video：

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Objective To analyze the report status of the pulmonary tuberculosis in the elderly people aged ≥ 65 years old. Methods The reported data of senile pulmonary tuberculosis and the whole population pulmonary tuberculosis at West China Hospital of Sichuan University between January 1, 2012 and December 31, 2022 were retrospective selection. Descriptive methods were used to analyze the different characteristics and etiology of senile pulmonary tuberculosis. Results A total of 2 182 senile pulmonary tuberculosis were reported. The report was mainly positive reports of etiology [1091 cases (50.00%)], and the component ratio increased year by year (χ²=49.986, P<0.001). The proportion of senile pulmonary tuberculosis in the whole population pulmonary tuberculosis increased from 17.62% in 2012 to 29.04% in 2022, and the difference between different years was statistically significant (χ²=40.261, P<0.001). In the reported patients, the male to female ratio was 2.30∶1. There were 7 cases of rifampicin resistant, 1 091 cases of etiology positivity, 674 cases of etiology negativity, and 410 cases of no etiology results. The number of reported cases in the age group of 65-74 was higher than that in the age group of 75 and above. The seasonal distribution was not obvious (concentration<0.3). The patients were mainly from other cities of the province [919 cases (42.12%)], and the Department of Pulmonary and Critical Care Medicine (including the Tuberculosis Ward) was reported the most [1439 cases (65.95%)]. The majority of occupations were retired individuals [952 cases (43.63%)]. Conclusions From 2012 to 2022, the prevention and treatment of senile pulmonary tuberculosis has achieved some results, but the overall burden is still very heavy. The detection of senile pulmonary tuberculosis should be strengthened.

Citation： ZENG Qinghui, HUANG Wenzhi, PENG Yalan, WANG Yantong, ZONG Zhiyong, CHEN Yi, HU Ti, QIAO Fu. Analysis of the reported epidemic situation of pulmonary tuberculosis in the elderly patients at West China Hospital of Sichuan University. West China Medical Journal, 2024, 39(3): 373-377. doi: 10.7507/1002-0179.202401134 Copy

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20.	Dorman SE, Schumacher SG, Alland D, et al. Xpert MTB/RIF ultra for detection of mycobacterium tuberculosis and rifampicin resistance: a prospective multicentre diagnostic accuracy study. Lancet Infect Dis, 2018, 18(1): 76-84.
21.	Ou X, Li Q, Xia H, et al. Diagnostic accuracy of the PURE-LAMP test for pulmonary tuberculosis at the county-level laboratory in China. PLoS One, 2014, 9(5): e94544.
22.	焦琳, 胡雪姣, 應斌武. 基于人工智能策略優化結核病診斷. 華西醫學, 2018, 33(8): 935-938.
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24.	鄭靜靜, 戴平一, 王斌, 等. 2016—2020 年浙江省寧海縣老年肺結核患者耐藥狀況及危險因素分析. 上海預防醫學, 2022, 34(4): 322-325.
25.	奚瑩, 唐軍, 喬瑞君, 等. 249 例老年肺結核患者耐藥狀況及產生耐多藥的危險因素分析. 中國防癆雜志, 2021, 43(6): 636-641.
26.	陳燕梅, 溫文沛, 吳惠忠, 等. 2016—2020 年廣東省結核病耐藥監測結果分析. 中國防癆雜志, 2022, 44(7): 685-689.
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29.	蘇華林, 唐利紅, 馬瓊錦, 等. 2009—2019 年上海市閔行區肺結核流行特征分析. 公共衛生與預防醫學, 2020, 31(6): 71-74.
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31.	Murali S, Krishnamoorthy Y, Knudsen S, et al. Comparison of profile and treatment outcomes between elderly and non-elderly tuberculosis patients in Puducherry and Tamil Nadu, South India. PLoS One, 2021, 16(8): e0256773.
32.	楊瑩, 房云霞, 翟亞楠, 等. 國內老年結核病流行病學研究現狀. 醫學動物防制, 2023, 39(1): 82-85.
33.	Zhang H, Xin H, Li X, et al. A dose-response relationship of smoking with tuberculosis infection: a cross-sectional study among 21008 rural residents in China. PLoS One. PLoS One, 2017, 12(4): e0175183.
34.	GBD Tuberculosis Collaborators. The global burden of tuberculosis: results from the global burden of disease study 2015. Lancet Infect Dis, 2018, 18(3): 261-284.
35.	Takahashi T, Sex differences in immune responses. Science, 2021, 371(6527): 347-348.
36.	Zhang CY, Zhao F, Xia YY, et al. Prevalence and risk factors of active pulmonary tuberculosis among elderly people in China: a population based cross-sectional study. Infect Dis Poverty, 2019, 8(1): 7.
37.	Koo HK, Min J, Kim HW, et al. Prediction of treatment failure and compliance in patients with tuberculosis. BMC Infect Dis, 2020, 20(1): 622.
38.	Wang Y, Gan Y, Zhang J, et al. Analysis of the current status and associated factors of tuberculosis knowledge, attitudes, and practices among elderly people in Shenzhen: a cross-sectional study. BMC Public Health, 2021, 21(1): 1163.
39.	Pengpid S, Peltzer K. Knowledge, attitudes, and practices regarding tuberculosis in timor-leste: results from the demographic and health survey 2016. J Prev Med Public Health, 2019, 52(2): 115-122.
40.	李婷, 劉雙, 逯嘉, 等. 2011—2020 年四川省肺結核發病年齡變化趨勢分析. 中國防癆雜志, 2022, 44(8): 808-814.
41.	余雅, 胡代玉, 吳成果, 等. 重慶市 2011—2018 年貧困區縣肺結核流行特征. 中國熱帶醫學, 2020, 20(5): 429-433.
42.	張燦有, 陳卉, 張慧, 等. 2011—2020 年全國 65 歲及以上老年人肺結核報告發病情況分析. 中華疾病控制雜志, 2022, 26(11): 1252-1258.
43.	熊自超, 陳錦峰, 郭庚秀. 2015—2019 年某三甲綜合性醫院呼吸道傳染病臨床分布特征. 解放軍預防醫學雜志, 2020, 38(9): 107-110.
44.	鄭珍慧, 江巧敏, 張尊敬. 基于傾向性評分法評估耐藥肺結核患者疾病感知與服藥依從性的相關性. 中國全科醫學雜志, 2023, 21(11): 1872-1875.

1. 宋敏, 陸普選, 方偉軍, 等. 2022 年 WHO 全球結核病報告: 全球與中國關鍵數據分析. 新發傳染病電子雜志, 2023, 8(1): 87-92.
2. Murray CJ, Ortblad KF, Guinovart C, et al. Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet, 2014, 384(9947): 1005-1070.
3. 譚文倩, 萬燕萍, 龔德華, 等. 2020 年湖南省老年肺結核患者流行特征及就診情況分析. 實用預防醫學, 2022, 29(12): 1473-1476.
4. World Health Organization. Global tuberculosis report 2021. Geneva: World Health Organization, 2021.
5. 魯周琴, 張正斌, 王曉君, 等. 2016—2020 年武漢市老年肺結核疫情特征分析. 公共衛生與預防醫學, 2023, 34(1): 35-38.
6. 張亞敬, 姜影, 孫浩, 等. 154 例老年肺結核患者的發現與治療轉歸情況分析. 結核與肺部疾病雜志, 2023, 4(1): 48-53.
7. 國務院辦公廳. 國務院辦公廳關于印發“十三五”全國結核病防治規劃的通知. 中華人民共和國國務院公報, 2017(7): 32-37.
8. 中華醫學會結核病學分會. 老年肺結核診斷與治療專家共識(2023 版). 中華結核和呼吸雜志, 2023, 46(11): 1068-1084.
9. Gardner Toren K, Spitters C, Pecha M, et al. Tuberculosis in older adults: Seattle and King county, Washington. Clin Infect Dis, 2020, 70(6): 1202-1207.
10. Sharma M, Onozaki I, Nunn P. TB in older people in Asia: why it is important. Int J Tubere Lung Dis, 2021, 25(7): 521-524.
11. 王榮, 楊晨, 苗瑞芬, 等. 南京市 2011—2019 年≥65 歲老年肺結核病例特征分析. 華南預防醫學, 2021, 47(11): 1470-1473.
12. 中華人民共和國國家衛生和計劃生育委員會. 肺結核診斷標準(WS288-2017). 新發傳染病電子雜志, 2018, 3(1): 59-61.
13. 國家衛生健康委辦公廳. 國家衛生健康委辦公廳關于調整肺結核傳染病報告分類的通知. (2019-03-21)[2024-01-03]. http://www.nhc.gov.cn/jkj/s3589/201903/d779ae48db6446c28d1f5371ef09f5ab.shtml.
14. 國家衛生計生委辦公廳. 國家衛生計生委辦公廳關于印發傳染病信息報告管理規范(2015 年版)的通知. 中華人民共和國國家衛生和計劃生育委員會公報, 2015(10): 36-42.
15. 郭祖超. 醫用數理統計方法. 3 版. 北京: 人民衛生出版社, 1988.
16. 國家衛生健康委, 國家發展改革委, 教育部, 等. 關于印發遏制結核病行動計劃(2019—2022 年)的通知. 中華人民共和國國家衛生健康委員會公報, 2019(Z1): 13-17.
17. 謝瑋, 方怡, 雷宇, 等. 2014—2019 年廣州市老年肺結核疫情特征. 熱帶醫學雜志, 2021, 21(8): 1069-1073.
18. 滕人聰, 李濤, 李玉紅, 等. 2015—2021 年全國 65 歲及以上老年肺結核患者登記情況分析. 中國防癆雜志, 2023, 45(4): 367-371.
19. Kuznetsov VN, Grjibovski AM, Mariandyshev AO, et al. A comparison between passive and active case finding in TB control in the Arkhangelsk region. Int J Cireumpolar Health, 2014, 73: 23515.
20. Dorman SE, Schumacher SG, Alland D, et al. Xpert MTB/RIF ultra for detection of mycobacterium tuberculosis and rifampicin resistance: a prospective multicentre diagnostic accuracy study. Lancet Infect Dis, 2018, 18(1): 76-84.
21. Ou X, Li Q, Xia H, et al. Diagnostic accuracy of the PURE-LAMP test for pulmonary tuberculosis at the county-level laboratory in China. PLoS One, 2014, 9(5): e94544.
22. 焦琳, 胡雪姣, 應斌武. 基于人工智能策略優化結核病診斷. 華西醫學, 2018, 33(8): 935-938.
23. 陳雪融. 新中國成立 70 年結核防治成就. 現代預防醫學, 2019, 46(15): 2689-2691,2700.
24. 鄭靜靜, 戴平一, 王斌, 等. 2016—2020 年浙江省寧海縣老年肺結核患者耐藥狀況及危險因素分析. 上海預防醫學, 2022, 34(4): 322-325.
25. 奚瑩, 唐軍, 喬瑞君, 等. 249 例老年肺結核患者耐藥狀況及產生耐多藥的危險因素分析. 中國防癆雜志, 2021, 43(6): 636-641.
26. 陳燕梅, 溫文沛, 吳惠忠, 等. 2016—2020 年廣東省結核病耐藥監測結果分析. 中國防癆雜志, 2022, 44(7): 685-689.
27. 范琳, 劉一典, 肖和平. 國內《耐藥結核病化學治療指南(2019 年)》與相關共識的特色及要點分析. 中國防癆雜志, 2020, 42(2): 91-94.
28. 郭海萍, 逄宇. 全面落實肺結核診斷國家行業標準提高分子技術診斷耐藥結核病能力. 結核與肺部疾病雜志, 2020, 1(3): 103-105.
29. 蘇華林, 唐利紅, 馬瓊錦, 等. 2009—2019 年上海市閔行區肺結核流行特征分析. 公共衛生與預防醫學, 2020, 31(6): 71-74.
30. Yew WW, Yoshiyama T, Leung CC, et al. Epidemiological, clinical and mechanistic perspectives of tuberculosis in older people. Respirology, 2018, 23(6): 567-575.
31. Murali S, Krishnamoorthy Y, Knudsen S, et al. Comparison of profile and treatment outcomes between elderly and non-elderly tuberculosis patients in Puducherry and Tamil Nadu, South India. PLoS One, 2021, 16(8): e0256773.
32. 楊瑩, 房云霞, 翟亞楠, 等. 國內老年結核病流行病學研究現狀. 醫學動物防制, 2023, 39(1): 82-85.
33. Zhang H, Xin H, Li X, et al. A dose-response relationship of smoking with tuberculosis infection: a cross-sectional study among 21008 rural residents in China. PLoS One. PLoS One, 2017, 12(4): e0175183.
34. GBD Tuberculosis Collaborators. The global burden of tuberculosis: results from the global burden of disease study 2015. Lancet Infect Dis, 2018, 18(3): 261-284.
35. Takahashi T, Sex differences in immune responses. Science, 2021, 371(6527): 347-348.
36. Zhang CY, Zhao F, Xia YY, et al. Prevalence and risk factors of active pulmonary tuberculosis among elderly people in China: a population based cross-sectional study. Infect Dis Poverty, 2019, 8(1): 7.
37. Koo HK, Min J, Kim HW, et al. Prediction of treatment failure and compliance in patients with tuberculosis. BMC Infect Dis, 2020, 20(1): 622.
38. Wang Y, Gan Y, Zhang J, et al. Analysis of the current status and associated factors of tuberculosis knowledge, attitudes, and practices among elderly people in Shenzhen: a cross-sectional study. BMC Public Health, 2021, 21(1): 1163.
39. Pengpid S, Peltzer K. Knowledge, attitudes, and practices regarding tuberculosis in timor-leste: results from the demographic and health survey 2016. J Prev Med Public Health, 2019, 52(2): 115-122.
40. 李婷, 劉雙, 逯嘉, 等. 2011—2020 年四川省肺結核發病年齡變化趨勢分析. 中國防癆雜志, 2022, 44(8): 808-814.
41. 余雅, 胡代玉, 吳成果, 等. 重慶市 2011—2018 年貧困區縣肺結核流行特征. 中國熱帶醫學, 2020, 20(5): 429-433.
42. 張燦有, 陳卉, 張慧, 等. 2011—2020 年全國 65 歲及以上老年人肺結核報告發病情況分析. 中華疾病控制雜志, 2022, 26(11): 1252-1258.
43. 熊自超, 陳錦峰, 郭庚秀. 2015—2019 年某三甲綜合性醫院呼吸道傳染病臨床分布特征. 解放軍預防醫學雜志, 2020, 38(9): 107-110.
44. 鄭珍慧, 江巧敏, 張尊敬. 基于傾向性評分法評估耐藥肺結核患者疾病感知與服藥依從性的相關性. 中國全科醫學雜志, 2023, 21(11): 1872-1875.

West China Medical Journal

Analysis of the reported epidemic situation of pulmonary tuberculosis in the elderly patients at West China Hospital of Sichuan University

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