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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9.	WHO Policy on Collaborative TB/HIV. Activities: guidelines for national programmes and other stakeholders. Geneva: World Health Organization, 2012.
10.	彭紅, 許衛國, 翟祥軍, 等. 江蘇農村社區一般人群胸部X線攝片主動篩查肺結核的效果評估. 中國防癆雜志, 2014, 36(12): 1029-1035.
11.	張偉. DR系統胸部攝影在肺結核病篩查中的應用價值分析. 心理醫生, 2018, 24(1): 45-46.
12.	黃維維, 孫宏英, 陳建, 等. 四川省綿陽市肺結核流行現狀及危險因素研究. 中國呼吸與危重監護雜志, 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. 唐河縣肺結核病流行病學特征調查及發病的危險因素分析. 中國初級衛生保健, 2020, 34(12): 53-55.
17.	吳紀明, 曹蕾, 陳敬義, 等. 湖北省鄂州市2011-2017年肺結核發病情況流行病學特征. 中國熱帶醫學, 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.	譚衛國, 管紅云, 吳清芳, 等. 流動人口結核病防控創新策略與實施效果. 新發傳染病電子雜志, 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.	楊凱璇, 費麗萍, 寇新榮, 等. 中國15歲以上人群結核病發病危險因素meta分析. 實用預防醫學, 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.	鄧敏. 浙江省結核病防治示范區規模化現場流行病學調查及發病危險因素分析. 杭州: 浙江大學, 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.	張思潮, 王偉洪, 鐘劍峰, 等. 湖州市結核病防治醫務人員結核病感染現狀調查研究. 中華預防醫學雜志, 2017, 12(18): 902-905.

1. World Health Organization. Global tuberculosis report 2020. Available from: https://apps.who.int/iris/handle/10665/336069.
2. 國家統計局. 2019年度甲乙類傳染病報告發病人數和死亡人數. 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. 全國第五次結核病流行病學抽樣調查技術指導組, 全國第五次結核病流行病學抽樣調查辦公室. 2010年全國第五次結核病流行病學抽樣調查報告. 中國防癆雜志, 2012, 34(8): 485-508.
5. 中華人民共和國國家衛生健康委員會. 中華人民共和國衛生行業標準-肺結核診斷(WS 288-2017). Available at: http://www.nhc.gov.cn/wjw/s9491/201712/a452586fd21d4018b0ebc00b89c06254.shtml.
6. 國家統計局. 中國2010年人口普查資料. Available at: http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
7. 瞿媛, 普麗, 蘇麗敏, 等. 玉溪市紅塔區重點人群肺結核主動篩查模式探究. 實用預防醫學, 2017, 24(8): 971-973.
8. L?nnroth 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. 彭紅, 許衛國, 翟祥軍, 等. 江蘇農村社區一般人群胸部X線攝片主動篩查肺結核的效果評估. 中國防癆雜志, 2014, 36(12): 1029-1035.
11. 張偉. DR系統胸部攝影在肺結核病篩查中的應用價值分析. 心理醫生, 2018, 24(1): 45-46.
12. 黃維維, 孫宏英, 陳建, 等. 四川省綿陽市肺結核流行現狀及危險因素研究. 中國呼吸與危重監護雜志, 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. 唐河縣肺結核病流行病學特征調查及發病的危險因素分析. 中國初級衛生保健, 2020, 34(12): 53-55.
17. 吳紀明, 曹蕾, 陳敬義, 等. 湖北省鄂州市2011-2017年肺結核發病情況流行病學特征. 中國熱帶醫學, 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. 譚衛國, 管紅云, 吳清芳, 等. 流動人口結核病防控創新策略與實施效果. 新發傳染病電子雜志, 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. 楊凱璇, 費麗萍, 寇新榮, 等. 中國15歲以上人群結核病發病危險因素meta分析. 實用預防醫學, 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. 鄧敏. 浙江省結核病防治示范區規模化現場流行病學調查及發病危險因素分析. 杭州: 浙江大學, 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. 張思潮, 王偉洪, 鐘劍峰, 等. 湖州市結核病防治醫務人員結核病感染現狀調查研究. 中華預防醫學雜志, 2017, 12(18): 902-905.

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