贵州省2011-2020年学生肺结核流行特征及其时空变化分析

目的 分析2011-2020年贵州省学生涂阳和其他类型肺结核流行特征及其时空变化趋势,为完善结核病防控措施提供参考依据。方法 学生肺结核数据来源于中国疾病预防控制信息系统结核病信息管理系统。采用Joinpoint 4.9.1.0软件分析登记率的变化趋势;采用ArcGIS 10.6软件进行环形地图制作和空间自相关分析;采用SaTScan 9.7软件进行时空扫描分析。结果 2011-2020年贵州省共报告学生肺结核患者32 682例,其中涂阳5 949例（18.20%）;发病年龄以16~18岁高中生为主（43.99%,14 376/32 682）;年平均登记率为36.22/10万,2018年最高（52.90/10万）,登记率呈上升趋势,涂阳和其他类型登记率变化趋势相同;学生肺结核发病呈现聚集性分布,涂阳和其他类型的高-高聚集区均主要位于毕节市;时空扫描分析共探测到涂阳和其他类型聚集区各6个,每个聚集区的差异均有统计学意义（P<0.001）。结论 2011-2020年贵州省学生肺结核发病呈上升趋势和聚集性分布,应加强对高中生的结核病监测,定期在高风险地区开展筛查,积极发现潜在的学生结核病患者,控制传染源和降低传播风险。

Epidemiological characteristics and spatio-temporal distribution of pulmonary tuberculosis cases reported in students from Guizhou Province, 2011-2020

Objective To analyze the trend of epidemiological characteristics and spatiotemporal distribution of pulmonary tuberculosis (PTB) among smear-positive or other types of students in Guizhou Province from 2011 to 2020, and to provide a reference for improving prevention and control measures. Methods Data were collected from the Chinese Information System''s Notifiable Disease and Tuberculosis Management Information System for disease control and prevention, the Joinpoint 4.9.1.0 software was used to analyze the trend of registration rate; the ArcGIS 10.6 software was used to construct a ring map and to perform spatial autocorrelation analysis; the SaTScan 9.7 software was used for spatial-temporal scan statistics. Results A total of 32 682 student PTB cases were reported in Guizhou Province from 2011 to 2020, including 5 949 (18.20%) smear-positive cases. Most cases occurred from high school students of 16 to 18 years old (43.99%, 14 376/32 682); the annual average registered rate was 36.22/100 000, the highest in 2018 (52.90/100 000), and the registration rate showed an increasing trend. Meanwhile, a similar trend of registration rate was observed among smear-positive or other types of students. The spatialtemporal heterogeneity was found that the "high-high" clustering patterns of smear-positive or other types were aggregated in Bijie City. Six spatialtemporal clusters with statistically significant (all P<0.001) were detected among smear-positive or other cases, respectively. Conclusions Upward trend with spatial- temporal clusters of PTB cases reported in students from Guizhou Province from 2011 to 2020. Surveillance should be strengthened for high school students, and regular screening should be conducted in high-risk areas to control the source of infection and reduce the risk of transmission.