West China Biomedical Big Data Center, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China.
West China School of Public Health, Sichuan University, Chengdu, China.
J Evid Based Med. 2017 Nov;10(4):281-286. doi: 10.1111/jebm.12243. Epub 2017 May 24.
To explore the risk factors of pulmonary tuberculosis incidence in Wenchuan earthquake-stricken area during a nine-year period of time.
The incidence and socioeconomic indicators in the 181 counties of Sichuan province from 2004 to 2012 were collected, multilevel extra-Poisson model was performed for variable screening, and Bayesian spatiotemporal models were fitted.
The morbidity showed a downward time trend from 2004 to 2012. The spatiotemporal interaction model was applied with the smallest deviance information criterion. The risk factors included: county latitude (0.949, 95%CI 0.765 to 1.098), float proportion (0.368, 95%CI 0.354 to 0.380), per capita GDP (-0.225, 95%CI -0.235 to -0.216), population density (0.072, 95%CI 0.041 to 0.105), and minority inhabited area (0.302, 95%CI 0.241 to 0.372). The variation of posterior median and Bayesian credibility interval was small, and the spatiotemporal patterns were similar among different periods.
The incidence presented a smooth curve without bursting after the earthquake during 2004 to 2012, and with a tendency of decreasing from north to south in Sichuan province; PTB countermeasures should be focused on the migrating population and in the minority inhabited and economic underdeveloped regions. Geographical adjacent structure was an important factor and regional collaborative prevention and control should be strengthened.
探讨汶川地震灾区 9 年间肺结核发病率的影响因素。
收集 2004-2012 年四川省 181 个县的发病率和社会经济指标,采用多水平零膨胀泊松回归进行变量筛选,拟合贝叶斯时空模型。
发病率从 2004 年到 2012 年呈下降趋势。采用偏差信息准则最小的时空交互模型。风险因素包括:县纬度(0.949,95%CI 0.765 至 1.098)、流动人口比例(0.368,95%CI 0.354 至 0.380)、人均 GDP(-0.225,95%CI -0.235 至 -0.216)、人口密度(0.072,95%CI 0.041 至 0.105)和少数民族聚居区(0.302,95%CI 0.241 至 0.372)。后验中位数和贝叶斯可信度区间的变化较小,不同时期的时空模式相似。
2004-2012 年地震后,发病率呈平滑曲线,无爆发趋势,四川省由北向南呈下降趋势;结核病防治应重点关注流动人口和少数民族聚居、经济欠发达地区。地理邻近结构是一个重要因素,应加强区域协作防控。