2014 年中国西藏自治区肺结核病的流行情况。

Prevalence of pulmonary tuberculosis in Tibet Autonomous Region, China, 2014.

机构信息

Tibet Center for Disease Control and Prevention, Lhasa, Tibet.

Shandong Provincial Chest Hospital, Jinan.

出版信息

Int J Tuberc Lung Dis. 2019 Jun 1;23(6):735-740. doi: 10.5588/ijtld.18.0614.

DOI:10.5588/ijtld.18.0614

PMID:31315707

Abstract

SETTING Tibet Autonomous Region, China. OBJECTIVES To determine the prevalence of pulmonary tuberculosis (TB) in Tibet. DESIGN We conducted a population-based, cross-sectional survey among residents aged ≥15 years in Tibet, China, in 2014. A door-to-door survey was conducted for each randomly selected cluster, followed by a screening interview and a chest X-ray (CXR). Those with symptoms of TB and/or abnormal CXR underwent sputum microscopy testing and culture. RESULTS Of 31 527 eligible residents, 30 113 (95.5%) participated, 215 of whom were active TB cases, including 49 (22.8%) known cases. Adjusted prevalence of smear-positive, bacteriologically positive and all pulmonary TB cases was respectively 8 (95%CI 62-97), 144 (95%CI 107-152) and 758 (95%CI 662-766) per 100 000 population. This represented a decline of 37% in the prevalence of active cases, and of 21.3% in smear-positive cases compared with a 1990 survey. About 51.3% of bacteriologically positive TB patients in Tibet showed no symptoms. CONCLUSION We observed a sharp decline in TB prevalence and a low rate of bacteriologically positive cases among all active patients. The low proportion of known cases in the survey reflected possible underdetection by the National TB Programme. .

摘要

背景中国西藏自治区。目的确定西藏的肺结核（TB）患病率。设计我们于 2014 年在中国西藏进行了一项基于人群的、横断面的、针对≥15 岁居民的调查。对每个随机选择的群组进行了逐户调查，随后进行了筛查访谈和胸部 X 光检查（CXR）。有 TB 症状和/或异常 CXR 的人进行了痰显微镜检查和培养。结果在 31527 名合格居民中，有 30113 人（95.5%）参与了研究，其中 215 人为活动性 TB 病例，包括 49 例（22.8%）已知病例。调整后的涂片阳性、细菌阳性和所有肺结核病例的患病率分别为 8（95%CI 62-97）、144（95%CI 107-152）和 758（95%CI 662-766）/100000 人。这代表与 1990 年的调查相比，活动性病例的患病率下降了 37%，涂片阳性病例的患病率下降了 21.3%。在西藏，约 51.3%的细菌阳性肺结核患者无症状。结论我们观察到 TB 患病率急剧下降，所有活动性患者中细菌阳性病例的比例较低。调查中已知病例的比例较低反映了国家结核病规划可能存在漏诊。