Khazaei Salman, Nematollahi Shahrzad, Doosti-Irani Amin, Zahiri Ali, Mofarrah-Zat Arash, Ayubi Erfan, Hooshmand Elham, Jenabi Ensiyeh, Saatchi Mohammad
Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tanaffos. 2019 Jan;18(1):18-24.
Tuberculosis (TB) despite being preventive and treatable still imposes a huge burden of morbidity and mortality in developing and developed countries. We aimed to investigate the spatial and geographical distribution of TB in Hamadan province during 1992-2013.
This cross-sectional study was performed in Hamadan province, West of Iran using the surveillance database. We examined the trend for incidence rates of all TB forms including Smear Positive Pulmonary TB (SPPT), Smear Negative Pulmonary TB (SNPT) and Extra pulmonary TB (EPT) per 100,000 populations. Poisson regression model was used to estimate the standardized rates for incidence rate of all types of TB per each county.
In this study 3,602 TB patients including 1,359 SPPT, 987 SNPT, and 1,256 EPT were included during 1992-2013. Trend of all types of TB decreased from 1992 to 2013. The Average Annual Percent change (AAPC) for all types of TB was significantly (P<0.05) decreased, AAPC= -6.4 (95% CIs: -10.7, -1.9). Among SPPT, SNPT, and EPT incidence rates, the maximum change was related to SNPT (-11.6; 95% CIs: -24.2, 3), while it was -1.4 (-8.7, 6.4) for SPPT and -5.8 (-11.4, 0.1) for EPT.
Our results showed that the incidence of TB in Hamadan province during a 22-year period has decreased 6.4% on average, somehow higher than the national average. Furthermore, our study showed that the risk of extra-pulmonary occurrence in western parts of the province is higher than others parts.
尽管结核病可预防且可治疗，但在发展中国家和发达国家，它仍然造成了巨大的发病和死亡负担。我们旨在调查1992 - 2013年期间哈马丹省结核病的空间和地理分布情况。
本横断面研究在伊朗西部的哈马丹省利用监测数据库进行。我们检查了每10万人口中所有结核病类型的发病率趋势，包括痰涂片阳性肺结核（SPPT）、痰涂片阴性肺结核（SNPT）和肺外结核（EPT）。采用泊松回归模型估计每个县各类结核病发病率的标准化率。
在本研究中，1992 - 2013年期间纳入了3602例结核病患者，其中包括1359例痰涂片阳性肺结核、987例痰涂片阴性肺结核和1256例肺外结核。1992年至2013年期间，所有类型的结核病发病率均呈下降趋势。所有类型结核病的年均变化百分比（AAPC）显著下降（P<0.05），AAPC = -6.4（95%置信区间：-10.7，-1.9）。在痰涂片阳性肺结核、痰涂片阴性肺结核和肺外结核的发病率中，变化最大的是痰涂片阴性肺结核（-11.6；95%置信区间：-24.2，3），而痰涂片阳性肺结核为-1.4（-8.7，6.4），肺外结核为-5.8（-11.4，0.1）。
我们的研究结果表明，哈马丹省在22年期间结核病发病率平均下降了6.4%，略高于全国平均水平。此外，我们的研究表明，该省西部地区肺外结核的发病风险高于其他地区。
