Department of Epidemiology, School of Public Health, Fudan University, No. 130 Dong'an Road, Xuhui District, Shanghai, China.
National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Infect Dis Poverty. 2021 Feb 24;10(1):16. doi: 10.1186/s40249-021-00806-7.
China has made progress in tuberculosis control, but this disease remains a burden in many regions of China. We performed time-series analysis to examine changes in the rates of newly notified and newly smear-positive cases of tuberculosis in different regions of China from 1997 to 2018 and assessed the effect of the current control program.
National and provincial notification data on tuberculosis from 1997 to 2018, which covers 31 provinces in the mainland of China, were extracted from the Chinese public health science data center. The annual percentage changes in newly notified and smear-positive cases were analyzed using a joinpoint regression method.
There were 18 646 672 newly notified tuberculosis cases from 1997 to 2018, with the greatest number in 2005. A total of 6 605 414 of these cases (35.42%) were smear-positive cases. The number of newly notified cases in China overall decreased (96.88-59.27 cases per 100 000) significantly during the most recent years. The decline during this period ranged from -3.9% (95% CI -5.7 to -2.9) in the western region to -4.3% (95% CI -4.8 to -3.7) in the eastern region. Most provinces had significant declines in newly notified and smear-positive cases, whereas the decline of newly smear-positive cases in Xinjiang was about half of that observed during the same period in China overall (-4.1% vs -9.9%). In addition to disparities in annual percentage changes, the rate of newly notified cases was higher in the western region than in the eastern and central regions.
The burden of tuberculosis has been on declining throughout China during recent years, but tuberculosis in western China continues to be a public health emergency that needs to be urgently addressed. Effective prevention and control strategies are needed for regions with high disease burdens and those with increasing or unchanging numbers of newly notified and smear-positive cases of tuberculosis.
中国在结核病控制方面取得了进展，但这种疾病在中国许多地区仍然是一个负担。我们进行了时间序列分析，以检查 1997 年至 2018 年中国不同地区新报告和新涂阳肺结核病例的发病率变化，并评估了当前控制计划的效果。
从中国公共卫生科学数据中心提取了 1997 年至 2018 年全国和省级结核病报告数据，覆盖了中国大陆的 31 个省。使用 joinpoint 回归方法分析新报告和涂阳病例的年度百分比变化。
1997 年至 2018 年共报告了 18646672 例新的肺结核病例，2005 年报告的病例最多。其中共有 6605414 例（35.42%）为涂阳病例。近年来，中国的新报告病例数量总体呈下降趋势（每 10 万人减少 96.88-59.27 例）。在此期间，西部地区下降幅度最大，为-3.9%（95%可信区间为-5.7 至-2.9），东部地区下降幅度为-4.3%（95%可信区间为-4.8 至-3.7）。大多数省份新报告和涂阳病例均有显著下降，而新疆新涂阳病例的下降幅度约为同期全国的一半（-4.1%对-9.9%）。除了年度百分比变化的差异外，西部地区新报告病例的比例高于东部和中部地区。
近年来，中国的结核病负担一直在下降，但中国西部地区的结核病仍然是一个紧急的公共卫生问题，需要紧急解决。对于疾病负担高的地区和新报告和涂阳肺结核病例数量增加或不变的地区，需要采取有效的预防和控制策略。
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