Li Shi-Jin, Li Yi-Fan, Song Wan-Mei, Zhang Qian-Yun, Liu Si-Qi, Xu Ting-Ting, An Qi-Qi, Liu Jin-Yue, Li Huai-Chen
Department of Respiratory and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwuweiqi Road, Huaiyin District, 250021, Jinan, Shandong, People's Republic of China.
Cheeloo College of Medicine, Shandong University, 250012, Jinan, Shandong, People's Republic of China.
BMC Infect Dis. 2021 Mar 25;21(1):302. doi: 10.1186/s12879-021-05994-z.
To explore population aging and the epidemic trend of pulmonary tuberculosis (PTB) in the elderly, and provide a basis for the prevention and control of pulmonary tuberculosis among the elderly.
We collected clinical information of 239,707 newly active PTB patients in Shandong Province from 2005 to 2017. We analyzed and compared the clinical characteristics, reported incidence and temporal trend of PTB among the elderly group (≥60 years) and the non-elderly group (< 60 years) through logistic model and Join-point regression model.
Among the total PTB cases, 77,192(32.2%) were elderly. Compared with non-elderly patients, newly active elderly PTB patients account for a greater proportion of male cases (OR 1.688, 95% CI 1.656-1.722), rural population cases (OR 3.411, 95% CI 3.320-3.505) and bacteriologically confirmed PTB cases (OR 1.213, 95%CI 1.193-1.234). The annual reported incidence of total, elderly, pulmonary bacteriologically confirmed cases were 35.21, 68.84, 35.63 (per 100,000), respectively. The annual reported incidence of PTB in the whole population, the elderly group and the non-elderly group has shown a slow downward trend since 2008. The joinpoint regression model showed that the overall reported incidence of PTB in the elderly significantly decreased from 2007 to 2017 (APC = -5.3, P < 0.05). The reported incidence of bacteriologically confirmed PTB among elderly patients declined rapidly from 2005 to 2014(2005-2010 APC = -7.2%, P < 0.05; 2010-2014 APC = -22.6%, P < 0.05; 2014-2017 APC = -9.0%, P = 0.1). The reported incidence of clinically diagnosed PTB among elderly patients from 2005 to 2017 (11.48-38.42/100,000) increased by about 235%. It rose significantly from 2007 to 2014 (APC = 9.4, P<0.05).
Compared with the non-elderly population, the reported incidence of PTB in the elderly population is higher. The main burden of PTB will shift to the elderly, men, rural population, and clinically diagnosed patients. With the intensification of aging, more researches on elderly PTB prevention and treatment will facilitate the realization of the global tuberculosis (TB) control targets.
探讨人口老龄化及老年人肺结核（PTB）的流行趋势，为老年人肺结核的防控提供依据。
收集2005年至2017年山东省239,707例新活动性肺结核患者的临床资料。通过逻辑模型和Join-point回归模型分析比较老年组（≥60岁）和非老年组（<60岁）肺结核的临床特征、报告发病率及时间趋势。
在所有肺结核病例中，77,192例（32.2%）为老年人。与非老年患者相比，新活动性老年肺结核患者中男性病例（OR 1.688，95%CI 1.656 - 1.722）、农村人口病例（OR 3.411，95%CI 3.320 - 3.505）和细菌学确诊肺结核病例（OR 1.213，95%CI 1.193 - 1.234）所占比例更大。总病例、老年病例、肺部细菌学确诊病例的年报告发病率分别为35.21、68.84、35.63（每10万）。自2008年以来，全人群、老年组和非老年组肺结核的年报告发病率呈缓慢下降趋势。Join-point回归模型显示，2007年至2017年老年人肺结核的总体报告发病率显著下降（APC = -5.3，P < 0.05）。2005年至2014年老年患者细菌学确诊肺结核的报告发病率迅速下降（2005 - 2010年APC = -7.2%，P < 0.05；2010 - 2014年APC = -22.6%，P < 0.05；2014 - 2017年APC = -9.0%，P = 0.1）。2005年至2017年老年患者临床诊断肺结核的报告发病率（11.48 - 38.42/10万）上升了约235%。2007年至2014年显著上升（APC = 9.4，P < 0.05）。
与非老年人群相比，老年人群肺结核的报告发病率更高。肺结核的主要负担将转移到老年人、男性、农村人口和临床诊断患者身上。随着老龄化加剧，更多关于老年肺结核防治的研究将有助于实现全球结核病控制目标。
