Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong , China.
Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, China.
Sci Rep. 2021 Oct 12;11(1):20259. doi: 10.1038/s41598-021-99651-9.
Summer-spring predominance of tuberculosis (TB) has been widely reported. The relative contributions of exogenous recent infection versus endogenous reactivation to such seasonality remains poorly understood. Monthly TB notifications data between 2005 and 2017 in Hong Kong involving 64,386 cases (41% aged ≥ 65; male-to-female ratio 1.74:1) were examined for the timing, amplitude, and predictability of variation of seasonality. The observed seasonal variabilities were correlated with demographics and clinical presentations, using wavelet analysis coupled with dynamic generalised linear regression models. Overall, TB notifications peaked annually in June and July. No significant annual seasonality was demonstrated for children aged ≤ 14 irrespective of gender. The strongest seasonality was detected in the elderly (≥ 65) among males, while seasonal pattern was more prominent in the middle-aged (45-64) and adults (30-44) among females. The stronger TB seasonality among older adults in Hong Kong suggested that the pattern has been contributed largely by reactivation diseases precipitated by defective immunity whereas seasonal variation of recent infection was uncommon.
夏春型肺结核（TB）发病优势广泛存在。然而，对于其发病季节性的形成原因，究竟是新近感染的外源性病原体，还是内源性的再激活，目前仍知之甚少。本研究使用香港地区 2005 年至 2017 年间 64386 例（41%年龄≥65 岁；男女性别比为 1.74:1）的结核每月报告数据，采用小波分析与动态广义线性回归模型相结合的方法，检验了季节变化的时间、幅度和可预测性。观察到的季节性变化与人口统计学和临床表现相关。结果显示，TB 报告病例的年度高峰出现在 6 月和 7 月。无论性别如何，年龄≤14 岁的儿童均未表现出明显的年度季节性。男性中年龄≥65 岁的老年人的季节性最强，而女性中中年（45-64 岁）和成年人（30-44 岁）的季节性模式更为明显。香港老年人群中较强的结核季节性表明，这种模式主要是由免疫功能缺陷引发的再激活疾病所致，而新近感染的季节性变化则较为少见。
