Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
BMC Infect Dis. 2022 Jan 31;22(1):109. doi: 10.1186/s12879-022-07071-5.
Internal migrants have an enormous impact on tuberculosis (TB) epidemic in China. Zhejiang Province, as one of the developed areas, also had a heavy burden caused by TB.
In this study, we collected all cases in Zhejiang Province through the TB Management Information System from 2013 to 2017. Description analysis and Spatio-temporal analysis using R software and ArcGIS were performed to identify the epidemiological characteristics and clusterings, respectively.
48,756 individuals in total were notified with TB among the migrant population (TBMP), accounting for one-third of all cases identified. The primary sources of TB from migrants outside the province were from Guizhou, Sichuan, and Anhui. Wenzhou, Taizhou, and Lishui were the three mainly outflowing cities among the intra-provincial TBMP and Hangzhou as the primarily inflowing city. Also, results implied that the inconsistency of the TBMP in spatial analysis and the border area of Quzhou and Lishui city had the highest risk of TB occurrence among the migrants. Additionally, one most likely cluster and four secondary clusters were identified by the spatial-temporal analysis.
The effective control of TB in extra-provincial MP was critical to lowering the TB burden of MP in Zhejiang Province. Also, it is suggested that active TB screening for migrant employees outflowed from high epidemic regions should be strengthened, and further traceability analysis needs to be investigated to clarify the mechanism of TB transmission in clustered areas.
流动人口对中国的结核病（TB）疫情有巨大影响。浙江省作为发达地区之一，也面临着结核病带来的沉重负担。
本研究通过 TB 管理信息系统收集了 2013 年至 2017 年期间浙江省所有流动人口结核病病例。使用 R 软件和 ArcGIS 进行描述性分析和时空分析，分别确定流行病学特征和聚类。
共报告流动人口结核病（TBMP）患者 48756 例，占总病例数的三分之一。来自外省的流动人口结核病的主要来源是贵州、四川和安徽。温州、台州和丽水是省内 TBMP 的三个主要流出城市，而杭州则是主要的流入城市。此外，空间分析表明 TBMP 的不一致性以及衢州和丽水市边界地区的流动人口结核病发生风险最高。时空分析还确定了一个最可能的集群和四个次要集群。
对外省流动人口结核病的有效控制对降低浙江省流动人口结核病负担至关重要。此外，建议加强对高疫情地区流动人口外出务工人员的主动筛查，并进行进一步的溯源分析，以阐明集群地区结核病传播的机制。
