Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China.
Front Public Health. 2023 Feb 9;11:1114248. doi: 10.3389/fpubh.2023.1114248. eCollection 2023.
Pulmonary tuberculosis (PTB) is a serious chronic communicable disease that causes a significant disease burden in China; however, few studies have described its spatial epidemiological features in students.
Data of all notified PTB cases from 2007 to 2020 in the student population were collected in the Zhejiang Province, China using the available TB Management Information System. Analyses including time trend, spatial autocorrelation, and spatial-temporal analysis were performed to identify temporal trends, hotspots, and clustering, respectively.
A total of 17,500 PTB cases were identified among students in the Zhejiang Province during the study period, accounting for 3.75% of all notified PTB cases. The health-seeking delay rate was 45.32%. There was a decreasing trend in PTB notifications throughout the period; clustering of cases was seen in the western area of Zhejiang Province. Additionally, one most likely cluster along with three secondary clusters were identified by spatial-temporal analysis.
Although was a downward trend in PTB notifications among students during the time period, an upward trend was seen in bacteriologically confirmed cases since 2017. The risk of PTB was higher among senior high school and above than of junior high school. The western area of Zhejiang Province was the highest PTB risk settings for students, and more comprehensive interventions should be strengthened such as admission screening and routine health monitoring to improve early identification of PTB.
肺结核（PTB）是一种严重的慢性传染病，在中国造成了巨大的疾病负担；然而，很少有研究描述过学生群体中该病的空间流行病学特征。
利用现有的结核病管理信息系统，收集了 2007 年至 2020 年中国浙江省学生人群中所有报告的肺结核病例数据。分别进行时间趋势、空间自相关和时空分析，以确定时间趋势、热点和聚集。
在研究期间，浙江省共发现 17500 例学生肺结核病例，占所有报告肺结核病例的 3.75%。就诊延迟率为 45.32%。整个期间肺结核报告呈下降趋势；在浙江省西部地区发现了病例的聚集。此外，时空分析还确定了一个最可能的聚集区以及三个次要聚集区。
尽管在研究期间学生肺结核报告呈下降趋势，但自 2017 年以来，细菌学确诊病例呈上升趋势。高中及以上学生的肺结核风险高于初中学生。浙江省西部地区是学生肺结核风险最高的地区，应加强更全面的干预措施，如入学筛查和常规健康监测，以提高肺结核的早期识别。
