Epidemiology Office, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Biomed Environ Sci. 2023 Feb 20;36(2):117-126. doi: 10.3967/bes2023.015.
To evaluate the trend of notified incidence of pulmonary tuberculosis (PTB) in China at different periods by population and region and to explore the effect of TB prevention and control in recent years.
Using pooled data on TB cases reported by the TB Information Management Reporting System (TBIMS) from 2005 to 2020, we calculated the annual percentage change (APC) using the Joinpoint regression model.
From 2005 to 2020, a total of 16.2 million cases of PTB were reported in China, with an average notified incidence of 75.5 per 100,000 population. The age standardization rate (ASR) continued to decline from 116.9 (/100,000) in 2005 to 47.6 (/100,000) in 2020, with an average annual decrease of 5.6% [APC = -5.6, 95% confidence interval ( ): -7.0 to -4.2]. The smallest decline occurred in 2011-2018 (APC = -3.4, 95% : -4.6 to -2.3) and the largest decrease in 2018-2020 (APC = -9.2, 95% : -16.4 to -1.3). From 2005 to 2020, the ASR in males (159.8 per 100,000 in 2005, 72.0 per 100,000 in 2020) was higher than that in females (62.2 per 100,000 in 2005, 32.3 per 100,000 in 2020), with an average annual decline of 6.0% for male and 4.9% for female. The average notified incidence was the highest among older adults (65 years and over) (182.3/100,000), with an average annual decline of 6.4%; children (0-14 years) were the lowest (4.8/100,000), with an average annual decline of 7.3%, but a significant increase of 3.3% between 2014 and 2020 (APC = 3.3, 95% : 1.4 to 5.2); middle-aged (35-64 years) decreased by 5.8%; and youth (15-34 years) decreased by an average annual rate of 4.2%. The average ASR in rural areas (81.3/100,000) is higher than that in urban areas (76.1/100,000). The average annual decline in rural areas was 4.5% and 6.3% in urban areas. South China had the highest average ASR (103.2/100,000), with an average annual decline of 5.9%, while North China had the lowest (56.5/100,000), with an average annual decline of 5.9%. The average ASR in the southwest was 95.3 (/100,000), with the smallest annual decline (APC = -4.5, 95% : -5.5 to -3.5); the average ASR in the Northwest China was 100.1 (/100,000), with the largest annual decline (APC = -6.4, 95% : -10.0 to -2.7); Central, Northeastern, and Eastern China declined by an average of 5.2%, 6.2%, and 6.1% per year, respectively.
From 2005 to 2020, the notified incidence of PTB in China continued to decline, falling by 55%. For high-risk groups such as males, older adults, high-burden areas in South, Southwest, and Northwest China, and rural regions, proactive screening should be strengthened to provide timely and effective anti-TB treatment and patient management services for confirmed cases. There is also a necessity to be vigilant about the upward trend of children in recent years, the specific reasons for which need to be further studied.
通过人群和地区分析评估中国不同时期肺结核（PTB）报告发病率的趋势，并探讨近年来结核病防控的效果。
使用中国结核病信息管理系统（TBIMS）报告的结核病病例汇总数据，采用 Joinpoint 回归模型计算年度变化百分比（APC）。
2005 年至 2020 年，中国共报告肺结核病例 1620 万例，平均报告发病率为 75.5/10 万人口。标准化率（ASR）持续下降，从 2005 年的 116.9/10 万下降至 2020 年的 47.6/10 万，平均每年下降 5.6%[APC=-5.6，95%置信区间（CI）：-7.0 至-4.2]。最小降幅出现在 2011 年至 2018 年（APC=-3.4，95%CI：-4.6 至-2.3），最大降幅出现在 2018 年至 2020 年（APC=-9.2，95%CI：-16.4 至-1.3）。2005 年至 2020 年，男性（2005 年为 159.8/10 万，2020 年为 72.0/10 万）的 ASR 高于女性（2005 年为 62.2/10 万，2020 年为 32.3/10 万），男性和女性的平均每年下降率分别为 6.0%和 4.9%。65 岁及以上老年人（182.3/10 万）的平均报告发病率最高，平均每年下降 6.4%；0-14 岁儿童（4.8/10 万）的发病率最低，平均每年下降 7.3%，但 2014 年至 2020 年之间呈显著上升趋势（APC=3.3，95%CI：1.4 至 5.2）；35-64 岁人群下降 5.8%；15-34 岁人群下降 4.2%。农村地区（81.3/10 万）的平均 ASR 高于城市地区（76.1/10 万），农村地区的平均年下降率为 4.5%，城市地区为 6.3%。华南地区（103.2/10 万）的平均 ASR 最高，平均每年下降 5.9%，而华北地区（56.5/10 万）的平均 ASR 最低，平均每年下降 5.9%。西南地区（95.3/10 万）的平均 ASR 最低，年下降率最小（APC=-4.5，95%CI：-5.5 至-3.5）；西北地区（100.1/10 万）的平均 ASR 最高，年下降率最大（APC=-6.4，95%CI：-10.0 至-2.7）；中部、东北和华东地区的平均下降率分别为 5.2%、6.2%和 6.1%。
2005 年至 2020 年，中国肺结核报告发病率持续下降，下降了 55%。对于男性、老年人、南方、西南和西北地区以及农村地区等高危人群，应加强主动筛查，为确诊病例提供及时有效的抗结核治疗和患者管理服务。对于近年来儿童发病率上升的情况也应保持警惕，具体原因还需要进一步研究。
