Chen Huijie, Bi Haiyan, Li Peng, Yang Zhixing, Wen Lihai, Sun Baijun, Sun Wei
Department of Infectious Disease, Shenyang Municipal Center for Disease Control and Prevention(Shenyang Municipal Health Supervision Institute), Shenyang, 110623, Liaoning Province, China.
Key Laboratory of Early Warning and Intervention Technologies and Countermeasures for Major Public Health Events in Liaoning Province, China Medical University, Shenyang, 110122, Liaoning Province, China.
BMC Infect Dis. 2025 Feb 4;25(1):166. doi: 10.1186/s12879-025-10572-8.
Pulmonary tuberculosis (PTB) is one of the most serious infectious diseases worldwide and poses a great threat to people's health. China has a vast territory with substantial regional disparities in the PTB disease burden. However, there have been no studies conducted to evaluate the PTB disease burden in Shenyang. The aim was to elucidate the magnitude, composition, and distribution of PTB disease burden in Shenyang.
The disability-adjusted life years (DALYs) calculated based on Global Burden of Disease (GBD) framework was used to assess the disease burden of PTB in Shenyang in 2023, and descriptive epidemiological methods were employed to elucidate the magnitude, composition, and distribution characteristics of PTB disease burden in Shenyang.
In 2023, 4,169 PTB cases were reported in Shenyang, including 2,901 males and 1,268 females. The incidence of PTB was 45.50/10, of which 64.29/10 for males and 27.30/10 for females. The incidence among males was higher than that among females (X = 688.56, p<0.001). The highest incidence was 107.00/10 in the group of the population aged 80 and above (X = 1171.75, p<0.001). In 2023, 189 PTB deaths were reported in Shenyang, including 156 males and 33 females. The mortality of PTB was 2.06/10 of which 3.46/10 for males and 0.71/10 for females. The mortality among males was higher than that among females (X = 83.69, p<0.001). The highest mortality was 16.04/10 in the group of the population aged 80 and above (X = 285.61, p<0.001). The PTB DALYs rate was 58.25/10, of which 91.73/10 for males and 21.22/10 for females. The DALYs rate among males was higher than that among females (X = 44.04, p<0.001). The highest DALYs rate was 149.86/10 in the group of the population aged 80 and above (X = 305.35, p<0.001). Years of life lost (YLLs) due to PTB accounted for 71.38% of total DALYs, of which 74.33% for males and 52.89% for females.
The PTB DALYs rate in Shenyang was 58.25/10, which was lower than that in China, equivalent to 80% of the national PTB disease burden rate. The disease burden showed a characteristic of increasing with age, and the PTB DALYs rate for males was higher than that for females, being equivalent to 4 times the female rate. The predominant disease burden of PTB was attributed to YLLs, accounting for as much as 71.38%, indicating that PTB primarily results in premature mortality rather than disability. Therefore, the focus should be shifted towards early intervention to reduce transmission, especially for the aged males.
肺结核（PTB）是全球最严重的传染病之一，对人们的健康构成巨大威胁。中国地域辽阔，肺结核疾病负担存在显著的地区差异。然而，尚未有研究对沈阳的肺结核疾病负担进行评估。本研究旨在阐明沈阳肺结核疾病负担的规模、构成和分布情况。
基于全球疾病负担（GBD）框架计算的伤残调整生命年（DALYs）用于评估2023年沈阳肺结核的疾病负担，并采用描述性流行病学方法阐明沈阳肺结核疾病负担的规模、构成和分布特征。
2023年，沈阳报告肺结核病例4169例，其中男性2901例，女性1268例。肺结核发病率为45.50/10万，其中男性为64.29/10万，女性为27.30/10万。男性发病率高于女性（X² = 688.56，p<0.001）。80岁及以上人群组发病率最高，为107.00/10万（X² = 1171.75，p<0.001）。2023年，沈阳报告肺结核死亡189例，其中男性156例，女性33例。肺结核死亡率为2.06/10万，其中男性为3.46/10万，女性为0.71/10万。男性死亡率高于女性（X² = 83.69，p<0.001）。80岁及以上人群组死亡率最高，为16.04/10万（X² = 285.61，p<0.001）。肺结核伤残调整生命年率为58.25/10万，其中男性为91.73/10万，女性为21.22/10万。男性伤残调整生命年率高于女性（X² = 44.04，p<0.001）。80岁及以上人群组伤残调整生命年率最高，为149.86/10万（X² = 305.35，p<0.001）。因肺结核导致的寿命损失年（YLLs）占总伤残调整生命年的71.38%，其中男性为74.33%，女性为52.89%。
沈阳肺结核伤残调整生命年率为58.25/10万，低于全国水平，相当于全国肺结核疾病负担率的80%。疾病负担呈现随年龄增长的特征，男性肺结核伤残调整生命年率高于女性，相当于女性的4倍。肺结核的主要疾病负担归因于寿命损失年，占比高达71.38%，表明肺结核主要导致过早死亡而非残疾。因此，应将重点转向早期干预以减少传播，特别是针对老年男性。
