中国东部地区活动性肺结核的年龄-时期-队列研究：15年监测数据分析

Age-period-cohort study of active pulmonary tuberculosis in eastern China: analysis of 15-year surveillance data.

作者信息

Luo Dan, Wang Fengying, Chen Songhua, Zhang Yu, Wang Wei, Wu Qian, Ling Yuxiao, Li Yang, Zhou Yiqing, Liu Kui, Chen Bin

机构信息

School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China.

Department of Tuberculosis and AIDS Control and Prevention, Jinhua Municipal Center for Disease Control and Prevention, Jinhua, Zhejiang, China.

出版信息

BMC Public Health. 2025 Feb 17;25(1):651. doi: 10.1186/s12889-025-21770-z.

DOI:10.1186/s12889-025-21770-z

PMID:39962430

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11834198/

Abstract

BACKGROUND

Tuberculosis remains a major public health challenge worldwide. This study aimed to determine the long-term trends in the notification rate of tuberculosis in Zhejiang Province, and to assess the potential independent risks associated with age, time period, and birth cohort.

METHODS

Data on all pulmonary tuberculosis (PTB) cases in Zhejiang Province from 2008 to 2022 were collected from the Tuberculosis Information Management System. Long-term trends in the notification rate and independent risks associated with quantitatively decomposed variables were determined using joinpoint regression model and age-period-cohort model.

RESULTS

Between 2008 and 2022, a total of 323,745 PTB cases were notified in Zhejiang Province. Overall, the notification rate declined, with notable turning points in 2010 and 2019. Net drift analysis revealed an average annual decrease of 5.7% (95% CI: -6.8%, -4.6%; P < 0.01), with faster declines among males than females. Age effects showed peaks in notification rates among people aged 15-29 and 65-74. Period effects peaked during 2008-2012 (RR = 1.4; 95% CI: 1.3, 1.5; P < 0.01). Cohort effects indicated decreasing risks in later birth cohorts, with the highest risk observed in the 1928-1932 birth cohort (RR = 11.0, 95% CI: 7.2, 16.8; P < 0.01) and relative protective effects in cohorts born after 1978-1982.

CONCLUSIONS

Notification rates of PTB declined consistently across various age groups in Zhejiang Province. Young individuals aged 15-29 and older individuals aged 65-74 were identified as high-risk groups requiring active intervention. Additionally, pre-1978 birth cohorts had a relatively higher risk of PTB. These findings provided valuable insights into the age, period, and birth cohort characteristics of patients with PTB in Zhejiang Province, aiding relevant authorities in formulating appropriate policies and implementing targeted preventive control measures.

摘要

背景

结核病仍然是全球主要的公共卫生挑战。本研究旨在确定浙江省结核病报告率的长期趋势，并评估与年龄、时间段和出生队列相关的潜在独立风险。

方法

从结核病信息管理系统收集了2008年至2022年浙江省所有肺结核（PTB）病例的数据。使用连接点回归模型和年龄-时期-队列模型确定报告率的长期趋势以及与定量分解变量相关的独立风险。

结果

2008年至2022年期间，浙江省共报告323745例PTB病例。总体而言，报告率下降，在2010年和2019年出现显著转折点。净漂移分析显示年平均下降5.7%（95%CI：-6.8%，-4.6%；P<0.01），男性下降速度快于女性。年龄效应显示15-29岁和65-74岁人群的报告率出现峰值。时期效应在2008-2012年期间达到峰值（RR=1.4；95%CI：1.3，1.5；P<0.01）。队列效应表明较晚出生队列的风险降低，在1928-1932年出生队列中观察到最高风险（RR=11.0，95%CI：7.2，16.8；P<0.01），而在1978-1982年以后出生的队列中存在相对保护作用。