Du Rong, Rao Lixin, Xiao Xiao, Zhao Qi, Shen Xin, Xu Biao
Department of Epidemiology, School of Public Health, Fudan University, 130 Dongan Road, Shanghai, 200032, China.
Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), 131 Dongan Road, Shanghai, 200032, China.
Aging Clin Exp Res. 2025 May 28;37(1):175. doi: 10.1007/s40520-025-03070-z.
The number and proportion of people aged 65 and above in Shanghai are increasing, posing challenges to tuberculosis (TB) control. This study aims to assess the impact of this demographic change on the TB epidemic in Shanghai.
Data were obtained from the TB Information Management System, with case counts and notification rates calculated by gender, age, and year. TB notification rates and trends were analyzed under two demographic scenarios: a constant aging scenario and an increasing aging scenario. Grey models (GM (1,1)) and age-period-cohort (APC) models were employed to forecast changes in the elderly population as well as age-specific TB notification rates. The estimated annual percentage change (EAPC) quantified trends over time.
From 2015 to 2023, a total of 29,694 TB cases were reported, with males accounting for 69.79%. In 2023, the notification rate was 19.55 per 100,000, with the highest rate observed among individuals aged 65 years and older, reaching 48.47 per 100,000. The proportion of older adults among TB patients increased annually. Predictions indicated a peak notification rate among those aged 70-79 over the next five years. Compared to the constant aging scenario, the increasing aging scenario was associated with a more moderate reduction in TB notification rates (34.49% vs. 42.81%) and a slower declining trend over the study period (EAPC = -3.50, 95% CI: -4.70 to -2.29 vs. EAPC = -4.45, 95% CI: -5.47 to -3.42).
Population aging poses challenges to TB control, highlighting the need for targeted strategies for older adults.
上海65岁及以上人口的数量和比例不断增加，给结核病防控带来了挑战。本研究旨在评估这一人口结构变化对上海结核病流行的影响。
数据来自结核病信息管理系统，按性别、年龄和年份计算病例数和报告率。在两种人口结构情景下分析结核病报告率及其趋势：一种是老龄化程度不变的情景，另一种是老龄化程度不断增加的情景。采用灰色模型（GM(1,1)）和年龄-时期-队列（APC）模型预测老年人口变化以及特定年龄组的结核病报告率。估计年度百分比变化（EAPC）量化随时间的趋势。
2015年至2023年，共报告29694例结核病病例，其中男性占69.79%。2023年，报告率为每10万人19.55例，65岁及以上人群报告率最高，达到每10万人48.47例。结核病患者中老年人的比例逐年增加。预测表明，未来五年70-79岁人群的报告率将达到峰值。与老龄化程度不变的情景相比，老龄化程度不断增加的情景下结核病报告率下降幅度较小（34.49%对42.81%），且在研究期间下降趋势较慢（EAPC=-3.50，95%CI：-4.70至-2.29对EAPC=-4.45，95%CI：-5.47至-3.42）。
人口老龄化给结核病防控带来挑战，凸显了针对老年人制定针对性策略的必要性。
