人口流入城市肺结核流行特征、时空分布及其社会影响因素分析

摘要

目的 探讨人口流入城市肺结核流行特征、时空聚集性及社会影响因素.方法 通过中国疾病预防控制信息系统收集宁波市2013-2015年肺结核发病数据,并进行描述流行病学分析.使用SaTScan9.1.1对街道/乡镇级发病数据进行时空扫描分析.利用ArcMap10.2对分析结果进行可视化展示.结果 宁波市2013-2015年累计报告肺结核12 109例,发病率呈逐年下降趋势,外地户籍病例占比逐年上升.男女比例为2.07∶ 1(8162/3947),各年龄组均有发病,其中15-34岁、65岁及以上发病率高,15-54岁年龄组占比73.95％,职业分布以农民、家政家务及待业、民工、工人为主.时空聚集性扫描共发现6个聚集区,其中一类聚集区分布在中心城区及其周边,二类聚集区分布在工业园区.与非聚集区相比,发病聚集区的流动人口占比(t=2.88,P=0.01)、省外流入人口占比(t=7.46,P=0.00)、人口密度(t=3.37,P=0.00)均较高,而人均公园绿地面积较低(t=-2.39,P=0.03).结论 人口流入城市的中心城区及其周边、工业园区是肺结核疫情高发区和聚集区.人口密度和流动人口高是发病聚集的重要影响因素.%We investigated the epidemiological characteristics and temporal-spatial clustering of pulmonary tuberculosis (PTB),and analyzed its social influence factors in immigration city.Descriptive epidemiological analysis was conducted on PTB cases data extracted from the National Disease Reporting System of Chinese Center for Disease Control and Prevention between 2013 and 2015.Kulldorff scan statistics was applied to community based and town-based incidence data by SaTScan 9.1.1.The results were visualized by ArcMap10.2.A total of 12 109 PTB cases were reported in Ningbo with a decreasing trend in incidence rate and an increasing trend in proportion of floating population from 2013 to 2015.The male to female ratio was 2.07 ∶ 1 (8 162/3 947).All age groups were affected by PTB,but the incidence in 15-34 years age group and 65+ years age group were higher.Patients aged between 15 and 54 years accounted for 73.95 ％ of all cases.Most cases were farmers,housekeepers or unemployed,migrants and workers.There were six temporal-spatial clusters,of which the most likely clusters were in downtown and its surrounding areas,and the second likely clusters were in industrial parks.Compared with non cluster areas,proportion of floating population (t =2.88,P=0.01) especially immigrants from other provinces (t=7.46,P =0.00),and population density (t=3.37,P=0.00) in cluster areas were higher,while per capita green area was lower (t =-2.39,P 0.03).The downtown and its surrounding areas,industrial parks could be the future PTB combating regions.High population density and immigrants are associated with PTB clustering.