1. School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang 830017, China; 2. Kashgar Center for Disease Control and Prevention, Kashgar, Xinjiang 844000, China; 3. Center of Respiratory and Critical Care Medicine, the People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang 830002, China; 4. School of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, Xinjiang 830017, China
Abstract：Objective To understand the epidemic characteristics of pulmonary tuberculosis and the shift trend of disease focus in Kashgar from 2016 to 2021, and to analyze the relevant factors affecting the incidence of pulmonary tuberculosis so as to provide scientific references for pulmonary tuberculosis prevention and control in this region. Methods The data about pulmonary tuberculosis cases in Kashgar from 2016 to 2021 were collected. The trend test was used to compare the differences in the incidence rate of pulmonary tuberculosis among subjects with different characteristics. The trend in gravity center migration of pulmonary tuberculosis incidence in Kashgar was analyzed using the gravity center migration model and the standard deviation ellipse method, and the Pearson correlation coefficient was employed to explore the factors affecting the incidence of pulmonary tuberculosis. Results A total of 100,330 cases of pulmonary tuberculosis were reported in Kashgar from 2016 to 2021, of which 33.33% were reported in 2018, and the annual average reported incidence rate was 36.22/10,000 (χ2=1,834.226, P<0.001). The peak period of incidence of pulmonary tuberculosis in Kashgar was in April-June. The sex ratio of male to female was 1.06:1. The incidence rate of pulmonary tuberculosis in Kashgar showed an upward trend with the increase of age, and the elderly aged 60-80 years were the high incidence population of the disease. Among the 12 counties and cities in Kashgar, Yingjisha County, Zepu County and Shache County had the highest average annual reported incidence rates, which were 64.08/10,000, 46,04/10,000 and 41,01/10,000 (χ2=56.504, P<0.001). During the study period, the gravity center of pulmonary tuberculosis incidence gradually shifted to the north, with the fastest migration speed in 2019. The aggregation of the disease gradually decreased in the southeast direction, and the oblateness of the ellipse showed a trend of rising first and then falling. The number of medical beds per 1,000 persons, the number of medical institutions, the total population, the population growth rate, and the proportion of rural population were all correlated with the incidence of pulmonary tuberculosis (P<0.05). Conclusion The incidence of pulmonary tuberculosis in Kashgar in 2016-2021 showed a trend of decrease after the first increase, with the seasonality. Males, farmers, and the elderly aged 60-80 years are the key groups for pulmonary tuberculosis prevention and control. The gravity center of pulmonary tuberculosis temporallyand spatiallyspreads from the southeast to the northwest, and the task of disease prevention and control remains daunting. It is still necessary to strengthen the allocation of health resources and the prevention and control of key populations in Kashgar in future so as to effectively prevent or reduce the occurrence and prevalence of the disease.
2023, Vol. 30 
