2010—2023年上海市嘉定区肺结核发病情况的流行特征分析及模型验证-现代医学

2010—2023年上海市嘉定区肺结核发病情况的流行特征分析及模型验证

单位：1. 上海市嘉定区疾病预防控制中心慢性传染病防治科, 上海 201800;
2. 复旦大学公共卫生学院流行病学教研室, 上海 200032

分类号：R183.3

出版年·卷·期（页码）：2025·53·第五期（713-718）

摘要：

目的： 分析上海市嘉定区肺结核发病流行病学特征和趋势，为嘉定区开展结核病精准综合防治提供参考依据。方法： 通过“中国疾病预防控制信息系统”子系统“结核病管理信息系统”，获取登记日期在2010年1月1日至2023年12月31日所有肺结核病例的病案数据，分析2010—2023年肺结核发病流行特征，运用季节性自回归移动平均混合模型(SARIMA)对2010—2022年数据进行建模，并利用2023年全年报告发病数据进行验证。结果： 2010—2023年上海市嘉定区共登记肺结核病例6 022例，报告发病率总体呈现下降趋势(χ²_趋势=239.150，P<0.001)，总体下降率43.85%，年均下降率4.34%。男女性别比为2.02∶1，构成比最高的年龄组别为20~29岁组(30.54%)，职业分布中最高的为家务及待业(17.55%)。季节高峰在7~9月份。地区占比最高为流动人口密集的江桥镇(17.55%)，其次是产业园区较为密集的安亭镇(14.55%)。SARIMA(0,1,1)×(0,1,1)₁₂模型能较好地拟合嘉定区的发病趋势(AIC=1 033.76，BIC=1 042.65)，预测总体相对误差为-7.49%，预测精度较高(RMSE=5.72，MAPE=18.89%)。结论： 2010—2023年上海市嘉定区肺结核发病呈总体下降趋势，登记病倒以男性、家务及待业为主，夏季是重点防控季节，同时需要关注流动人口及产业园区密集地区的结核病防控和健康教育。

Objective: To analyze the epidemiological characteristics and trends of pulmonary tuberculosis(TB) incidence in Jiading District, Shanghai and to provide reference data for precise and integrated TB prevention and control measures in the region. Methods: Case data of all TB patients registered between January 1, 2010, and December 31, 2023, were retrieved from the “Tuberculosis Management Information System”, a subsystem of the “China Disease Prevention and Control Information System”. The epidemiological characteristics of TB incidence during this period were analyzed. A seasonal autoregressive integrated moving average(SARIMA) model was employed to fit the data from 2010 to 2022, and the model was validated using the 2023 annual incidence data. Results: A total of 6 022 TB cases were registered in Jiading District, Shanghai, from 2010 to 2023. The reported incidence rate showed a significant downward trend(χ² _trend =239.150, P<0.001), with an overall reduction of 43.85% and an average annual decline rate of 4.34%. The male-to-female ratio was 2.02∶1, and the age group with the highest proportion was 20-29 years(30.54%). Among occupational groups, the highest proportion was observed in homemakers and unemployed individuals(17.55%). The seasonal peak occurred from July to September. Geographically, Jiangqiao Town, which has a high concentration of migrant populations, accounted for the largest proportion of cases(17.55%), followed by Anting Town, characterized by dense industrial parks(14.55%). The SARIMA(0,1,1)×(0,1,1)₁₂ model effectively captured the incidence trend in Jiading District(AIC=1 033.76, BIC=1 042.65), with a total relative prediction error of -7.49% and high predictive accuracy(RMSE=5.72, MAPE=18.89%). Conclusion: From 2010 to 2023, TB incidence in Jiading District, Shanghai, exhibited an overall downward trend, The distribution of registered cases were predominantly among males and individuals engaged in household duties and unemployed. Attention should be focused on TB prevention, control, and health education during the summer season, among migrant populations, and in industrial park areas with densely populated.

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