Study On Tuberculosis Epidemic Status And Risk Factors In Eastern Areas Of China

ObjectiveTo understand the epidemic status of tuberculosis and incidence characteristics of rural,urban populations in eastern areas of China. To analyze the prevalence and incidence rate oftuberculosis among rural, urban populations in eastern areas of China. To discuss the riskfactors of incidence associated with tuberculosis among rural, urban populations in easternareas of China, so as to provide some reference advices and propose prevention and controlmeasures reasonably.MethodThe sample size was determined by typical sampling. All the residents in the study sitesof Minhang (urban areas) and Danyang (rural areas) were interviewed to obtain demographicdata and prevalence of TB by using cross-sectional survey, then the observation objects werefollowed-up for about12month to obtain the annual incidence and its features. Data werecollected and entered into an Excel (version2007) database and checked for errors. Dataanalysis was done using the SAS statistical soft program version9.2(SAS9.2).Result1. A total of238,310people were interviewed from2study sites in the baseline survey,and the result showed that male/female ratio in the2study sites was close to1:1. The largestage group in urban/rural areas were25～35and35～45year, respectively, the occupation ofpeople interviewed were mainly cadre or retirees (52.33%), and farmer or migrant labour (43.82%), respectively. The educational level of people interviewed in urban areas wasmainly senior middle school or above (64.84%), and junior middle school or below in rural(54.34%), the marital status among people interviewed in2study sites were married mainly,of that73.18%and71.67%, respectively, the medical insurance in urban/rural areas weremainly basic medical insurance for urban residents or workers (82.08%), and the new ruralcooperative medical care system (93.98%), respectively.2. In the baseline survey, a total of27active pulmonary tuberculosis patients weredetected, patients in urban/rural areas were mainly through clinical consultation (44.44%),and referral (53.49%), respectively, the rate of sputum smear-positive among tuberculosispatients of urban was significantly higher than that of rural, patients detected in urban/ruralareas were mainly treated initially.3. The prevalence of active tuberculosis of total population in eastern areas was29.37/100,000, the prevalence in urban/rural areas was18.59/100,000,46.21/100,000respectively. When standardized with merged population, the prevalence of active andsmear-positive tuberculosis of urban areas was57.10%and37.00%lower than that of rural.The incidence density of active tuberculosis of total population in eastern areas was29.36/100,000, the incidence density of urban/rural areas was15.06/100,000,50.76/100,000respectively. When standardized with merged population, the standardized incidence densityof active and smear-positive tuberculosis of urban was70.80%and78.80%lower than that ofrural, respectively.4. The proportion of new male tuberculosis patients was higher than female among thefollow-up populations in both2study sites, the largest age group among urban/rural patientswere25~45and55~year, respectively. In both2study sites, the educational level of newpatients was mainly below junior middle school, the occuption of new patients in urban/ruralareas was mainly cadre or retirees (45.00%), and farmer or migrant labour (33.33%),respectively; the marital status of new patients in both areas was unmarried mainly.5. Cox regression analysis shown influence factors resulting in tuberculosis in easternareas of China were male (RR=2.124,95%CI:1.195-3.775)，age (RR=1.417,95%CI: 1.011-1.985)，educational level (RR=0.653,95%CI:0.453-0.940)，occupation (RR=1.384,95%CI：1.020-1.878)，the medical history of TB (RR=11.834，95%CI:4.330-32.344) anddiabetes history (RR=3.657,95%CI:1.279-10.458).Conclusion1. There was significant difference in prevalence and incidence density of tuberculosisbetween urban and rural areas in eastern China, both of prevalence and incidence density oftuberculosis in rural areas were higher than that of urban.2. In eastern areas of China, there were differences in demographic characteristics, casedetection and structure of tuberculosis patients, and tuberculosis related education andscreening for tuberculosis would improve and increase the detection and cure rate.3. People with characteristics such as male, lower educational level, older, hard physicallabour, tuberculosis history or diabetes history may be at higher risk for tuberculosis ineastern areas of China.