Study On Tuberculosis Incidence And Its Risk Factors In Rural Areas Of China

ObjectiveTo understand tuberculosis epidemic status and explore risk factors oftuberculosis incidence in order to provide a basis for the prevention and control oftuberculosis in rural areas. To understand tuberculosis incidence in different parts inthe study field and explore the impact of the risk factors, to detect the extent of theharm of the different risk factors on population in order to provide theoretical basisfor the prevention and control of tuberculosis.MethodTypical sampling was used to select the study field. The subjects in the cohortwere those who were not the patients of tuberculosis in baseline investigatement.Tuberculosis incidence and influencing factors was reported based onpopulation-based prospective cohort study in two rural areas. The differences betweenrural subjects were found by2test or Fisher exact and Cox proportional risk modelwas used to detecte the risk factors of tuberculosis mobility. In nested case controlstudy, the risk factors of the incidence and the Population Attributable Risk among thetotal subjects were figured out by conditional logistic regression.Results1. Of total408,889cohort subjects the incidence density of active tuberculosis was41.75per100,000person-years (95%CI:35.56-48.73), with that of18.59per100,000person-years (95%CI:14.57-23.38) for sputum smear positivetuberculosis.2. As the rural subjects, the prevalence of active tuberculosis in Xiangtan andDanyang was122.89per100,000(95%CI:99.29-146.49) and46.21per100,000 (95%CI:32.40-60.02) respectively, the corresponding data for sputum smearpositive tuberculosis was30.72per100,000(95%CI:18.91-42.53) and17.19per100,000(95%CI:8.77-25.61).3. Of total177,529in rural field, during one year follow-up, the incidence density ofactive tuberculosis was85.26per100,000person-years (95%CI:65.57-104.95)and50.76per100,000person-years (95%CI:35.93-65.59) respectively, with34.34per100,000person-years (95%CI:21.84-46.84) and24.81per100,000person-years (95%CI:14.44-35.18) for sputum smear positive tuberculosiscorrespondingly.4. The radio of male-female among the patients in rural cohort was3.33:1, andpatients were mainly in55-and65-. According to the multiple analysistuberculosis history and per captia living space media and above may increasetuberculosis with RR7.00(95%CI:2.76-17.18) and1.86(95%CI:1.15,3.01)respectively in Xiangtan. While the risk factor was only tuberculosis history withRR31.08(95%CI:13.22-73.10) in Danyang.5. The nested case control study among the total cohort found out that tuberculosishistory and former smoking were risk factors for tuberculosis with OR15.82(5.62-44.53) and6.54(3.26-12.37) respectively. The Population Attributable Riskfor tuberculosis history and former smoking was32.34%and30.69%respectively.Conclusion1. Tuberculosis epidemic was not proportional in rural areas in China. Incidence inthe middle was higher than in the east. Although incidence in the east wasrelatively low, the proportion of stupum smear active was high. So thetuberculosis control must be assignable.2. The most potential population of suffering tuberculosis was those who have thetuberculosis history. The department of tuberculosis control should follow thecured patients to avoid relapse. 3. The screening among tuberculosis contact should be done to detect and treattuberculosis in the early period.