| Objective:To understand the incidence status of the pulmonary tuberculosis in Xiangtan County, and to explore impact factors of the TB prevalence and TB incidence, in order to provide the basis for the better design of TB control strategy in Xiangtan County.Method:Towns in Xiangtan County were divided to high, medium and low grades according to registration rate of new smear positive pulmonary tuberculosis in2006-2008, population and working condition of towns, Using the stratified cluster sampling method, to respectively select one town from three grades as the total study site. Three towns include85000people. This research was divided into the baseline survey in2009, cohort observation and the nested case-control study in2010, and the terminal household survey in2010, in order to understand the research object social demographic information the prevalence, incidence and impact factors of the tuberculosis. Households Cards and investigations tables of suspicious symptoms/TB history patients and investigations tables TB patients were collected, and whole information was imported EXCEL software database, and then the data was imported the reporting system of the major special project tuberculosis early warning model according to the overall program requirements, Using SPSS13.0statistical analysis software to analyze, using mean, proportion, rate and et al to describe social demographic information, suspicious symptoms of TB, the prevalence and incidence of TB. χ-test was used to compare the different prevalence rate and incidence rate in different population characteristics. The nested case-control study was used to analyze impact factors of TB incidence. The case group (80cases) and the control group (320cases) were build according to the ratio of1:4; and cases group of prevalence impact factors analysis was be confirmed activities patients (104cases) in the baseline survey and the control group was the same as the control group (320cases) in incidence impact factors analysis. Univariate and multivariate non-conditional Logistic regression analysis were used to analyze association between the exposure factors and the Tuberculosis prevalence and TB incidenceResults:1.The basic characteristics:there were84,630people to verified in baseline household survey, Yangjiaqiao town was29,288people, and the Jiangshe town was29,117people and zhonglupu town was26,225people. The male were44,343people (52.4%), the female was40,287people (47.6%), and the ratio of male to female was1.1:1. Survey population mostly was young adults, the15-54years old accounted for66.2%, with the largest number of junior high school education, accounting for44.2%(37,396/84,630), and married population was53,910people (63.7%).2. The prevalence condition:prevalence was122.9/100000(104/84630) in2009baseline survey, the smear-positive prevalence was30.7/100000(26/84630), the sputum Mycobacterium positive prevalence was54.4/100000(49/84630). The male prevalence was184.9/100000(82/44343) The female prevalence was54.6/100000(22/40287), the difference was statistically significant (χ2=29.206, P=0.000). The male prevalence was higher than female, and the difference of over35years old was more obvious. The age of patients all was older than15years old, the average age was (58.4±12.471) years old, and the minimum was18years old, the maximum was83years old. The prevalence was increasing with age increasing, the prevalence rate of the55age group was peak, and the differences of prevalence rate in different age groups was statistically significant (χ2=111.839, P=0.000). The differences of TB prevalence in different education, different occupations, different marital status was respectively statistically significant, χ2=28.885,13.284and35.437, P values were less than0.05.3. The incidence condition:84,683people were surveyed in2010, of which male was44,373people and female was40,310people,80TB patients were found in follow-up study, The tuberculosis incidence was94.5/100000(80/84683), the smear-positive incidence was38.9/100000(33/84683), the sputum Mycobacterium positive incidence was49.6/100000(42/84683). The male incidence was142.0/100000(63/44373), the female incidence42.2/100000(17/40310), the difference was statistically significance (χ2=22.292, P=0.000).The age of80patients was older than15years old, and the average age was (54.1±16.847) years old and the minimum was19years old, the maximum wad83years old. The incidence rate was increasing with age increasing.The incidence rate of65age group was peak, The differences of the incidence in different age groups was statistically significance (χ-=49.041,P=0.000). The differences in different education, different occupations, different marital status was respectively statistically significant, χ2=17.697,28.643and22.777, P values was less than0.05.4. Impact factors analysis:(1) the prevalence factors analysis:the univariate logistic regression was used to analyze the prevalence in different gender, ethnicity, age, education, occupation, marital status, annual Per capita income, per capita living space, insurance status, contact history with TB, history of tuberculosis, diabetes history, smoking history and suspicious symptoms of TB, and the results showed:the difference was statistically significant in different sex, age, educational, contact history of TB, history of tuberculosis, history of smoking, suspicious symptoms of tuberculosis."Present TB patients" was defined as a dependent variable, all of possible factors as independent variables, using non-conditional logistic stepwise regression analysis (α入=0.05, α出=0.1), and the result showed that sex, age, per capita living space, suspicious symptoms of TB, contact history of TB, history of tuberculosis were influencing factors, of which age, per capita living space, suspicious symptoms of, contact history of tuberculosis and history of tuberculosis were risk factor, and the sex was a protective factor.(2) Incidence factors analysis:the univariate logistic regression was used to analyze incidence in different age, sex, education, occupation, marital status, annual income, per capita living space, insurance status, contact history of TB, history of TB, diabetes history, smoking history, TB suspicious symptoms, and the results showed:the difference were statistically significant in different gender, age, education, occupation, marital status, history of tuberculosis, contact history of TB, smoking history and suspicious symptoms were statistically significant."Follow-up TB patents" was defined as a dependent variable and all of possible factors as independent variables, using non-conditional logistic regression multivariate analysis (α入=0.05, α出=0.1), the result showed sex and education were protective factor and TB suspicious symptoms and marital status were risk factors.Conclusion:1. Tuberculosis epidemic had decreased significantly in Xiangtan County, but disease burden is still heavy. The prevalence rate was122.9/100000, the incidence rate was94.5/100000. The male prevalence and incidence were higher than female, which was both increasing with the age increasing, and elderly male population was the focus of TB prevention and control.2. Male, older age, suspicious symptoms of TB, contact history of TB, history of TB and the smaller living area per capita is the risk factors for TB prevalence.3. Male, suspicious symptoms and married is risk factors, and high education levels is protective factor. |
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