Age-period-cohort analysis of pulmonary tuberculosis reported incidence, China, 2006-2020.

IF 4.8 1区医学 Q1 INFECTIOUS DISEASES

Infectious Diseases of Poverty Pub Date : 2022-07-28 DOI:10.1186/s40249-022-01009-4

Zhe Dong, Qi-Qi Wang, Shi-Cheng Yu, Fei Huang, Jian-Jun Liu, Hong-Yan Yao, Yan-Lin Zhao

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引用次数: 14

Abstract

Background: Tuberculosis (TB) poses a severe public health challenge in China and worldwide. This study evaluated the effects of age, period, and birth cohort on reported incidence trends of TB based on population and refined the characteristics of high-risk groups.

Methods: Aggregate data that reported pulmonary tuberculosis (PTB) cases from China Tuberculosis Management Information System (TBIMS) from 2006 to 2020 were used to analyze effect coefficients through the age-period-cohort (APC) model based on intrinsic estimator (IE) method, and converted them into relative risk (RR) to estimate trends.

Results: A total of 14.82 million cases of PTB were reported in China from 2006 to 2020, showing a continuous downward trend. The reporting rate increased with age by age group, with 70-74 years old being 2-3 times higher than that in 20-24 years old. APC analysis model showed that age effects were bimodal in 20-24 years old [RR = 2.29, 95% confidence interval (CI): 1.73-3.03] and 70-74 years old (RR = 1.95, 95% CI: 1.67-2.27), and lower than the overall average in the groups under 15 years old. Stratified results showed that the risk was higher for women under age 40 than men and higher for men over 40. The risk was higher in urban than in rural areas under 30 years old and slightly higher in rural than in urban between 30 and 64 years old. The risk for 15-34 years old was significantly higher in the east than in other regions. The period effects showed a decreasing trend, and the risk was higher in rural in recent years. Except for cohorts born in 1961-1965 and 2001-2005, where the RR increased, the later the cohort was born, the lower the risk. The cohort 1926-1930 in eastern had the highest risk (RR = 3.49, 95% CI: 2.44-4.98).

Conclusions: The reported incidence of PTB continued to decline in China from 2006 to 2020. The young (20-24 years old) and the elderly (70-74 years old) were equally at high risk. There were differences in the age, period and cohort effects on PTB incidence among gender, urban-rural and regions. Our findings better reflected the characteristics of high-risk populations, thus contributing to the development of timely and effective intervention strategies, and providing clues for etiological research.

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2006-2020年中国肺结核报告发病率的年龄-时期-队列分析

背景:结核病(TB)在中国和世界范围内都是一个严峻的公共卫生挑战。本研究评估了年龄、时期和出生队列对人口报告的结核病发病率趋势的影响，并细化了高危人群的特征。方法:利用中国结核病管理信息系统(tims) 2006 - 2020年肺结核(PTB)病例报告汇总数据，采用基于本征估计(IE)方法的年龄-时期-队列(APC)模型分析影响系数，并将其转化为相对危险度(RR)估算趋势。结果:2006 - 2020年，全国共报告肺结核1482万例，呈持续下降趋势。报告率随年龄的增长而增加，其中70-74岁是20-24岁的2-3倍。APC分析模型显示，年龄效应在20 ~ 24岁(RR = 2.29, 95%可信区间(CI): 1.73 ~ 3.03)和70 ~ 74岁(RR = 1.95, 95% CI: 1.67 ~ 2.27)呈双峰型，且低于15岁以下年龄组的整体平均水平。分层结果显示，40岁以下女性的风险高于男性，40岁以上男性的风险更高。在30岁以下的人群中，城市的风险高于农村，在30岁至64岁之间，农村的风险略高于城市。东部地区15-34岁人群的患病风险明显高于其他地区。近年来，时期效应呈下降趋势，农村地区风险较高。除了出生在1961-1965年和2001-2005年的人群(RR增加)外，出生越晚的人群风险越低。东部1926-1930年队列的风险最高(RR = 3.49, 95% CI: 2.44-4.98)。结论:2006 - 2020年，中国肺结核发病率持续下降。年轻人(20-24岁)和老年人(70-74岁)的风险同样高。性别、城乡、地区对肺结核发病率的影响在年龄、时期和队列效应上存在差异。本研究结果较好地反映了高危人群的特点，有助于制定及时有效的干预策略，并为病因学研究提供线索。

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来源期刊

Infectious Diseases of Poverty Medicine-Public Health, Environmental and Occupational Health

CiteScore

16.70

自引率

1.20%

发文量

368

审稿时长

13 weeks

期刊介绍： Infectious Diseases of Poverty is a peer-reviewed, open access journal that focuses on essential public health questions related to infectious diseases of poverty. It covers a wide range of topics and methods, including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies, and their application. The journal also explores the impact of transdisciplinary or multisectoral approaches on health systems, ecohealth, environmental management, and innovative technologies. It aims to provide a platform for the exchange of research and ideas that can contribute to the improvement of public health in resource-limited settings. In summary, Infectious Diseases of Poverty aims to address the urgent challenges posed by infectious diseases in impoverished populations. By publishing high-quality research in various areas, the journal seeks to advance our understanding of these diseases and contribute to the development of effective strategies for prevention, diagnosis, and treatment.