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Abstract：
To estimate whether WHO\'s End TB Strategy targets can be achieved by analysing the incidence trend of pulmonary tuberculosis in Shanghai during 1992-2016.
The age-adjusted annual incidence of tuberculosis (TB) was calculated based on data from the national TB registration system. Linear regression was applied to analyse the trend of the epidemic, together with the statistical indicator of annual percent change (APC).
The overall age-standardised rate decreased from 34.8/100 000 in 1992 to 21.2/100 000 in 2016, or by 2.15% (t = -13.258, P < 0.05) annually. After rapidly declining between 1999 and 2003 (-5.4% p.a.), the epidemic remained at a stable level with a lower annual declining rate (-1.1% p.a). In 2035, the estimated incidence will be 17.2/100 000 based on the APC in 2004-2016. There were two peaks in average incidence of the total population, 30.9/100 000 in the 20-24 age group and 66.4/100 000 in the 70-74 age group. Overall, the ratio of new to retreated cases continually rose and eventually reached 8.36:1 in 2016. The constituent ratio of smear-positive cases ranged from 35.9% to 47.8% without rising or decreasing trend (P = 0.065).
The epidemic of TB in Shanghai has steadily declined during last two decades. A new strategy should be developed to rapidly reduce the incidence rate to achieve the WHO Goals in 2035.
The age-adjusted annual incidence of tuberculosis (TB) was calculated based on data from the national TB registration system. Linear regression was applied to analyse the trend of the epidemic, together with the statistical indicator of annual percent change (APC).
The overall age-standardised rate decreased from 34.8/100 000 in 1992 to 21.2/100 000 in 2016, or by 2.15% (t = -13.258, P < 0.05) annually. After rapidly declining between 1999 and 2003 (-5.4% p.a.), the epidemic remained at a stable level with a lower annual declining rate (-1.1% p.a). In 2035, the estimated incidence will be 17.2/100 000 based on the APC in 2004-2016. There were two peaks in average incidence of the total population, 30.9/100 000 in the 20-24 age group and 66.4/100 000 in the 70-74 age group. Overall, the ratio of new to retreated cases continually rose and eventually reached 8.36:1 in 2016. The constituent ratio of smear-positive cases ranged from 35.9% to 47.8% without rising or decreasing trend (P = 0.065).
The epidemic of TB in Shanghai has steadily declined during last two decades. A new strategy should be developed to rapidly reduce the incidence rate to achieve the WHO Goals in 2035.
摘要：
通过对上海市1992-2016年肺结核发病趋势的分析,评估WHO的终结结核病战略目标能否实现。
根据国家结核病登记系统的数据计算了按年龄调整的结核病年发病率。应用线性回归分析疫情趋势,以及年度百分比变化(APC)的统计指标。
总体年龄标准化率从1992年的34.8/10万下降到2016年的21.2/10万，每年下降2.15%（t=-13.258，P<0.05）。在1999年至2003年期间迅速下降(-5.4%p.a.)之后，疫情保持在稳定水平，年下降率较低(每年下降1.1%)。2035年，根据2004-2016年的APC估计发病率为17.2/100000。总人口平均发病率有两个高峰，20-24岁年龄组为30.9/100000，70-74岁年龄组为66.4/100000。总的来说,新发病例与退发病例的比率持续上升,最终在2016年达到8.36:1.涂片阳性病例的构成比为35.9%~47.8%,无上升或下降趋势(P=0.065)。
在过去的二十年中，上海结核病的流行稳步下降。应制定一项新战略，以迅速降低发病率，以在2035年实现世卫组织的目标。
根据国家结核病登记系统的数据计算了按年龄调整的结核病年发病率。应用线性回归分析疫情趋势,以及年度百分比变化(APC)的统计指标。
总体年龄标准化率从1992年的34.8/10万下降到2016年的21.2/10万，每年下降2.15%（t=-13.258，P<0.05）。在1999年至2003年期间迅速下降(-5.4%p.a.)之后，疫情保持在稳定水平，年下降率较低(每年下降1.1%)。2035年，根据2004-2016年的APC估计发病率为17.2/100000。总人口平均发病率有两个高峰，20-24岁年龄组为30.9/100000，70-74岁年龄组为66.4/100000。总的来说,新发病例与退发病例的比率持续上升,最终在2016年达到8.36:1.涂片阳性病例的构成比为35.9%~47.8%,无上升或下降趋势(P=0.065)。
在过去的二十年中，上海结核病的流行稳步下降。应制定一项新战略，以迅速降低发病率，以在2035年实现世卫组织的目标。
