CAJ | 학술논문

目的了解2006-2009年上海市松江区肺结核病例的空间分布特征及其影响因素.方法收集2006-2009年松江区所有活动性肺结核病例和菌阳肺结核病例(共1815例),应用空间扫描统计量探测结核病例的空间聚集区,并应用logistic回归模型比较聚集区内、外肺结核病例的人口学特征和临床特征差异.结果松江区2006-2009年共确诊活动性肺结核1815例,其中,菌阳肺结核730例.活动性肺结核病例的空间聚集区为车墩镇和新桥镇[相对危险度(RR)=1.38,对数似然比(LLR)=16.78,P＜0.01],是国家级工业区所在地.2006-2007年肺结核病例没有空间聚集性,但2008-2009年出现了空间聚集区车墩镇(RR=1.70,LLR=15.06,P＜0.01).本地人口病例的空间聚集区为西南部的5个街道(镇),分别为新浜镇、石湖荡镇、小昆山镇、泖港镇和永丰街道(RR=1.49,LLR=10.52,P＜0.01),流动人口病例的空间聚集区为车墩镇(RR=1.55,LLR=15.64,P＜0.01).对本地病例来说,空间聚集区内农民(AOR=4.9,95％ CI:1.9 ～ 12.3)和其他职业者(非工人非农民)(AOR =2.6,95％CI:1.1 ～5.9)群体中的比例更高；在流动病例中,空间聚集区内在上海居住不满5年(居住＜1年:AOR =5.9,95％CI:1.8～19.5；居住1～5年:AOR=3.2,95％CI:1.0 ～9.9)和其他职业者(AOR=2.8,95％ CI:1.5 ～5.1)群体中的比例较高,来自中国东部地区(AOR=0.3,95％CI:0.1 ～0.8)和中部地区(AOR =0.5,95％CI:0.3 ～0.9)的比例较低.结论松江区肺结核病例的分布存在空间聚集性,聚集区为车墩镇.对本地人口病例来说,农民或其他职业者群体中聚集性较高；在流动人口病例中,在上海居住不满5年及来源于中国西部地区群体中聚集性较高.
목적 료해2006-2009년상해시송강구폐결핵병례적공간분포특정급기영향인소.방법 수집2006-2009년송강구소유활동성폐결핵병례화균양폐결핵병례(공1815례),응용공간소묘통계량탐측결핵병례적공간취집구,병응용logistic회귀모형비교취집구내、외폐결핵병례적인구학특정화림상특정차이.결과 송강구2006-2009년공학진활동성폐결핵1815례,기중,균양폐결핵730례.활동성폐결핵병례적공간취집구위차돈진화신교진[상대위험도(RR)=1.38,대수사연비(LLR)=16.78,P＜0.01],시국가급공업구소재지.2006-2007년폐결핵병례몰유공간취집성,단2008-2009년출현료공간취집구차돈진(RR=1.70,LLR=15.06,P＜0.01).본지인구병례적공간취집구위서남부적5개가도(진),분별위신빈진、석호탕진、소곤산진、묘항진화영봉가도(RR=1.49,LLR=10.52,P＜0.01),류동인구병례적공간취집구위차돈진(RR=1.55,LLR=15.64,P＜0.01).대본지병례래설,공간취집구내농민(AOR=4.9,95％ CI:1.9 ～ 12.3)화기타직업자(비공인비농민)(AOR =2.6,95％CI:1.1 ～5.9)군체중적비례경고；재류동병례중,공간취집구내재상해거주불만5년(거주＜1년:AOR =5.9,95％CI:1.8～19.5；거주1～5년:AOR=3.2,95％CI:1.0 ～9.9)화기타직업자(AOR=2.8,95％ CI:1.5 ～5.1)군체중적비례교고,래자중국동부지구(AOR=0.3,95％CI:0.1 ～0.8)화중부지구(AOR =0.5,95％CI:0.3 ～0.9)적비례교저.결론 송강구폐결핵병례적분포존재공간취집성,취집구위차돈진.대본지인구병례래설,농민혹기타직업자군체중취집성교고；재류동인구병례중,재상해거주불만5년급래원우중국서부지구군체중취집성교고.
Objective To identify spatial distribution and risk factors among tuberculosis (TB) cases in Songjiang district,Shanghai,2006 -2009.Methods All active TB cases and all bacteriologically confirmed TB cases diagnosed during the period from 2006 to 2009 were recruited into the study.Spatial scan statistics were used to identify spatial clusters.Using logistic regression,we compared the demographic and clinical characteristics of TB cases in spatial clusters versus TB cases not in spatial clusters.Results A total of 1815 active TB cases and 730 bacteriologically confirmed TB cases were recruited during 2006 -2009.Chedun township and Xinqiao township was detected to be a spatial cluste( RR =1.38,LLR =16.78,P ＜0.01 ),which was the location of the municipal industrial zone.No spatial cluster was found during 2006 - 2007,while during 2008 - 2009 Chedun township was detected to be a spatial cluster (RR =1.70,LLR =15.06,P ＜ 0.01 ).Among resident population,the spatial cluster of TB cases was located in the southwestern part of Songjiang district,which included five townships Xinbang,Shihudang,Xiaokunshan,Maogang and Yongfeng( RR =1.49,LLR =10.52,P ＜ 0.01 ) ; while among migrant population,the spatial cluster of TB cases was located in Chedun township(RR =1.55,LLR =15.64,P ＜0.01 ).There were higher proportions of resident TB cases who were farmers (AOR =4.9,95％ CI:1.9 - 12.3 ) or had other occupations (AOR =2.6,95％ CI:1.1 - 5.9 ) in the spatial cluster.There were higher proportions of migrant TB cases who lived here for less than 5 years( ＜1 year:AOR=5.9,95％CI:1.8-19.5; 1 -5 years:AOR =3.2,95 ％ CI:1.0 - 9.9 ) or worked at other occupations ( AOR =2.8,95 ％ CI:1.5 - 5.1 ) and lower proportions of migrant TB cases who came from Eastern region (AOR =0.3,95％ CI:0.1 -0.8 ) or Middle region(AOR =0.5,95％ CI:0.3 -0.9) in the spatial cluster.Conclusion In Songjiang district there was a spatial cluster in TB cases,which was Chedun township.Local residents with TB who were farmers or had other occupations were more likely to be in the spatial cluster.Migrants with TB who lived here for less than 5 years or came from Western region were more likely to be in the spatial cluster.