基于贝叶斯结构时间序列的和田地区“活动性肺结核患者全疗程住院治疗”防治策略实施效果定量评价  

Quantitative evaluation of implementation effect of“full course hospitalization for active pulmonary tuberculosis patients”in Hotan area based on Bayesian structured time series

作　　者：王俊安 王森路 刘年强[2] 王小敏 曹明芹[1] WANG Junan;WANG Senlu;LIU Nianqiang;WANG Xiaomin;CAO Mingqin(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830011,China;Xinjiang Center for Disease Control and Prevention,Urumqi,Xinjiang 830002,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐市830011 [2]新疆维吾尔自治区疾病预防控制中心,新疆乌鲁木齐市830002

出　　处：《热带医学杂志》2025年第1期99-103,共5页Journal of Tropical Medicine

基　　金：国家自然科学基金(82060622);“天山英才”医药卫生高层次人才培养计划(TSYC202301B166);新疆维吾尔自治区自然科学基金(2023D01C57);新疆维吾尔自治区“十四五”高等学校特色学科-公共卫生与预防医学。

摘　　要：目的分析新疆维吾尔自治区和田地区“活动性肺结核患者全疗程住院治疗”肺结核防治策略实施效果,为和田地区在肺结核防治方面的持续进步提供必要的科学支持和理论依据。方法收集2012-2021年南疆四地州肺结核疫情监测数据,描述和田地区肺结核发病的时间趋势和季节特征。以喀什地区、克孜勒苏柯尔克孜自治州、阿克苏地区三地州肺结核发病数据为参照构建贝叶斯结构时间序列模型(BSTS),拟合策略实施后和田地区肺结核发病的反事实发病数,通过比较反事实肺结核发病数和实际值定量评价该策略实施效果。结果和田地区2012-2021年累计肺结核报告发病数56426例,2018年发病率最高为465.10/10万,2021年最低为129.40/10万。肺结核报告发病率2012-2021年呈下降趋势(χ_(趋势)^(2)=67.449,P<0.001),年均递降率为5.30%;2012-2018年呈上升趋势(χ_(趋势)^(2)=2042.501,P<0.001),年均递降率为-14.07%;2018-2021年呈下降趋势(χ_(趋势)^(2)=1326.131,P<0.001),年均递降率为34.72%。季节性分析显示,6月为发病高峰,10月为发病低谷。BSTS模型结果显示,自2018年7月和田地区开始实施干预后,和田地区肺结核报告发病数总体相对减少11.60%(95%CI:-40.23%~62.82%)。结论BSTS模型可以全面、客观、定量地评价和田地区“活动性肺结核患者全疗程住院治疗”策略的实施效果,该策略与降低肺结核发病之间存在因果关系,实施该策略可有效遏制肺结核疫情流行,可根据实际情况推广至其他地区,以加速实现终止结核病流行的目标。Objective To analyze the effectiveness of the tuberculosis prevention and control strategy of“full-course hospitalization treatment for active tuberculosis patients”implemented in the Hotan region of the Xinjiang Uygur Autonomous Region,providing necessary scientific support and evidence for the continuous progress in tuberculosis prevention and control in Hotan.Methods Surveillance data on tuberculosis epidemics in Southern Xinjiang from 2012 to 2021 were collected to describe the temporal trends and seasonal characteristics of tuberculosis incidence in Hotan.The tuberculosis incidence data from Kashgar,Kizilsu Kirghiz Autonomous Prefecture,and Aksu Prefecture were used as a reference to construct a Bayesian structural time series(BSTS)model,fitting the counterfactual tuberculosis incidence in Hotan post-intervention.The effectiveness of the strategy was quantitatively evaluated by comparing the counterfactual incidence with the actual values.Results From 2012 to 2021,a total of 56426 tuberculosis cases were reported in Hotan,with the highest incidence in 2018(465.10 per 100000)and the lowest in 2021(129.40 per 100000).The incidence showed a declining trend from 2012 to 2021(χ_(trend)^(2)=67.449,P<0.001),with an average annual decline rate of 5.30%.An increasing trend was observed from 2012 to 2018(χ_(trend)^(2)=2042.501,P<0.001),with an average annual decline rate of-14.07%;while from 2018 to 2021,a decline was noted(χ_(trend)^(2)=1326.131,P<0.001),with an average annual decline rate of 34.72%.Seasonal analysis indicated that June had the highest incidence,while October had the lowest.The results of the BSTS model indicated that since the intervention began in July 2018,the reported tuberculosis incidence in Hotan had generally decreased by 11.60%(95%CI:-40.23%to 62.82%).Conclusion The BSTS model could comprehensively,objectively,and quantitatively evaluate the implementation effects of the“full-course inpatient treatment for active tuberculosis patients”strategy in the Hotan region.This strategy had

关 键 词：贝叶斯结构时间序列 肺结核 防治策略 实施效果 

分 类 号：R521[医药卫生—内科学]