【摘要】 目的 对2015―2024年云南省普洱市肺结核的报告发病情况进行时空动态分析，为制定针对性的区域防控策略提供依据。方法 收集2015―2024年普洱市肺结核发病数据，使用时间序列分析，结合空间自相关和时空扫描方法来识别普洱市乡(镇)层面的时间趋势和空间模式。结果 2015―2024年普洱市共报告肺结核24 826例，年均发病率为98.33/10万，病例以45～<60岁年龄组(30.21%)、男性(69.30%)和农民(88.10%)为主。澜沧拉祜族自治县和墨江哈尼族自治县病例占比最高(40.64%,10 090/24 826)。Joinpoint回归分析结果显示，2015―2024年普洱市肺结核发病率总体呈上升趋势(AAPC=3.66%,P=0.013)。全局空间自相关分析结果显示，2015―2024年普洱市肺结核报告发病率的莫兰指数为0.33～0.59,差异均有统计学意义(均P<0.001);局部空间自相关分析结果显示，2015―2024年普洱市肺结核发病率每年均存在热点区域(“高-高”聚集),各年度热点区域主要集中在普洱市西南部(孟连傣族拉祜族佤族自治县、西盟佤族自治县、澜沧拉祜族自治县)和北部(墨江哈尼族自治县)。时空扫描分析共探测到3个时空聚集区(均P<0.05),其中一类聚集区主要位于孟连傣族拉祜族佤族自治县、西盟佤族自治县、澜沧拉祜族自治县3个县的28个乡(镇),聚集时间为2018―2022年(RR=1.73,LLR=487.57);二类聚集区为墨江哈尼族自治县的5个乡(镇),聚集时间为2020―2024年(RR=2.20,LLR=185.88)。结论 2015―2024年普洱市肺结核疫情呈上升趋势，应重点关注西南部和北部的高发地区并制定针对性防控策略和提供政策支持。更多还原

【Abstract】 Objective A spatio-temporal dynamic analysis of reported tuberculosis incidence in Pu′er City of Yunnan Province from 2015 to 2024 was conducted to provide evidence for the formulation of targeted regional prevention and control strategies. Methods Pulmonary tuberculosis incidence data in Pu′er City from 2015 to 2024 were collected and analyzed using time series analysis, in combination with spatial autocorrelation and spatiotemporal scan statistics, to identify temporal trends and spatial patterns at the township level in Pu′er City. Results From 2015 to 2024, Pu′er City reported a total of 24 826 cases of tuberculosis, with an annual incidence rate of 98.33 per 100 000. The majority of cases occurred among individuals aged 45-<60 years(30.21%), males(69.30%), and farmers(88.10%). Lancang Lahuzu Autonomous County and Mojiang Hani Autonomous County had the highest numbers of reported cases, accounting for 40.64%(10 090/24 826) of all cases in Pu′er City. Joinpoint regression analysis results showed that the incidence rate of tuberculosis in Pu′er City from 2015 to 2024 exhibited an overall upward trend(AAPC=3.66%, P=0.013). Global spatial autocorrelation analysis showed that the Moran′s I values for the reported incidence of tuberculosis in Pu′er City from 2015 to 2024 ranged from 0.33 to 0.59, all positive and statistically significant(all P<0.001). Local spatial autocorrelation analysis showed that there were hotspot areas( "high-high" clustering) in the incidence of tuberculosis in Pu′er City every year from 2015 to 2024, with the hotspots primarily concentrated in the southwestern(Menglian Daizu Lahuzu Wazu Autonomous County, Wa Autonomous County of Ximeng, Lancang Lahuzu Autonomous County) and northern(Mojiang Hani Autonomous County) regions of Pu′er City. Spatiotemporal scan analysis detected three statistically significant space-time clusters(all P<0.05). The primary cluster encompassed 28 townships across Menglian Dai, Lahu, and Va Autonomous County; Ximeng Va Autonomous County; and Lancang Lahu Autonomous County, with clustering occurring from 2018 to 2022(RR=1.73, LLR=487.57). The secondary cluster was located in five townships of Mojiang Hani Autonomous County, with clustering observed from 2020 to 2024(RR=2.20, LLR=185.88). Conclusions From 2015 to 2024, the incidence of tuberculosis in Pu′er City showed an upward trend. The southwestern and northern of Pu′er City should be prioritized for strengthened surveillance and targeted prevention and control measures, accompanied by tailored policy support.更多还原