【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56 426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(χ²_趋势=67.449,P<0.001)，年均递降率为5.30%;2012-2018年呈上升趋势(χ²_趋势=2 042.501,P<0.001)，年均递降率为-14.07%;2018-2021年呈下降趋势(χ²_趋势=1 326.131,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。更多还原

【Abstract】 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 56 426 tuberculosis cases were reported in Hotan, with the highest incidence in 2018（465.10 per 100 000） and the lowest in 2021（129.40 per 100 000）. The incidence showed a declining trend from 2012 to 2021 (χ²_trend=67.449,P<0.001), with an average annual decline rate of 5.30%. An increasing trend was observed from 2012 to 2018 (χ²_trend=2 042.501,P<0.001), with an average annual decline rate of-14.07%; while from 2018 to 2021, a decline was noted (χ²_trend=1 326.131,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 a causal relationship with the reduction of tuberculosis incidence. Its implementation could effectively curb the epidemic of tuberculosis and might be adapted for use in other regions based on specific circumstances, thereby accelerating the goal of eliminating tuberculosis outbreaks.更多还原