Background:The problem of population aging is a critical public health concern in modern China,and more tuberculosis(TB)control efforts are needed to reach elderly people at high priority.In this study,we aim to deter...Background:The problem of population aging is a critical public health concern in modern China,and more tuberculosis(TB)control efforts are needed to reach elderly people at high priority.In this study,we aim to determine the prevalence and identify the risk factors of TB among elderly people in China.Methods:A multistage cluster-sampled cross-sectional survey was conducted in 2013,and 27 clusters were selected from 10 counties of 10 provinces in China.All consenting participants greater than or equal to 65 years of age were screened for pulmonary TB with a chest X-ray(CXR)and a symptom questionnaire.Three sputum specimens for bacteriological examination by microscopy and culture were collected from those whose screening was positive.Prevalence was calculated,a multiple logistic regression model was performed to confirm the risk factors,and population attributable fraction(PAF)of each risk factor was calculated to indicate the public health significance.Results:Of 38888 eligible people from 27 clusters,34269 participants finished both questionnaire and physical examination.There were 193 active pulmonary TB cases,62 of which were bacteriologically confirmed.The estimated prevalence of active pulmonary TB and bacteriologically confirmed TB in those 65 years of age and older was 563.19 per 100000(95%CI:483.73-642.65)and 180.92 per 100000(95%CI:135.89-225.96),respectively.Male sex,older age,living in rural areas,underweight,diabetes,close contact of pulmonary TB(PTB)and previous TB history are all risk factors for TB.The risk of TB increased with increasing age and decreasing body mass index(BMI)after adjusting for other factors,and there is a positive dose-response relationship.Conclusions:In China,active case finding(ACF)could be implemented among elderly people aged 65 and above with underweight,diabetes,close contact history and previous TB history as a priority,which will get significant yields and be cost-effective.展开更多
目的调查了解广州市社区中老年人骨量减少、骨质疏松症(osteoporosis,OP)的患病率及骨质疏松性骨折发生率,分析近年来骨质疏松患病率的增减趋势。方法采用现场问卷调查了解受试者的基本资料(包括性别、年龄、身高、体重、骨折史等),并...目的调查了解广州市社区中老年人骨量减少、骨质疏松症(osteoporosis,OP)的患病率及骨质疏松性骨折发生率,分析近年来骨质疏松患病率的增减趋势。方法采用现场问卷调查了解受试者的基本资料(包括性别、年龄、身高、体重、骨折史等),并用美国双能X线骨密度仪测量1529例40～87岁中老年人群的腰椎正位和左髋部骨密度(bone mineral density,BMD),以性别、年龄分组进行分析。结果随着年龄递增,各组髋部BMD值逐渐下降,而腰椎BMD值并未随着增龄而呈现递减的趋势,60岁以上中老人髋部BMD值显著低于腰椎BMD值(P<0.05)。根据腰椎BMD值计算,中老年人OP总患病率为30.7%,其中女性为34.2%,明显高于男性的17.9%(P<0.05)。低骨量(osteopenia,OPA)总患病率为41.8%,男女分别为42.4%和41.6%(P>0.05)。根据髋部BMD值计算,OP总患病率更高,达到38.2%,女性为39.4%,高于男性的33.9%(P<0.05)。OPA总患病率为47.4%,男性为52.7%,女性为46.0%(P>0.05)。受调查的中老年男性中有骨折史的为82例,女性为357例,OP患者骨折发生率为37.8%,远高于非OP患者23.1%(P<0.01),再骨折发生率OP患者为6.2%,高于非OP患者的2.64%(P<0.01)。结论广州市社区中老年人骨质疏松患病率和脆性骨折发生率较高,且其发生率均较以往有明显增高的趋势,建议早筛查、早诊断、早治疗。根据髋部BMD值进行骨质疏松评估的敏感性更高,应该首选髋部作为骨密度测量的部位。展开更多
基金The National Twelfth Five-year Mega-Scientific Projects of Infectious Diseases in China(Grant No:2013ZX10003004-001).
文摘Background:The problem of population aging is a critical public health concern in modern China,and more tuberculosis(TB)control efforts are needed to reach elderly people at high priority.In this study,we aim to determine the prevalence and identify the risk factors of TB among elderly people in China.Methods:A multistage cluster-sampled cross-sectional survey was conducted in 2013,and 27 clusters were selected from 10 counties of 10 provinces in China.All consenting participants greater than or equal to 65 years of age were screened for pulmonary TB with a chest X-ray(CXR)and a symptom questionnaire.Three sputum specimens for bacteriological examination by microscopy and culture were collected from those whose screening was positive.Prevalence was calculated,a multiple logistic regression model was performed to confirm the risk factors,and population attributable fraction(PAF)of each risk factor was calculated to indicate the public health significance.Results:Of 38888 eligible people from 27 clusters,34269 participants finished both questionnaire and physical examination.There were 193 active pulmonary TB cases,62 of which were bacteriologically confirmed.The estimated prevalence of active pulmonary TB and bacteriologically confirmed TB in those 65 years of age and older was 563.19 per 100000(95%CI:483.73-642.65)and 180.92 per 100000(95%CI:135.89-225.96),respectively.Male sex,older age,living in rural areas,underweight,diabetes,close contact of pulmonary TB(PTB)and previous TB history are all risk factors for TB.The risk of TB increased with increasing age and decreasing body mass index(BMI)after adjusting for other factors,and there is a positive dose-response relationship.Conclusions:In China,active case finding(ACF)could be implemented among elderly people aged 65 and above with underweight,diabetes,close contact history and previous TB history as a priority,which will get significant yields and be cost-effective.
文摘目的调查了解广州市社区中老年人骨量减少、骨质疏松症(osteoporosis,OP)的患病率及骨质疏松性骨折发生率,分析近年来骨质疏松患病率的增减趋势。方法采用现场问卷调查了解受试者的基本资料(包括性别、年龄、身高、体重、骨折史等),并用美国双能X线骨密度仪测量1529例40～87岁中老年人群的腰椎正位和左髋部骨密度(bone mineral density,BMD),以性别、年龄分组进行分析。结果随着年龄递增,各组髋部BMD值逐渐下降,而腰椎BMD值并未随着增龄而呈现递减的趋势,60岁以上中老人髋部BMD值显著低于腰椎BMD值(P<0.05)。根据腰椎BMD值计算,中老年人OP总患病率为30.7%,其中女性为34.2%,明显高于男性的17.9%(P<0.05)。低骨量(osteopenia,OPA)总患病率为41.8%,男女分别为42.4%和41.6%(P>0.05)。根据髋部BMD值计算,OP总患病率更高,达到38.2%,女性为39.4%,高于男性的33.9%(P<0.05)。OPA总患病率为47.4%,男性为52.7%,女性为46.0%(P>0.05)。受调查的中老年男性中有骨折史的为82例,女性为357例,OP患者骨折发生率为37.8%,远高于非OP患者23.1%(P<0.01),再骨折发生率OP患者为6.2%,高于非OP患者的2.64%(P<0.01)。结论广州市社区中老年人骨质疏松患病率和脆性骨折发生率较高,且其发生率均较以往有明显增高的趋势,建议早筛查、早诊断、早治疗。根据髋部BMD值进行骨质疏松评估的敏感性更高,应该首选髋部作为骨密度测量的部位。
