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In 2011–2020, a total of 189,416 cases of PTB were reported in Kashgar, with the rate of reported cases increased from 402.18/100,000 in 2011 to 524.64/100,000 in 2017 (χ2trend=26.09, P<0.01) and remarkably declined from 806.75/100,000 in 2018 to 250.74/100,000 in 2020 (χ2trend=314.44, P<0.01). The mean annual rate of reported PTB from 2011 to 2020 was 450.91/100,000, and the mean annual rate of reported bacteriological confirmed (Bac+) PTB was 89.17/100,000. The rate of reported Bac+ PTB increased from 64.76/100,000 in 2011 to 139.12/100,000 in 2020 (χ2trend=74.44, P<0.01). The Bac+ cases accounted for 19.76% (37,425/5.48% (6,336/11,420) in 2020 (Figure 1).
Figure 1.The number and case notification rate of reported pulmonary tuberculosis (PTB) in Kashgar, 2011–2020.
During 2011–2017, there were mainly 2 peaks in the reported cases of PTBs observed in December and in May of each year, accounting for 10.13% (19,632/189,416) and 10% (19,374/189,416), respectively. The lowest reported PTB cases was reported in September, accounting for 6.52% of all reported PTB cases (12,638/189,416), and the highest reported PTB cases occurred in the second half of 2018, June of 2019, and May of 2020 (Figure 2).
Figure 2.Monthly distribution of reported pulmonary tuberculosis (PTB) cases in Kashgar, 2011–2020.
In 2011–2020, PTB cases were reported in all age groups, with the group of 50–79 years of age accounting for 70.95% (134,399/189,416), but the age group only accounted for 15.46% (6,490,776/41,972,493) of the whole population. The top 3 age groups with the highest rate of reported PTB were 75–79 (402.18/100,000), 85+ (4,864.42/100,000), and 70–74 (4,219.59/100,000) (Table 1).
Age (years) Number of reported cases (n) Total population Average reported incidence (1/100,000) 0–4 207 4,198,100 4.93 5–9 161 4,021,820 4.00 10–14 619 3,204,956 19.31 15–19 3,265 3,725,311 87.64 20–24 5,293 4,5641,71 115.97 25–29 6,097 4,132,047 147.55 30–34 5,755 3,249,461 177.11 35–39 5,624 3,104,012 181.18 40–44 6,590 2,706,171 243.52 45–49 8,918 2,299,515 387.82 50–54 12,244 1,740,359 703.53 55–59 18,392 1,435,042 1,281.63 60–64 27,393 1,381,596 1,982.71 65–69 32,820 963,946 3,404.76 70–74 26,498 627,976 4,219.59 75–79 17,052 341,857 4,988.05 80–84 7,910 182,041 4,345.17 85+ 4,578 94,112 4,864.42 Total (average) 189,416 41,972,493 451.29 Table 1. Age distribution of reported pulmonary tuberculosis cases in Kashgar, 2011–2020.
During 2011–2020, the mean annual rate of reported PTB of males was 451.88/100,000, and that of females was 450.67/100,000. Among all patients, males accounted for 50.13% (95,123/189,416) and females accounted for 49.87% (94,289/189,416). However, as the percentage of male patients increased over the years, there was a statistically significant difference in the ratio of male and female patients (χ2trend=204.85, P<0.01) (Table 2).
Year Male Female Number of cases Population Incidence (1/100,000) Number of cases Population Incidence (1/100,000) 2011 7,929 2,034,894 389.65 8,073 1,944,510 415.17 2012 7,800 2,005,603 388.91 8,311 1,998,390 415.88 2013 7,717 2,010,057 383.92 7,955 2,002,272 397.30 2014 7,525 2,036,026 369.59 8,153 2,003,363 406.97 2015 8,884 2,053,422 432.64 9,777 2,044,954 478.10 2016 9,522 2,133,707 446.27 10,098 2,080,940 485.26 2017 11,180 2,121,851 526.90 11,126 2,129,834 522.39 2018 17,981 2,149,467 836.53 16,950 2,180,376 777.39 2019 10,539 2,234,589 471.63 8,476 2,253,754 376.08 2020 6,046 2,270,730 266.26 5,370 2,283,754 235.14 Total 95,123 21,050,346 451.88 94,289 20,922,147 450.67 Table 2. Gender distribution of reported pulmonary tuberculosis cases in Kashgar, 2011–2020.
In 2011–2020, the top 3 occupations of PTB patients reported were farmers (83.81%, 158,741/189,416), housework & unemployed (6.54%, 12,383/189,416), and retirees (4.51%, 8,544/189,416), which accounted for 94.86% of all cases (179,67/189,416). The reported average annual PTB rates in Kashgar Prefecture were from Yengisar County (828.09/100,000), Zepu County (656.56/100,000), Yopurga County (556.22/100,000), Shule County (505.57/100,000), Yecheng County (477.00/100,000), Shache County (447.24/100,000), Shuhu County (396.88/100,000), Makit County (377.93/100,000), Bachu County (349.90/100,000), Kashgar City (341.33/100,000), Payzawat County (339.82/100,000), and Tashkurghan County (126.68/100,000). The 4 counties in southern Kashgar (Yecheng, Zepu, Shache, and Yengisar) accounted for 50.33% of all cases (95,335/189,416).
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