- 期刊
北臺灣結核病發生率性別差異之研究
Gender Differences in Incidence and Clinical Manifestations of Tuberculosis in Northern Taiwan
摘要
目的：根據美國舊金山的研究，結核病發生率性別差異男／女比值整体為2.1，而且從兒童期14歲後性別差異才開始顯現，最大男／女比值發生在45-64歲，但全球結核病流行病學性別差異的原因大部份未被解釋，本文主旨在探索臺北市結核病臨床表徵和發生率的性別差異。方法：本研究以1998-2002年臺北市9,566位結核病個案為對象，針對性別發生率作回朔性流行病學分析，進一步在肺結核、肺外結核及8個肺外部位進行分層分析，以探索結核病發生率的性別差異，並以卡方或Fisher exact檢定比較男女結核病發生率的差異。結果：在研究期間，男／女發生率比值為1.78，發生率性別的差異性在青春期25歲之後才顯現出來，令人意外的發現是，在25-34歲年齡層，男／女比值逆轉為0.88，最高男／女比值在65+歲年齡層。分層分析顯示，肺外結核男／女比值整體縮小為1.38，而且直到中老年期55歲後，男女差異性才出現；肋膜部位，男／女比值介於1.22-2.52；相反地，淋巴部位男／女比值變成在0.27-0.95之間，而且形成一個有趣的雙峰分佈，一個高峰在25-34歲，另一在65+歲。結論：我們研究發現臺北市結核病發生率有顯著的性別差異，但與美國的研究結果截然不同。這些結果擴大了結核病流行病學的基礎知識，加強我們對臺北市結核病發生率性別差異的瞭解，有助於結核病防治計畫的擬定。
並列摘要
Backgrounds and Purpose: Global differences in the incidence of gender-specific tuberculosis remain largely unexplained. The objective of this study was to explore the gender differences in the incidence and clinical manifestations of tuberculosis in Taipei, Taiwan. Methods: Data of all 9,566 tuberculosis cases recorded from 1998 through 2002 were obtained from the National Tuberculosis Registry Center. A retrospective epidemiologic analysis of the incidence rate of gender-specific tuberculosis was conducted. Stratified analyses were performed on pulmonary cases, extrapulmonary cases and eight anatomic sites of extrapulmonary. We used the x2 or Fisher exact tests, as appropriate, to test the differences between male and female patients. Results: During this study period, the male/female incidence rate ratio was 1.78, Differences in genderspecific rates were noted in patients older than 25 years and the highest male/female ratio was noted in patients older than 65 years. Moreover, it is somewhat contrary to our expectation that the gender-specific incidence ratio of the patients 25-34 years old was 0.88. Stratified analysis showed that the gender difference ratio of extrapulmonary cases was 1.38 and the effect was less pronounced. In those with plural tuberculosis, the ratio was between 1.22 and 2.52. In contrast, the ratio for those with lymphatic tuberculosis was between 0.27 and 0.95 and the age-specific incidence showed an apparent bimodal pattern. One peak difference in the gender ratio was at ages 25-34 years, and the other was at older than 65 years. Conclusion: There are apparent gender differences in the rates of tuberculosis in Taipei. This expands the knowledge base regarding the epidemiology of tuberculosis and enhances understanding of gender differences in tuberculosis. The results may be useful in improving the effectiveness of TB control programs in Taipei, Taiwan.