台北市結核病流行病學性別差異之研究：1998~2005

Gender Differences in the Epidemiology of Tuberculosis in Taipei City, 1998~2005

目的：本文主旨在探索台北市結核病發生率和臨床表徵的性別差異。方法：我們以1998-2005年台北市15,853位新診斷且確診的結核病個案為對象，針對性別發生率作回溯性流行病學分析，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，並以卡方檢定或Fisher exact檢定比較男女結核病發生率之差異。結果：在研究期間，男／女發生率比值為1.76，發生率性別差異在青春期25歲之後才顯現出來，最高男／女比值在65+歲年齡層。其中令人意外發現的是，在25-34歲年齡層男／女比值逆轉為0.83。分層分析顯示，肺外結核男／女比值整體縮小為1.53，其中肋膜部位男／女比值介於1.22-2.19；相反的，淋巴部位男／女比值變成在0.41-1.38之間，而且形成一個有趣的雙峰分佈。結論：我們研究發現台北市結核病流行病學有顯著的性別差異，這些結果擴大了結核病流行病學的基礎知識，有助於結核病防治計畫的擬訂。

Purposes: The objective of this study was to explore gender differences in incidence and clinical manifestations of tuberculosis in Taipei City. Methods: Data of all 15,853 newly diagnosed and verified Tuberculosis cases recorded from 1998 to 2005 were obtained from the National Tuberculosis Registry Database. A retrospective epidemiologic analysis of the gender-specific incidence rate of tuberculosis was conducted. Stratified analyses were performed on pulmonary tuberculosis cases and eight anatomic sites. Results: During this study period, the male/female incidence rate ratio was 1.76. Differences in gender-specific rates were noted in patients older than 25 years and the highest male/female ratio (2.27) was noted in patients older than 65 years. Moreover, it is somewhat contrary to our expectation that the gender-specific incidence ratio of patients 25-34 years old was 0.83. Stratified analysis of rates in site of disease showed that gender difference ratio of extrapulmonary cases was 1.53. For pleural tuberculosis, the ratios were between 1.22 and 2.19. The ratios for those with lymphatic tuberculosis were between 0.41 and 1.38, and the age-specific incidence showed an apparent bimodal pattern. Conclusions: Our findings show that there are apparent gender differences in the ratio of tuberculosis in Taipei City. These results expand the knowledge base regarding the epidemiology of tuberculosis, and may be useful in improving the effectiveness of TB control programs in Taipei City.