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At present, the annual incidence of pulmonary tuberculosis(TB) is approximately 1.3 million in China, and is NO.2 in the world,amounted to t14.3 percent, the work of pulmonary tuberculosis prevention and control is facing great challenges,because of the severe prevalence. This study is aimed to find the influential factors of pulmonary tuberculosis, and create a reasonable model to forcast the prevalence and the trends in the future of tuberculosis in chongqing.Then it provides a scientific basis for rational distribution of health resources and sustainable effectively work of pulmonary tuberculosis prevention and control.Firstly, the study screened preliminary he influential factors of pulmonary tuberculosis by Delphi method . Then the study was carried out in 4 areas in chongqing which were selectd by the fifth national tuberculosis epidemiology investigation ,and a cross-sectional survey was conducted,with the sample of 4678 ,to investigte the status of awareness on knowledge about tuberculosis prevention and control.; Meanwhile adopts a case-control study was apdpted in 3 sampling areas all active pulmonary tuberculosis patients, including 322 new discovered and known patients ,and 268 controls group with same age and group percentage in the same area, without respiratory system diseases .Then a investigation was conducted to find out the i influential factors of TB.The registration data were Collected from institute of tuberculosis prevention and treatment of chongqing about the yearly numbers of TB patients from 1993 to 2009 and monthly from 2005 to 2009 . 5 models which include grey system model (GM (1, 1)), Grey-Markov M odel,Auto Regressive Integrated Moving Average (ARIMA), Back Propagation Artificial Neural Network(BP-ANN) , Combinational Forecasting Model Based on ARIMA and bp-ANN (ARIMA - BPNN) were used to forcast the prevalence of tuberculosis in chongqing.Then compare the perdictability of these models,the best model would be chosen to forecast the prevalence of tuberculosis.The results of this study: influential factors of TB were preliminary screened Through Delphi investigation, whose scores were higher than 3 points,including(sorted by descending): (1) the individual factors: the individual burden of disease, individual bedroom ventilation, individual tuberculosis exposure, individual nutritive condition, the dust exposure, individual working strength, Individual cultural degree, individual smoking, and individuals living area and physical exercise; individual (2) index of TB work in controling: tuberculosis cure rate, TB registered rate, DOTS coverage, TB prevalence rate, BCG pitching rate, TB mortality; (3) population factors: multi-drug resistance prevalence of TB , HIV prevalence, migrants, TB and HIV infection, social economic factors, awareness about the tuberculosis knowledge in the population, public health behavior in public , tuberculosis report rate in the comprehensive hospital, population density; (4) other factors: the government’s concerns, tuberculosis prevention funds, the human resources in prevention and treatment of tuberculosis, improving in the legal system about TB prevention and control, centralized administration, social concerns, controling social circulation field of anti-tuberculosis drugs.In the results of awareness about tuberculosis knowledge in the masses the awareness rate of the core information is 64.71%,they had a higher awareness in 2 aspects which were "Have you heard of tuberculosis," and "Do you think tuberculosis is contagious" , the percentage were 90.83%, 79.69%.,respectively .And they had a lower awareness in 5 aspects which were " major infectious approach of tuberculosis ", "if you doubt that you have tuberculosis, "Dou you think what is the key measures to cure tuberculosis ", what kind of hispital you should choose ", "what are the symptoms of tuberculosis ", " the free policy in examination and the treatment of tuberculosis", the percentage were 54.66%, 54.40%, 58.00%,60.24%, 63.45%, respectively.In the case-control study, there are statistical significance in career, cultural degree, medial assurance, BMI, average income by month last year in urban residents between case and cotrol group(P < 0.05). The logistic regression results showed that prevalence of tuberculosis were related to the type of household ( OR=1.602 ,95%CI=1.046~2.454), BCG pitching (OR = 5.464, 95% CI = 3.472 ~8.598), smoking (OR = 3.02, 95% CI = 1.791 ~ 5.094), nutrition status (OR = 1.387, 95% CI = 0.954 ~ 2.017), psychological pressure (OR = 1.317, 95% CI = 1.105 ~ 1.571).The results of prevalence forecasting of pulmonary tuberculosis in chongqing: GM (1, 1) model, gray markov model, ARIMA model, the BP neural network model, ARIMA -- ANN ,their average relative error 35.53%, 32.62% 28.64%, 13.62%, 14.43% ,respectively.Conclusion:⑴Through two round Delphi method expert consultation survey, it find out that the influential factors include: tuberculosis cure rate, the government’s concerns, tuberculosis prevention funds, TB registered rate, DOTS coverage, the HIV prevalence, migrants, TB and HIV infection, the human resources in prevention and treatment of tuberculosis, awareness about the tuberculosis knowledge in the population, individual bedroom ventilation, etc.⑵The population have a lower awareness about 5 aspects ,including ; major infectious approach of tuberculosis, institute of tuberculosis prevention and treatment , the key measures to cure tuberculosis, the symptoms of tuberculosis , the free policy in examination and the treatment of tuberculosis.So it is necessary to strengthen awareness of the related knowledge.⑶The influential factors of pulmonary tuberculosis are the type of household, BCG pitching, smoking, nutrition, psychological pressure. Therefore strengthening exercise, paying attention to rest, and keeping a good living habits are important to reduce the possibility of cathching TB.⑷BP-ANN model is the best fitted model compared with GM (1, 1) model, ARIMA model. Combinational Forecasting Model has a higher prediction accuracy relative to a single model , data forcasted is more reasonable.
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