天津市学校结核病防控工作分析

Investigation and analysis of tuberculosis prevention and control in schools in Tianjin

目的了解天津市学校结核病防控工作现状,为进一步有针对性完善学校结核病防控策略提供依据。方法对天津市387所学校进行调查,对数据资料进行卡方检验统计分析。结果大部分学校在结核病防控工作领导责任制、工作计划和疫情报告人方面落实较好,但高等学校责任制(72.34%,34/47)和工作计划(68.09%,32/47)落实欠佳。600人以上学校配备专职卫生人员比例偏低,依次为小学1∶2497,中等学校1∶1537,高等学校1∶2673。高等学校开展晨午检(27.66%)和因病缺勤追踪(82.98%)的比例偏低,差异均有统计学意义(P值均<0.05)。小学和中等学校规范开展结核病新生入学体检比例相对较低(χ^2=26.05,P<0.001);高等学校对在校生/高疫情地区学生结核病体检比例均偏低(P<0.001)。小学结核病患者密切接触者筛查比例偏低(P<0.001)。各级学校接受预防性治疗比例均较低(P<0.001)。结论天津市各级学校均需加强学校卫生工作人员队伍建设,提高疫情中潜伏感染者接受预防性治疗的比例。小学及中等学校需进一步规范新生体检及疫情处置。高等学校需建立多级结核病疫情监测网络并开展主动筛查。

Objective To understand the current situation of tuberculosis(TB)prevention and control in schools,and to provide a basis for further improving school TB prevention and control strategies.Methods A survey of 387 schools in Tianjin was conducted.The data was statistically analyzed by chi-square test.Results Most of the schools implemented the TB prevention and control work well,including leadership responsibility,work plan and epidemic report.However,the leadership responsibility(72.34%,34/47)and the work plan(68.09%,32/47)in colleges and universities were not well implemented.The proportion of full-time health care personnel in schools with more than 600 students was relatively low,which was 1∶2497 in primary schools,1∶1537 in secondary schools,and 1∶2673 in colleges and universities.The proportion of morning and afternoon checking(27.66%)and sickness absenteeism tracking(82.98%)was low in colleges and universities.There was a lower proportion of new students carrying out TB test in primary schools and secondary schools(χ^2=26.05,P<0.001).The colleges and universities had a low proportion of TB check-up among students in schools and students in high epidemic areas(P<0.001).The screening rate of students who had close contacts with TB patients in primary schools was low(P<0.001).The proportion of preventive treatment in schools at all levels was low(P<0.001).Conclusion Schools at all levels in Tianjin need to utilize additional school health care personnel and increase the proportion of latent infection patients receiving preventive treatment.Primary and secondary schools should further standardize the physical examination of new students and the treatment of epidemic situation.It is necessary for colleges and universities to establish multi-level tuberculosis surveillance networks and carry out active screening.