上海市青浦区不同类别高中肺结核密接感染及预防治疗现况分析

Analysis of Tuberculosis Infection and Preventive Treatment among Close Contacts in Different Types of High Schools in Qingpu District of Shanghai

目的:通过对上海市青浦区8起高中学校肺结核散发疫情的密切接触者感染情况及预防性服药分析,为学校开展结核病防控工作提供参考。方法:2018年1月1日—2020年12月31日,选取上海市青浦区高中发生肺结核疫情的密切接触学生401例作为研究对象。分析职业高中和普通高中两种不同类别学校肺结核疫情密切接触人员判定、感染情况及预防性服药的差异。结果:2018年1月1日—2020年12月31日,职业高中共有5起肺结核疫情,判定密切接触人员192例;普通高中共有3起疫情,判定密切接触人员209例,两类学校平均每例患者判定密接例数为38.4例和69.7例;职业高中和普通高中学生密切接触人员结核分枝杆菌潜伏感染率分别为7.45%和14.14%;职业高中和普通高中密切接触人员结核菌素试验强阳性例数分别为5例和7例,其中预防性抗结核治疗例数分别0例和5例。结论:职业高中肺结核疫情的密切接触人员结核分枝杆菌潜伏感染率虽低于普通高中,但疫情发生频次较高,且接受预防性服药率较低,强化职业高中肺结核疫情防控措施是防止青浦区高中肺结核疫情发生的关键。

OBJECTIVE To provide reference for tuberculosis prevention and control in schools by analyzing the infection of close contacts(close contacts)in 8 sporadic cases of tuberculosis in high schools in Qingpu District.METHODS A retrospective analysis was conducted on 8 sporadic tuberculosis cases in high schools in Qingpu district from 2018 to 2020,and the differences of tuberculosis epidemic characteristics,close infection and prophylactic medication in vocational high schools and ordinary high schools were discussed.RESULTS In three years,there were 5 cases of tuberculosis epidemic in vocational high schools and 3 cases of tuberculosis epidemic in ordinary high schools,and 192 cases and 209 cases of students were identified as close contacts,and the close contacts were determined to be 38.4 and 69.7.The latent infection rates of tuberculosis were 7.45%in vocational high schools and 14.14%in common high schools,the difference was statistically significant.There were 5 cases of TST strong positive in vocational high school and 7 cases in ordinary high school.Among them,the number of cases which took preventive medicine is 0 and 5.CONCLUSION The Guidelines for the Prevention and Control of Tuberculosis in Schools in China define close contact groups in a user-friendly and more precise manner.Although the dense latent infection rate of tuberculosis in vocational high schools is lower than that in ordinary high schools,the frequency of the epidemic is higher,and the rate of prophylactic medication is lower.Strengthening the prevention and control measures of TB epidemic in vocational high schools is the key to reduce the epidemic of TB in high schools.