嵊州市2008-2011年学校肺结核聚集性疫情分析

Analysis of school clustering outbreak of tuberculosis in Shengzhou,2008-2011

目的了解学校结核病聚集性疫情发生原因,为学校肺结核病防控提供依据。方法对嵊州市2008-2011年报告处置的学校肺结核聚集性疫情进行流行病学分析。结果 2008-2011年共报告处置学校肺结核聚集性疫情4起,发现肺结核病例38例。首发病例出现症状后,随着就诊延误时间的延长,密切接触者的PPD强阳性率和肺结核罹患率增加(χ2趋值分别为18.10,10.34,P值均<0.01);涂阳病例密切接触者和一般接触者PPD强阳性率和肺结核罹患率差异有统计学意义(χ2值分别为44.16,11.21,P值均<0.01)。结论首发涂阳病例出现症状后就诊延误,未及时确诊和隔离治疗,易造成聚集性感染疫情的发生。

Objective To analyze the causes of clustering outbreak of tuberculosis in schools and to provide evidence for taking measures of tuberculosis controlling. Methods Descriptive study was used to analyze the data of school clustering outbreak of tuberculosis in Shengzhou city during 2008 -2011. Results During the period, 4 outbreaks of school tuberculosis epidemic were successfully managed, and 38 cases with tuberculosis were detected. It was found that based on the symptoms of the first cases, the percentage of strong positive reaction cases with PPD and percentage of tuberculosis cases increased significantly with the delay duration of diagnosis （χ2 = 18.10,10.34, P 〈 0.01 ） ; Further analysis by use of chi-square tests showed that there was significant difference in strong positive reaction cases with PPD between cases who had close contacts with smear-positive cases （χ2 = 44.16,P 〈 0.01） and those having normal contact with smear-positive cases （χ2 = 11.21 ,P 〈 0.01 ）. Conclusion Delay in detecting the symptoms of the first cases with smear-positive, missing the timely diagnosis and isolated treatments may be the critical factors which cause the clustering outbreak of tuberculosis in schools.