上海市卢湾区涂阳肺结核病患者及密切接触者筛查情况

Screening of sputum smear positive pulmonary tuberculosis patients and close contacts in Luwan District of Shanghai

目的了解上海市卢湾区涂阳肺结核患者及其密切接触者的筛查情况,为结核病预防控制策略的制定提供科学依据。方法采用结核病管理信息系统中病案管理导出表和涂阳肺结核患者家庭密切接触者筛查报表分析该区涂阳肺结核患者及其密切接触者的筛查情况。结果 114例涂阳肺结核患者中,以男性为主,且多数是具有劳动力的年龄,老人和学生也占一定比例;复发和失败患者占24.6%,49.1%的患者首次胸片有空洞,30.7%的患者2月末痰涂片和痰培养阳性,首次痰培养阳性的87人中有26.4%耐药,其中耐多药者占5.7%。114例涂阳肺结核病患者的密期接触者236人均报告无肺结核可疑症状,而主动进行结核检查的人数仅占6.4%(15/236)。结论涂阳肺结核患者有很强的传染性,传染危害大,其密期接触者人群主动求医检查的意识淡薄。因此,需要了解该人群结核病防治知识信念行为情况及免费筛查意愿等,以提出针对肺结核患者家庭密切接触者干预的合理对策与建议。

[Objective]To understand the screening situation of sputum smear positive pulmonary tuberculosis（TB） patients and close contacts in Luwan District of Shanghai,provide the scientific basis for developing the rational strategy of TB prevention and control.[Methods]Based on the medical records of TB Management Information System and screening reports of family close contacts of sputum smear positive TB patients,the screening situation of sputum smear positive TB patients and close contacts in Luwan District were analyzed.[Results]Among 114 sputum smear positive TB patients,male patients were more than female patients,and most people were in labor force age,while old people and students accounted for a certain proportion.24.6% of cases were relapse or treatment failure patients,49.1% showed cavity on the first chest film,and 30.7% have positive results in sputum smear and sputum culture test after two month＇ treatment.26.4% of 87 TB cases that were positive in the first sputum culture have drug resistance,and multidrug resistance cases account for 5.7%.236 close contacts of 114 sputum smear positive TB patients all reported no suspicious TB symptoms,but only 6.4%（15/236） have actively asked for TB examination.[Conclusion]The sputum smear positive TB patients have strong infectivity and can cause serious harms,but their close contacts are lacking in the awareness of actively asking for treatment and examination.Therefore,it is urgent to understand the situation of knowledge,attitude and practice on TB prevention and treatment,as well as willingness of seeking free screening of this population,to put forward the reasonable measures and suggestions for intervention of family close contacts of TB patients.