与涂阳肺结核患者密切接触的0～14岁儿童筛查情况分析

Screening situation analysis on children aged 0 to 14 in close contact to patients with smear-positive pulmonary tuberculosis

目的 分析0～14岁儿童涂阳肺结核患者密切接触者的患病情况,探讨0～ 14岁儿童涂阳肺结核患者密切接触者预防感染结核病的有效方法.方法 对确认的1787例涂阳肺结核患者密切接触儿童进行结核菌素纯蛋白衍生物（PPD）皮肤试验、胸部X线及痰或胃液涂片检查.结果 无卡介苗接种史的比有卡介苗接种史的发病率高20倍,差异有统计学意义（x2=104.6,P＜0.05）.流动人口的儿童比本地户籍人口的儿童结核病发病率高,差异有统计学意义（x2=8.45,P＜ 0.05）.有卡介苗接种史的儿童中观察组发病率比对照组高4倍,但差异无统计学意义（x2=2.41,P＞ 0.05）.无卡介苗接种史的儿童中观察组发病率比对照组高,但差异无统计学意义（x2=2.88,P＞ 0.05）.7～14岁儿童组患病率较高,但观察组和对照组患病年龄比较差异无统计学意义（x2=0.000,P＞0.05）.两组儿童发病年龄无明显差异.观察组患病率比对照组高,差异有统计学意义（x2=4.261,P＜0.05）.观察组患病涂阳率比对照组高,差异有统计学意义（x2=4.601,P＜ 0.05）.患病儿童主要来自家庭密切接触,非家庭密切接触未发现患病儿童,但家庭与非家庭密切接触的患病率差异无统计学意义（x2=0.578,P＞0.05）.结论 对儿童密切接触者进行早期筛查,及时做好涂阳肺结核患者防控,能减少社区和家庭传播,普及预防接种卡介苗,加大结核病防治常识的宣教,有利于结核病的控制.

Objective To analyze the prevalence status of children aged 0 to 14 years with close contacts to smear positive tuberculosis （TB） patients,and explore effective way to prevent TB infection.Methods 1787 children cases in close contact with smear-positive tuberculosis patients were selected and examined by tuberculin purified protein derivative （PPD） skin test,chest X-ray and sputum or gastric smears.Results The children without history of Bacillus Calmette Guerin （BCG） vaccination had a 20 times high incidence than those with BCG vaccination history,the difference was statistically significant （x 2=104.6,P ＜ 0.05）.Floating population of children had a high incidence of TB than that of those local household population,the difference was statistically significant （x2=8.45,P ＜ 0.05）.There was a four times higher incidence of in children with history of BCG vaccination as observation group than those in the control group,but the difference was not statistically significant （x2=2.41,P ＞ 0.05）.Children without history of BCG vaccination in the observation group had higher incidence than those in the control group,but the difference was not statistically significant （x2=2.88,P ＞ 0.05）.Children aged 7 to 14 years were higher prevalence group,but the observation group and the control group were not statistically significant in age difference illness （x 2=0.000,P ＞ 0.05）.No difference between the two groups of children age was found.The prevalence of the observation group was higher than that of the control group,the difference was statistically significant （x 2=4.261,P ＜ 0.05）.The patients were mainly found in children with close family contact,there was no patients found in those without close family contact,but it did not show statistical significant difference between close family contact and nonfamily contact in the prevalence （x 2=0.578,P ＞ 0.05）.Conclusion Children with close contacts should be early screened,in order to timely prevent and control the smear positive pulmonary tuberculosis patients,to reduce the spread of communities and families and promote the BCG vaccination education,to strengthen and increase the common sense of tuberculosis prevention and treatment knowledge,which is helpful for TB control.