大连2010-2015年高校学生结核病疫情特征分析

Prevalence of tuberculosis among college students in Dalian city,2010-2015

目的观察辽宁省大连市高校学生结核病发病特征及趋势变化,了解高校结核病流行现状及特点,为学校结核病防治策略调整提供依据。方法回顾性收集2010—2015年大连市结核病医院资料室和国家结核病管理信息系统登记的学生结核病疫情资料,并进行统计和分析。结果 2010—2015年大连市高校结核病报告发病率为48.19/10万,2010—2015各年份结核病发病率分别为54.93/10万、55.14/10万、43.15/10万、41.94/10万、44.74/10万和50.33/10万,趋势变化无统计学意义(χ~2=2.456,P>0.05)。结核菌痰涂片报告涂阳发病率为6.19/10万,患者中涂阳率为12.85%。病例年龄介于16~30岁,平均年龄为21.09岁;男女比例2.61:1,季节发病率以第二季度最高。学生新发活动性肺结核以初治为主(97.18%);涂阴患者最多(74.52%)。高校肺结核聚集性疫情每年均有发生,呈增多趋势。2010—2015年散发患者发病率分别为49.9/10万、47.3/10万、41.8/10万、35.6/10万、34.6/10万和38.67/10万,趋势变化有统计学意义(χ~2=10.318,P<0.05);聚集性续发患者发病率分别为5.0/10万、7.9/10万、1.3/10万、6.4/10万、10.1/10万和11.7/10万,趋势性变化亦有统计学意义(χ~2=13.097,P<0.05)。结论 2010—2015年大连市高校学生肺结核发病疫情形势变化不明显,但学校肺结核聚集性疫情呈逐年增多趋势,提示防控需注意聚集性疫情,创新策略,并重视学校结核病健康教育工作,预防结核病发生。

Objective To describe the characteristics and trend in tuberculosis （TB） incidence among college students in Dalian city and to provide bases for making control strategy in the students. Methods Data on registered TB cases among college students in Dalian city between 2010 and 2015 were extracted from National Information System for TB Registration and Management and Dalian Municipal Tuberculosis Hospital and analyzed statistically. Results The re- ported average annual TB incidence was 48.19/100 000 among the students, with the yearly incidence of 54. 93,55. 14, 43. 15,41.94,44. 74, and 50. 33 per 100 000 population,respectively, and no significant change in the incidence was ob- served during the 6-year period （X^2 = 2. 456, P 〉 0. 05 ）. The average reported annual incidence was 6. 19/100 000 for smear-positive TB and the proportion of smear-positive was 12. 85% among the reported TB cases among the students. The ages of reported cases ranged from 16 to 30 years,with an average age of 21.09 years and a male to female ratio of 2.61：1. More TB cases were reported in the second quarter of a year and almost all the registered TB cases （97.18%） were initially treated and the majority （ 74. 52% ） of the registered cases were smear-negative. There was a significant change trend in both the incidence of sporadic TB cases （ with the annual incidences of 49. 9,47. 3,41.8,35.6,34. 6, and 38.67 per 100 000 population） （X^2= 10. 318, P 〈 0. 05 ） and the incidence of secondary cluster TB cases （with the annual incidences of 5.0,7.9,1.3,6.4,10. 1, and 11.7 per 100 000 population） （X2 = 13. 097,P 〈 0. 05 ）. Conclusion The re- ported TB incidence did not changed significantly but the aggregation TB epidemic increased significantly among college students in Dalian city between 2010 to 2015, suggesting that health education on TB control needs to be promoted among the students.