北京市海淀区高校结核病患者及其密切接触者筛查分析

Screening of college students contacts among tuberculosis index patients in Haidian district,Beijing

目的通过分析海淀区高校结核病患者及密切接触者筛查情况,为海淀区高校密切接触者筛查策略的修改提供科学依据。方法对海淀区2015年3月~2016年3月发现的高校结核患者及其密切接触者进行问卷调查,并对密切接触者均进行结核菌素试验(purified protein derivative test,PPD)及胸片检查。分析患者基本人口学特征,密切接触者人口学特征、结核感染情况及患者检出情况。结果本次研究共诊断88例结核病患者,筛查得到密切接触者3 604名。密切接触者中共检出肺结核患者16例,且均为菌阴患者,患者检出率为443.95/10万。3 604名密切接触者中,PPD强阳性率8.32%。随着PPD反应直径的增加,密切接触者中患者检出率升高,且趋势有统计学意义(x_(trend)~2=8.06,P<0.001)。疫情期间密切接触者PPD强阳性率和患者检出率均高于非疫情期(均有P<0.05)。结论应加强高校学生结核病的筛查,根据不同的结核病检出情况适当扩大筛查范围,从而及早发现感染者及患者,进行预防性治疗,避免高校结核病的暴发流行。

Objective To screen college students contacts of tuberculosis index cases among colleges located in Haidian District,Beijing,so as to provide evidence for the modification of screening strategies for college students.Method The purified protein derivative test （PPD） and chest X-ray examination were carried out in colleges,located in Haidian District from March 2015 to March 2016.The basic demographic characteristics,tuberculosis infection and detection of patients,etc were analyzed.Results A total of 88 cases of tuberculosis index cases were diagnosed,and 3 604 college students contacts were detected 16 pulmonary tuberculosis cases were detected among close contacts,and all patients were negative,the detection rate was 443.95/100 000.Among the 3 604 close contacts,the positive rate of PPD was 8.32%.With the increase of the diameter of the PPD reaction,the detection rate of tuberculosis patients increased significantly （xtrend =8.06,P 〈0.001）.During the period of outbreak,the PPD positive rate and the detection rate of patients were significantly higher than that of non-outbreak period,and the difference was statistically significant（all P 〈0.05）.Conclusions It is necessary to strengthen the screening of tuberculosis among college students,and to find out the infected persons and patients as early as possible,so as to prevent the outbreak of tuberculosis.