2016年重庆市学校结核病疫情流行概况分析

Epidemic situation of tuberculosis in schools in Chongqing Municipality,2016

目的通过对2016年重庆市学校结核病疫情处置现状进行分析,了解当前学校结核病疫情处置的不足,为学校结核病防控措施提供参考。方法利用Excel 2007建立重庆市学校结核病疫情监测及处置数据库,以辖区内学校为监测单位,收集重庆市2016年学校结核疫情处置信息,采用SPSS 16.0进行统计学分析。结果 2016年重庆市39个区县528所学校发生了结核病疫情,其中303所学校发现528次散发病例,13所学校发现14次聚集性疫情苗头,1所学校发现1次聚集性疫情,主要集中在公办、寄宿制、高级中等教育阶段。筛查学校结核病患者的密切接触者46 831例,发现结核病患者53例,检出率为0.11%,学生(0.11%)、教职工(0.05%)、家属(0.63%)接触者中结核病检出率差异有统计学意义(Fisher精确概率法,P=0.000)。寄宿制学生、非寄宿制学生休学比例分别为70.87%、80.83%,差异有统计学意义(χ2=8.28,P=0.004)。学校发生结核病疫情后开展结核病健康教育、培训、感染控制比例较低,分别为67.80%、56.44%、69.32%,不同教育阶段学校开展健康教育的比例不同,差异有统计学意义(χ2=13.484,P=0.018),其中学前教育、中等职业教育、高等教育比例较低,分别为42.86%、58.72%、58.82%。结论 2016年重庆市学校结核病疫情主要为散发病例,寄宿制高级中等教育阶段是学校结核病防控工作的重点,规范密切接触者筛查方式,加强休学管理,重视健康教育、培训、感染控制对学校结核病防控工作具有重要意义。

Objective To investigate the insufficient disposal of tuberculosis （TB） epidemic in schools through analyzing the current situation of management of TB epidemic in Chongqing Municipality in 2016, so as to provide references for TB prevention and control measures in schools. Methods Excel 2007 was used to establish a database regarding monitoring and disposal of TB epidemic in schools in Chongqing Municipality. The schools in the administrative districts served as the monitoring units, and the information about disposal of TB epidemic in schools in Chongqing Municipality in 2016 was collected. SPSS16.0 software was used for statistical analysis. Results TB epidemic occurred in 528 schools in 39 districts/counties in Chongqing Municipality in 2016, including 528 sporadic cases in 303 schools, 14 clustering epidemic signs in 13 schools and 1 clustering epidemic in 1 school. TB patients were mainly distributed in public, boarding and senior secondary schools. 46,831 close contacts of TB patients in the schools were screened, and 53 TB patients were detected, with the detection rate being 0.11%. There were statistically significant differences in the TB detection rate of the family contacts among students（0.11%）, staff members（0.05%） and relatives（0.63%） （Fisher χ^2=3.478, P=0.000）. The rates of temporary absence from school of boarding students and non-boarding ones were 70.87% and 80.83% respectively, showing a statistically significant difference（χ^2=8.28, P=0.004）. The ratios of conducting TB health education （67.80%）, training （56.44%） and infection control （69.32%） after TB outbreaks in schools were low. There were statistically significant differences in the ratio of conducting TB health education among schools with different educational stages （χ^2=13.484, P=0.018）, of which the ratios in preschool education （42.86%）, secondary vocational education （58.72%） and high education （58.82%） were all low. Conclusions TB epidemics occurring in schools in Chongqing Municipality in 2016 were mainly sporadic cases. TB prevention and control work in schools should focus on the boarding senior secondary education stage. It is of great value to regulate the screening methods of close contacts, enhance the management of temporary absence from school, and pay special attention to health education, training and infection control in TB prevention and control work in schools.