2015-2017年重庆市涂阳肺结核患者的儿童密切接触者筛查情况分析

Screening Result of Tuberculosis Among Children Close Contact With Smear Positive Tuberculosis Patients in Chongqing City From 2015 to 2017

目的分析2015-2017年重庆市涂阳肺结核患者的0~14岁儿童密切接触者的筛查及检出情况。方法对2015-01-01/2017-06-31重庆市1 223名与涂阳肺结核患者密切接触的儿童先进行症状筛查,有肺结核可疑症状的进行检查,检查方法包括结核菌素皮肤试验(PPD试验)、结核抗体检查、痰涂片检查以及胸部X线摄片等。结果接受PPD试验筛查的儿童比例为58.30%,筛查发现感染结核分枝杆菌的儿童共65名,感染率为9.12%。共有268名儿童进行了X线胸片检查,胸片检查率为21.91%,胸片异常11例;32名儿童进行了痰涂片检查,痰涂片检查率为2.62%,均为阴性。确诊涂阴肺结核患儿4名。结论基层结核病定点医疗机构对传染性肺结核患者的密切接触儿童筛查力度不足,应进一步加强健康教育宣传,主动干预,扩大范围早期筛查。有条件的地区可对结核感染的儿童开展预防性服药,以减少后期发病。

Objective To analyze the screening and detection result of children aged 0 to 14 years who had a close contact with smear-positive tuberculosis（ TB） patients in Chongqing,and to explore the effective methods of improving the childhood tuberculosis detection. Methods Symptom screening has been done with 1 223 children firstly who had close contact with smear-positive TB patients. If there was any suspected tuberculosis symptom,medical tests were implemented include tuberculin purified protein derivative（ PPD） skin test,sputum smears,chest X-ray and etc. Results The proportion of children screened by PPD test was 58. 30%. A total of 65 children were found to be infected with tuberculosis through PPD screening,with an infection rate of 9. 12%. A total of 268 children were examined by chest X-ray,the chest X-ray examination rate was 21. 91%,and 11 of them were abnormal. 32 children were negative in sputum smears. The sputum smear test rate was 2. 62%. Four children were diagnosed with smear-positive TB.Conclusion Screening for children aged 0 to 14 years old who had a close contact with infectious TB patients was inadequate with tuberculosis designated primary medical institution. Health education should be further strengthened,and active intervention should be carried out to expand the scope of early screening. In order to reduce the incidence of TB,children with TB could take preventive medication in good socioeconomic area.