2014—2016年上海口岸赴英人群肺结核筛查结果分析

Analysis of tuberculosis screening among applicants for immigration to the United Kingdom at Shanghai port from 2014 to 2016

目的分析上海口岸赴英国签证人群肺结核检出情况,了解英国肺结核筛查策略,对我国口岸监控肺结核提出建议。方法按照2013年9月《英国结核病筛查技术指南》要求,并参照我国肺结核诊断标准,对2014年1月—2016年12月上海口岸12 903名赴英签证人群进行肺结核筛查。结果 2014—2016年,上海口岸11岁及以上赴英签证人群中共检出活动性肺结核患者13例,检出率为101.76/10万;男性检出率为155.88/10万;女性检出率为65.42/10万;男女性别比为2.38∶1。检出非活动性肺结核65例,检出率为508.81/10万。活动性肺结核集中在11~29岁组,检出率为106.88/10万。经痰液细菌学检查,11例痰阳患者中,检出涂阳培阳3例、涂阴培阳8例;11例菌株均属结核分枝杆菌。结论加强对口岸重点人群(11~29岁)的结核病监测,通过加强胸部影像学筛查标准,提高痰检率,从而增加活动性肺结核的检出率,控制肺结核传播。

Objective To investigate the prevalence of tuberculosis（TB） among applicants for immigration to the United Kingdom at Shanghai port,understand the UK tuberculosis technical instructions and to make recommendations for Shanghai port. Methods Accordance to UK tuberculosis technical instructions in 2009,12 903 immigration applicants to the UK at Shanghai port were received TB screening,2014-2016. Results During these four years,among applicants for immigration to the UK in Shanghai International Travel Healthcare Center,13 cases were active TB,detection rate was 101.76/100 000. The prevalence in male（155.88/100 000） was higher than in female（65.42/100 000）. Male and female prevalence ratio was 2.38 ∶ 1. 65 cases were inactive TB,detection rate was 508.81/100 000.The peak incidence was between 11-29 years old（106.88/100 000）. By bacteriological examinations,among 11 case,3 cases were smear positive and culture positive（S＋C＋）,8 cases were smear negative but culture positive（S-C＋）.All the 11 culture positive cases were identified as MTB complex and confirmed by DST as susceptible TB.Conclusion We should strengthen TB screening in target populations（11 ~30 years old）during immigration health check improve standard of chest X-Ray,raise the rate of sputum test,to control transmission of tuberculosis by travelers.