陕北某高级中学结核病聚集性疫情监测调查

Surveillance and analysis of tuberculosis aggregation in a high school in Northern Shaanxi

目的对陕北某高中结核病聚集性疫情进行调查分析,为进一步规范疫情处置提供可借鉴经验。方法通过现场流行病学方法,对疫情进行调查、处置,对所有定性、定量数据进行收集整理,分析该校发生结核病聚集性疫情的原因。结果有首发病例的高二1班、高三4班结核菌素(PPD)阳性率分别为61.2%、61.4%,高二、高三年级其他班级PPD阳性率在6.1%～21.7%之间,两班PPD阳性率和强阳性率明显高于其他班级,差异具有统计学意义(P <0.05)。全校学生查出活动性肺结核23例,罹患率1 586.2/10万,病例主要集中在高二1班12例,高三4班7例,罹患率分别为22 222.2/10万和14 583.3/10万,明显高于同年级其他班级(P <0.005)。结论高二1班、高三4班发生结核病聚集性疫情,就诊延迟、密切接触者筛查不及时、各项防控措施不到位是疫情扩散的主要原因。

Objective To investigate tuberculosis aggregation in a high school in Northern Shaanxi Province, so as toprovide reference for disposal measures of the epidemic situation in school. Methods The epidemic situation wasinvestigated and disposed by field epidemiological method. The qualitative and quantitative data were collected and analyzed tofind out the cause of tuberculosis epidemics in the school. Results Purified protein derivative（PPD） positive rates of Class 1 grade 2 and class 4 grades 3 was 61.2% and 61.4% respectively, which class the first case belong to. And the PPD positive ofother classes was between 6.1% and 21.7%. The PPD positive and strong positive rate of the two classes was significantlyhigher than others（P〈0.05）. There were 23 active pulmonary tuberculosis cases found in the school. The attack rate was 1586.2/100 000. Most cases belong to class 1 grade 2（12 cases） and class 4 grade 3（7 cases）, the attack rate was 22 222.2/100000 and 14 583.3/100 000, which was higher than the other classes in the same grade（P〈0.005）. Conclusions There was acluster of TB epidemic in class 1 grade 2 and class 4 grade 3. Delayed treatment, lack of timely TB screening and preventionand control measures are the main reasons for the spread of the epidemic.