2014-2018年绵阳市414例中学生肺结核患者疫情分析

Analysis of Epidemiological Characteristics of 414 Middle School Students With Tuberculosis in Mianyang City From 2014 to 2018

目的掌握不同年级中学生结核病流行特征,为进一步制定学校结核病防控策略提供参考依据。方法采用描述流行病学方法,对2014-2018年报告为绵阳市普通中学的414例学生患者登记资料进行分析,描述不同年级学生患者发病与时间、性别、就诊方式、病例分型、就诊延迟等特征的关联。结果2014-2018年绵阳市共报告中学生病例414例,其中初中生89例,报告发病率13.32/10万,高中生325例,报告发病率57.97/10万;初中生报告发病率低于高中生(/=180.56,P<0.01),初中生各年报告发病率均低于全人群,高中生在2014年和2015年低于全人群(/><0.05),2016-2018年与全人群差异无统计学意义(P>0.05)。报告病例中新生以第4季度占比最高(P<0.05),其中初一第4季度发病人数占初一新生的43.75%(7/16),高一新生第4季度发病人数占35.56%(16/45);而毕业班则以第1、2季度占比最高,其中初三第1、2季度发病人数分别占31.43%(11/35)、28.57%(10/35),高三第1、2季度发病人数分别占34.36%(67^95)、35.38%(34/195);中学生患者中男生患者报告发病率高于女生(x^2=12.28,P<0.01),性别比低于全人群(x^2=64.55<0.01);就诊方式以转诊到位为主(49.52%,205/414),因症就诊占比较低(24.64%,102/414)。患者中病原学阳性初中生高于高中生(x^2=4.30,P=0.038),而初中3个年级间(x^2=O.11,P=0.945)和高中3个年级间(x^2=0.89,P=0.641)差异无统计学意义。出现就诊延迟患者占36.96%(153/414),延迟就诊天数平均值达到30 d,中位数为17dD结论针对中学生中结核病患者的特点,进一步加强学校健康教育,提高防病意识,使患者能够及时得到发现和隔离治疗,是有效杜绝学校结核病疫情发生的重点。

Abstract Objective To understand the epidemiological characteristics of pulmonary tuberculosis in middle school students between the different grades,and to provide the more effective strategies to prevention and control tuberculosis in schools.Methods The registration data of 414 students with pulmonary tuberculosis reported in our city from 2014 to 2018 were analyzed by descriptive epidemiological survey,and the association between the time of morbidity,different gender,the treatment modes,case classification and treatment delay of the different grades were described.Results From 2014 to 2018,there were 414 cases of middle school students with pulmonary tuberculosis reported in Mianyang city,and 89 of them were junior high school students,the incidence was 13.32/105,and 325 cases of them were high school students,the incidence was 57.97/105.the incidence of junior high school was lower than that of senior high school students(^=180.56,P<0.00〇,the incidence of junior high school was lower than that of population of Mianyang city each year,the incidence of senior high school was lower than that of population of Mianyang city in 2014 and 2015.The difference was not statistical significant between senior high school and the whole population from 2016 to 2018.New student cases were accounted for the highest proportion in the fourth quarter,the number of cases in the first grade junior high school was accounted for 43.75%(7/16)in the fourth quarters,the number of cases in the freshman in high school was accounted for 35.5 6%(16/45).The graduating class had the highest proportion in the first and second quarters,the number of cases in third grade junior high school students was accounted for 31.43%(11/35),28.57%(10/35)in the first and second quarters,The number of cases in Senior three school students was accounted for 34.36%(67/195),35.38%(34/195)in the first and second quarters.The incidence of boys was higher than that of girls(X2=12.28,P<0.001),sex ratio was lower than that of the entire population(/2=64.55,P<0.00〇,referral was the main mode of consultation(49.52%,205/414),The symptomatic visiting was relatively low(24.64%,102/414).The positive numbers of etiological of junior high school was higher than that of senior high school(^=4.30,P=0.038),there was no significant difference between junior high school students(/2=0.11,P=0.945)and senior high school students(^=0.89,/>=0.641).The delayed treatment of patients were 36.96%(153/414),an average days of delayed visiting was 30 days,and the median days was 17 d.Conclusion According of the characteristic of tuberculosis in patients of middle school students,the most efficient way to prevent tuberculosis in middle school was given more health education to them,to improve their awareness of preventing illness,it was important to find out the patients and isolated for treatment in time.