湘潭农村居民结核潜伏感染现状及影响因素研究

Prevalence of latent tuberculosis infection and its related risk factors in rural Xiangtan County

目的了解湖南省湘潭农村居民结核感染现状及其影响因素,为农村居民结核病防控提供科学的数据支撑。方法采取整群随机抽样方法,抽取湘潭县中路铺镇6个自然村为研究现场,以这6个村5岁及以上常住人群为研究对象,采用γ-干扰素释放试验(IGRA)检测其结核分枝杆菌感染情况,运用单因素和多因素研究方法探讨其影响因素。结果本研究应检人数5440人,实检4913人,受检率为90.3%。受检人群潜伏感染率为26.0%(1276/4913),其中男性为29.8%(660/2216),女性22.8%(616/2697),差异有统计学意义(χ^2=30.502,P<0.001);不同年龄组QuantiFERONTB Gold In-Tube(QFT)阳性率的差异有统计学意义(χ^2=297.531,P<0.001),年龄越大结核分枝杆菌潜伏感染率越高。非条件二分类logistic回归分析显示:吸烟人群(OR=1.684,95%CI=1.462~1.939)、年龄46~60岁(OR=2.076,95%CI=1.748~2.465)、年龄>60岁(OR=3.152,95%CI=2.655~3.741);BMI<18.5 kg/m^2:(OR=1.792,95%CI=1.397~2.300)、BMI 24~27.9 kg/m^2:(OR=2.037,95%CI=1.563~2.656)、BMI≥28 kg/m^2:(OR=2.597,95%CI=1.899~3.551)、有结核密切接触史(OR=1.214,95%CI=1.021~1.442)是结核潜伏感染的影响因素。结论湘潭农村居民结核分枝杆菌感染率较高,感染的重点人群为老年人、吸烟人群、BMI异常人群以及有结核密切接触史的人群,需对以上重点人群采取针对性的措施。

To explore the prevalence of latent tuberculosis infection(LTBI)and its risk factors for rural residents of Xiangtan county.The cross-sectional study was conducted in six villages which selected by random cluster sampling method in Zhonglupu town,Xiangtan County.The residents who were born before June 1,2008(≥5 years old)were recruited in the study.Interferon gamma release assay(IGRA)was used to detect tuberculosis(TB)infection.Using univariate analysis and multiple logistic regression methods,the related risk factors were identified.4913 actually participated from 5440 eligible participants,with a response rate of 90.3%.Overall,26.0%(1276/4913)of participants were Quanti-FERONTB Gold In-Tube(QFT)positive.Higher positive QFT results in men(29.8%,660/2216)were observed than that in women(22.8%,616/2697)(χ^2=30.502,P<0.001).An increasing trend for QFT positivity with increasing age was also noted(P for trend<0.001).Factors significantly associated with QFT positivity were identified as history of smoking(OR=1.684,95%CI=1.462~1.939),46~60 years:OR=2.076,95%CI=(1.748~2.465);>60 years:(OR=3.152,95%CI=2.655~3.741),BMI<18.5 kg/m^2:(OR=1.792,95%CI=1.397~2.300),BMI between 24 to 27.9 kg/m^2(OR=2.037,95%CI=1.563~2.656),BMI≥28kg/m^2(OR=2.597,95%CI=1.899~3.551),history of close contact with a TB patient(OR=1.214,95%CI=1.021~1.442.In conclusion,the prevalence of latent tuberculosis infection in rural residents of Xiangtan county was relatively high and the elderly people,smokers,people with abnormal BMI,and people with close contacts with patients of tuberculosis might be potential target populations,who should be taken some key measures,such as monitoring of latent tuberculosis infection.