山西某高校一起肺结核聚集性疫情的调查分析

Investigation and analysis of a tuberculosis epidemic in a university in Shanxi province

目的了解山西某高校肺结核聚集性疫情的流行病学特点和处理结果,为学校肺结核防控提供依据。方法先对活动性肺结核病例开展流行病学个案调查,并采用描述性方法进行分析。之后对其密切接触人群开展症状筛查、TST检测、胸片、痰涂片检查。根据筛查人群的性别、体质量指数、TST结果等分组,对不同组之间的患病率进行比较。结果该校在筛查中共诊断活动性肺结核病例38例,检出率为4.74%。对比前后两次不同密切接触人群的筛查结果,肺结核病例的检出率和TST强阳性率的差异有统计学意义(P<0.05)。男生的肺结核患病率高于女生。BMI偏低组的肺结核患病率高于BMI正常组和偏高组(P<0.05)。在有明确肺结核病人接触史后,人群的PPD强阳性率对比接触前明显升高(P<0.05)。结论早期发现并隔离传染源是学校结核病防控的关键环节,采取有效且适宜的筛查方法,注重结核病防治知识的宣传,是控制学校肺结核聚集性疫情发生的重要手段。

Objective To understand the epidemiological characteristics and treatment results of pulmonary tuberculosis cluster in a college in Shanxi province,and to provide an evidence for the prevention and control of pulmonary tuberculosis in colleges.Methods Epidemiological investigation was carried out on active pulmonary tuberculosis cases,and descriptive methods were used for analysis.Close contacts were collected to perform the symptom screening,TST test,the chest radiography,and the sputum smears.The prevalence rate was compared between different groups according to the gender,BMI and TST results of the close contacts.Results A total of 38 active pulmonary tuberculosis cases were diagnosed in the college,and the detection rate was 4.74%.By comparing the two screening results of different close contacts,the detection rate of tuberculosis cases and the strong positive rate of TST were statistically different(P<0.05).The prevalence of tuberculosis was higher in boys than in girls.The prevalence of TB in low BMI group was higher than that in normal and high BMI groups(P<0.05).Based on a clear history of contact with TB patients,the PPD positive rate of the population increased significantly after the contact(P<0.05).Conclusion Early detection and isolation of the source of infection is the key point of tuberculosis prevention and control in colleges.Effective and appropriate screening methods and publicity of tuberculosis prevention and control knowledge are important means to control the occurrence of tuberculosis cluster in colleges.