重庆市肺结核患者密切接触儿童的早期筛查研究

Study on early screening of pulmonary tuberculosis patients in close contact with children in Chongqing

目的通过对与活动性肺结核患者密切接触儿童进行主动追踪和筛查,提高肺结核患儿的早期发现率。方法选取重庆市10个区县,分为干预组和对照组,于2017年7月1日至2018年6月31日采取连续选例的方法收集肺结核患者密切接触儿童信息,随访观察时间为6个月,干预组进行主动干预和早期筛查,对照组按照国家规划进行管理。比较两组结核菌素皮肤试验(TST)强阳性率和结核病检出率。结果干预组有746例儿童密切接触者,对照组有673例。干预组TST强阳性率高于对照组[15.7%(117/746)vs.2.7%(18/673)],差异有统计学意义(OR=5.6,95%CI:3.3~9.6,P<0.05)。干预组结核检出率高于对照组[6.0%(45/746)vs.1.2%(8/673)],差异有统计学意义(OR=3.5,95%CI:1.5~8.0,P<0.05)。结论通过对密切接触活动性肺结核患者的儿童进行早期TST筛查,有助于提高肺结核患儿的发现率。

Objective By actively tracking and screening children who were in close contact with active tuberculosis patients,to increase the early detection rate of children with tuberculosis.Methods Selected 10 districts and counties of Chongqing and divided into the intervention group and the control group.From July 1,2017 to June 31,2018,the method of continuous selection was adopted to collect information on children in close contact.The follow-up observation time was 6 months.The intervention group was carried out active intervention and early screening,and the control group was managed according to the national plan.Compared the two groups of tuberculin skin test(TST)strong positive rate and tuberculosis detection rate.Results The intervention group included 746 close contacts of children,while the control group included 673 cases.The TST strong positive rate in the intervention group was higher than that in the control group[15.7%(117/746)vs.2.7%(18/673)],the difference was statistically significant(OR=5.6,95%CI:3.3—9.6,P<0.05).The detection rate of tuberculosis in the intervention group was higher than that in the control group[6.0%(45/746)vs.1.2%(8/673)],the difference was statistically significant(OR=3.5,95%CI:1.5—8.0,P<0.05).Conclusion Early screening for TST in children who are in close contact with patients with active tuberculosis could help increase the detection rate of children with tuberculosis.