2011-2019年贵州省学校肺结核流行特征分析

Epidemiological characteristics of pulmonary tuberculosis in schools in Guizhou,2011–2019

目的了解贵州省学校肺结核流行特征,为优化学校结核病防控策略提供参考依据。方法从结核病信息管理系统导出2011—2019年贵州省学生和教师患者病案信息,进行回顾性描述分析。结果2011—2019年贵州省登记学生和教师新发肺结核各29596例和2470例。学生登记率呈上升趋势,教师相反,但教师年均登记率(57.15/10万)高于学生(36.55/10万)(χ2=464.174,P<0.05)。学校病例集中在3—5月,15~19岁学生病例最多;教师与学生病例年均登记率均为男性高于女性,学生登记率男女性均呈上升趋势,教师登记率男性呈下降趋势,女性无明显变化趋势。地区分布均以毕节市最高;发现方式以被动发现手段为主,健康体检发现病例逐渐增多;就诊延迟率为54.76%,女性、教师、被动发现和复治患者延迟率更高。结论学校结核病是贵州省防治工作的重点,当前加强教师病例的关注也是减少传染源的关键,提高经费投入保障健康教育、师生健康体检、新生入学体检和密切接触者筛查等工作对于提高主动和早期发现病例具有重要意义。

Objective To understand the epidemiological characteristics of pulmonary tuberculosis(TB)in schools in Guizhou province and provide reference for optimizing the TB prevention and control strategy in schools.Methods The medical record information of pulmonary TB cases in students and teachers in Guizhou from 2011 to 2019 were collected from the Tuberculosis Information Management System for a retrospective analysis.Results A total of 29596 pulmonary TB cases in students and 2470 pulmonary TB cases in teachers were registered in Guizhou from 2011 to 2019.The registration rate in students increased,while the registration rate in teachers decreased with year.But the average annual registration rate in teachers(57.15/100000)was higher than that in students(36.55/100000)(χ2=464.174,P<0.05).The school pulmonary TB cases mainly occurred during March-May,most pulmonary TB cases in students were aged 15–19 years.The average annual registration rate was higher in males than in females in both teachers and students.The registration rate in both boy students and girl students increased.In teachers,the registration rate in men decreased,but there was no significant change in women.The registration rates of TB cases in both teachers and students were highest in Bijie.Passive detection was the main way of case finding and the cases found in physical examination increased.The overall medical care seeking delay rate was 54.76%,and it was higher in females,teachers,passively detected and retreated patients.Conclusion The prevention and control of pulmonary TB in schools is a priority of TB prevention and control in Guizhou.Close attention needs to be paid to the pulmonary TB cases in teachers to reduce the source of infection.It is of great significance to increase investment to ensure health education,physical health examination in schools,including routine and freshmen examinations,and close contact screening to improve the active and early detection of TB cases.