重庆市2021年学校结核病聚集性疫情调查分析

Investigation analysis of tuberculosis aggregation in schools in Chongqing, 2021

目的分析重庆市2021年学校结核病聚集性疫情特征及处置措施落实情况,为科学制定学校结核病防控策略和措施提供参考。方法通过“重庆市学校结核病信息管理系统”和《重庆市学校结核病防控工作调查表》收集2021年重庆市学校结核病聚集性疫情资料,分析学生活动性肺结核患者特征、密切接触者筛查情况,采用SPSS 25.0进行描述性分析和χ^(2)检验。结果2021年重庆市发现学校结核病聚集性疫情21起,分别为高校10起、高中7起、初中4起。确诊学生活动性肺结核患者106例,病原学阳性率27.36%,其中初中病原学阳性率最高,为42.86%。学校结核病聚集性疫情密切接触者结核菌素纯蛋白衍生物(purified protein derivative Tuberculin,PPD)筛查一般阳性率以高校(14.86%)最高,不同教育阶段之间比较差异有统计学意义(χ^(2)=74.41,P<0.05);PPD中度阳性率以初中(15.59%)和高校(12.79%)较高,不同教育阶段之间比较差异有统计学意义(χ^(2)=33.34,P<0.05);PPD总体强阳性率为7.80%,不同教育阶段之间比较差异无统计学意义(χ^(2)=2.40,P>0.05)。高校PPD强阳性密切接触者预防性服药率(20.17%)最低,不同教育阶段之间比较差异有统计学意义(χ^(2)=37.71,P<0.05)。疾控机构筛查的PPD一般阳性率(7.94%)最低,不同筛查机构之间比较差异有统计学意义(χ^(2)=11.55,P<0.05);不同医疗机构筛查的PPD总体中度阳性率为11.52%,不同筛查机构之间比较差异无统计学意义(χ^(2)=5.48,P>0.05);定点医疗机构筛查的PPD强阳性率(15.79%)最高,不同筛查机构之间比较差异有统计学意义(χ^(2)=22.63,P<0.05)。结论进一步加强高校结核病疫情防控工作,应由结核病定点医疗机构开展学校结核病密切接触者筛查的相关工作,确保筛查质量,避免校园结核病聚集性疫情的发生。。

ObjectiveTo analyze the characteristics of tuberculosis aggregation epidemic and the implementation of disposal measures in schools in Chongqing,and to provide references for formulating strategies and measures for tuberculosis prevention and control in schools.MethodsThrough"tuberculosis information management system in schools in Chongqing"and"tuberculosis prevention and control questionnaire in Chongqing",the data on tuberculosis aggregation epidemic situation in 2021 was collected.The characteristics of students with active pulmonary tuberculosis and the screening of close contacts were analyzed.Descriptive analysis and chi-square statistic test were performed by SPSS 25.0.ResultsThere were 21 cases of tuberculosis aggregation epidemic in Chongqing in 2021,10 from universities,7 from high schools,and 4 from junior high schools.106 cases of active pulmonary tuberculosis in students were diagnosed,and the positive rate of etiology was 27.36%,of which the positive rate of etiology in junior high school was the highest,42.86%.In the screening of close contacts of tuberculosis epidemic in schools,the general positive rate of purified protein derivative Tuberculin(PPD)was the highest in universities(14.86%),and the difference was statistically significant in different education stages(χ^(2)=74.41,P<0.05).The moderately positive rate of PPD was higher in junior high school(15.59%)and universities(12.79%),and the difference was statistically significant in different education stages(χ^(2)=33.34,P<0.05).The total strong positive rate of PPD was 7.80%,and the difference was not statistically significant in different education stages in different education stages(χ^(2)=2.40,P>0.05).The rate of prophylactic medication among close contacts with strong PPD positive in universities(20.17%)was the lowest,and the difference was statistically significant in different screening institutions(χ^(2)=37.71,P<0.05).The general positive rate of PPD detected by disease control institutions(7.94%)is the lowest,and the difference was statistically significant in different screening institutions(χ^(2)=11.55,P<0.05).The moderately positive rate of PPD screened by different medical institutions was 11.52%,and the difference was not statistically significant in different screening institutions(χ^(2)=5.48,786P>0.05).The strong positive rate of PPD was the highest in designated medical institutions(15.79%),and the difference was statistically significant in different screening institutions(χ^(2)=22.63,P<0.05).ConclusionFurther strengthening the prevention and control of tuberculosis epidemic in universities,tuberculosis related medical institutions should be carried out the relevant work of screening close contacts of TB patients in schools,so as to ensure the quality of screening and avoid the occurrence of campus TB epidemic.