江门市新会区高二学生潜伏性结核筛查结果感染现状调查和危险因素分析

Current situation and risk factors of latent tuberculosis infection:Findings of TB screening among second⁃year high school students in Xinhui District of Jiangmen

目的:了解江门市新会区高中学生潜伏性结核(LTBI)的感染情况及相关危险因素,为新会区教育部门在学校开展结核病的筛查和预防工作提供理论依据。方法:对2021年9月至2022年1月江门市新会区在读的高中二年级学生开展结核分枝杆菌特异性细胞免疫反应检测(IGRA)及问卷调查,对所有IGRA阳性学生进行结核菌素试验和X光胸片检查排除活动性肺结核;对IGRA阳性组与阴性组进行比较分析,采用多因素logistic回归分析与LTBI发生相关的危险因素。结果:共有9496人接受IGRA检测,LTBI阳性率2.65%(252/9496)。多因素logistic回归分析显示,糖尿病史(OR=8.634,P<0.05)、结核密切接触史(OR=1.684,P<0.05)、职业类高中(OR=1.357,P<0.05)的学生人群均为LTBI发生的危险因素。结论:江门市新会区高二学生LTBI感染率较高,教育部门应加强职业类高中学生、肺结核患者的接触者和患糖尿病学生的筛查,通过主动方式更早、更多发现学生肺结核患者。

Objective:To investigate the current situation and risk factors of latent tuberculosis infection(LTBI)among second⁃year high school students in Xinhui District of Jiangmen,so as to provide a theoretical basis for tuberculosis screening and prevention in schools initiated by the educational authority in this region.Methods:Interferon⁃gamma release assay(IGRA,a cellular immune test specific for Mycobacterium tuberculosis)combined with a questionnaire survey were conducted among second⁃year high school students in Xinhui District of Jiangmen between September 2021 and January 2022.All IGRA⁃positive students were subjected to tuberculin testing and chest X⁃ray examination for ruling out active tuberculosis.The survey data were analyzed and compared between IGRA⁃positive and negative students.Multivariate Logistic regression was used to analyze the risk factors associated with LTBI.Results:Out of 9496 subjects who underwent IGRA,252(2.65%)tested positive for LTBI.Multivariate Logistic regression analysis showed that a history of diabetes(OR=8.634,P<0.05),a history of close contact with tuberculotic patients(OR=1.684,P<0.05),and attendance in vocational high schools(OR=1.357,P<0.05)were all risk factors for occurrence of LTBI.Conclusion:The prevalence of LTBI was high among second⁃year high school students in Xinhui District of Jiangmen.It is advisable for local educational authority to strengthen LTBI screening among students attending vocational high schools,those who had a history of contact with tuberculotic patients,or those with diabetes mellitus.Proactive approaches would help earlier and more effective identification of students with LTBI.