重庆市渝北区学校结核病筛查与疫情分析

Tuberculosis screening and epidemic analysis in schools of Yubei District in Chongqing

目的了解重庆市渝北区学生结核菌素纯蛋白微生物(tuberculin purified protein derivative,PPD)试验筛查结果和学校结核病发病情况,为学校结核病防控工作提供科学依据。方法收集重庆市渝北区2018—2021年所有学校入学新生、高二年级学生PPD试验结果及学校结核病确诊病例信息,采用SPSS 19.0软件进行统计分析,率的两两比较采用χ^(2)检验。结果2018—2021年渝北区PPD试验筛查强阳性率3.08%(3169/103032),发现结核病病例33例,PPD试验强阳性率随学生年龄增加而升高,差异有统计学意义(χ^(2)=623.000,P<0.001)。2018—2021年共处置386起学校结核病散发疫情,4起聚集疫情,接触者PPD试验筛查强阳性率为3.96%(514/12964)。2021年调查处理98例学校结核病病例,91.84%为学生病例,接触者PPD试验筛查强阳性率4.20%(191/4544),预防性服药比例为4.71%(9/191)。学校结核病聚集疫情的PPD试验强阳性率大于散发疫情,两者差异有统计学意义(χ^(2)=5.758,P<0.05)。学生病例从发病到确诊时间较长,平均时间为21.96d,中位数为14d。结论PPD试验筛查有助于及时发现结核病病例,落实健康教育、因病缺勤登记和追踪、体检筛查等常规防控措施是学校结核病防控工作的关键。

Objective To understand the screening results of tuberculin purified protein derivative(PPD)test in students and the incidence of tuberculosis in schools in Yubei District of Chongqing,so as to provide scientific basis for the prevention and control of tuberculosis in schools.Methods The PPD test results of freshmen and sophomore students in Yubei District of Chongqing and the information of confirmed tuberculosis cases in the school from 2018 to 2021 were collected.SPSS 19.0 software was used for statistical analysis,and theχ^(2) test was used for pairwise comparison of rates.Results From 2018 to 2021,the strong positive rate of PPD test screening was 3.08%(3169/103032)in Yubei District,and 33 cases of tuberculosis were detected.The strong positive rate of PPD test increased with the age of the students,and the difference was statistically significant(χ^(2)=623.00,P<0.001).From 2018 to 2021,a total of 386 sporadic tuberculosis outbreaks and four clusters of tuberculosis in schools were dealt with,and the strong positive rate of PPD test screening of contacts was 3.96%(514/12964).A total of 98 tuberculosis cases in schools were investigated and treated in 2021,91.84%of them were students.The strong positive rate of PPD test screening of contacts was 4.20%(191/4544),and 4.71%(9/191)of them took preventive drugs.The strong positive rate of PPD test in the epidemic situation of school tuberculosis was higher than that in the epidemic situation of sporadic tuberculosis.The difference was statistically significant(χ^(2)=5.758,P<0.05).Student cases took longer from onset to diagnosis with the average time of 21.96 days,and the median period was 14 days.Conclusion PPD test screening is helpful for the timely detection of tuberculosis cases.The implementation of routine prevention and control measures such as health education,registration and tracking of absenteeism due to illness,and physical examination screening are the key to the prevention and control of tuberculosis in schools.