2016—2022年吉林省学生肺结核疫情特征分析

Characteristics of pulmonary tuberculosis epidemic among students in Jilin Province,2016-2022

目的分析2016—2022年吉林省学校结核病疫情变化趋势及密切接触者检查情况,为科学制定学校结核病防控策略提供参考。方法通过“结核病管理信息系统”获取2016—2022年吉林省学生肺结核登记情况,分析吉林省学校肺结核登记率的变化趋势以及学校肺结核患者密切接触者筛查情况。结果2016—2022年吉林省共登记学生肺结核3930例,登记率分别为18.00/10万、20.16/10万、21.87/10万、20.96/10万、19.26/10万、20.76/10万、13.63/10万,差异有统计学意义(χ_(趋势)^(2)=7.23,P<0.05);病原学阳性率为23.89%(939/3930),利福平耐药率为3.18%(125/3930);肺结核密切接触者应筛查数51234例,实际筛查人数55330例,有可疑症状822例;PPD检测21447例,其中强阳性2104例,PPD检测强阳性率为9.81%(2104/21447);IGRA检测55例,其中阳性55例;胸片检查41714例。确诊肺结核107例,确诊患者发现率为0.19%(107/55330),结核感染应治疗2075例,接受结核感染治疗105例,接受结核感染治疗率为5.06%(105/2075),完成结核感染治疗25例,完成结核感染治疗率为23.81%(25/105)。结论2016—2022年吉林省学生肺结核登记率呈先上升后下降的趋势,病原学阳性率和利福平耐药率逐渐增加,接受结核感染治疗和完成治疗的患者较低,需进一步加强学校肺结核感染治疗工作。

Objective To analyze the trend of tuberculosis(TB)epidemic and TB screening results in close contacts of those with TB in Jilin's schools from 2016-2022,providing a reference for scientific formulation of school-based strategies to control and prevent TB.Methods Through the Tuberculosis Information Management System,the registration information of students with pulmonary TB in Jilin Province from 2016 to 2022 was obtained,and the trend of registration rates and screening results in close contacts of those with pulmonary TB in schools were analyzed.Results A total of 3930 students with pulmonary TB were registered from 2016 to 2022,and the annual registration rates for the seven years were 18.00/100000,20.16/100000,21.87/100000,20.96/100000,19.26/100000,20.76/100000,and 13.63/100000,respectively,with statistically significant differences(χ_(trend)^(2)=7.23,P<0.05).The pathogenic positive rate for TB was 23.89%(939/3930),and the rifampicin resistance rate was 3.18%(125/3930).The number of close contacts that should be screened was 51234,among whom 55330 participated in the screening,and 822 cases were found with suspicious symptoms.Purified-protein derivative(PPD)skin test was performed in 21447 cases,of whom 2104 cases were strongly positive,with a strong positive rate of 9.81%(2104/21447).Fifty-five cases underwent interferon-γrelease assay(IGRA),and all of them had positive results.Chest X-ray was performed in 41714 cases.And 107 cases obtained a confirmed diagnosis of pulmonary TB,accounting for 0.19%(107/55330)of the total cases.Of the 2075 cases that should receive treatment for TB infection,105 received relevant treatment,with a treatment rate of 5.06%(105/2075),but only 25 cases completed the treatment,yielding a completion rate of treatment of 23.81%(25/105).Conclusion The registration rate of pulmonary TB among students in Jilin from 2016 to 2022 showed a trend of first increasing and then decreasing,with a gradual increase in rates of pathogenic positivity and rifampicin resistance,and a small number of patients receiving and completing relevant treatment,requiring further strengthening of treatment for pulmonary TB infection in schools.