2023年江苏省扬州市17093名入学新生重组结核杆菌融合蛋白皮肤试验结果与肺结核检出情况分析

Results of recombinant Mycobacterium tuberculosis fusion protein skin test and detection of pulmonary tuberculosis in 17093 freshmen in Yangzhou,Jiangsu,2023

目的了解江苏省扬州市入学新生基于重组结核杆菌融合蛋白(EC)皮肤试验筛查出的结核分枝杆菌(MTB)感染和肺结核发病情况及影响因素,为完善扬州市学校结核病防控策略提供数据支撑和科学依据。方法对扬州市2023年秋季寄宿制初中、高中/职高及高校新生开展EC皮肤试验筛查,对EC皮肤试验阳性者再行胸部电子计算机断层扫描检查。分析比较新生中EC皮肤试验阳性与肺结核患者检出情况。结果EC皮肤试验筛查17093名新生,阳性173例(1.01%),发现肺结核患者18例(10.53/万)。多因素logistics回归分析显示中部地区[比值比(OR)=2.31,95%置信区间(CI):1.22~4.37]和西部地区(OR=5.99,95%CI:3.07~11.68)新生感染MTB风险高于东部地区;西部地区新生(OR=18.31,95%CI:2.43~138.05)检出肺结核的风险高于东部地区;结核病既往史(OR=7.47,95%CI:1.43~39.00)和结核病接触史(OR=6.79,95%CI:2.13~21.72)是新生感染MTB的危险因素;有结核病既往史(OR=31.77,95%CI:3.50~288.60)和有结核病接触史(OR=13.62,95%CI:1.63~113.66)的新生检出肺结核的风险也越高。结论应用EC皮肤试验开展结核病筛查是发现扬州市入学新生中结核病传染源的重要途径,针对MTB感染者和肺结核患者采取相应的防治措施,能够有效降低学校结核病疫情的发生风险,应推广至全市范围。来自中、西部地区、有结核病既往史及结核病接触史的新生是结核病筛查的重点人群。

Objective To investigate the performance of Mycobacterium tuberculosis infection and incidence of pulmonary tuberculosis(TB)in school or college freshmen in Yangzhou based on recombinant M.tuberculosis fusion protein(EC)test,and provide data support and scientific evidence for the improvement of TB prevention and control strategy in schools in Yangzhou.Methods The EC screening was conducted in freshmen of boarding junior high schools,senior high schools/vocational high schools and colleges in Yangzhou in autumn 2023,and the students with positive EC test results were examined by chest computed tomography.The positive EC test and the detection results of pulmonary TB in freshmen were analyzed and compared.Results In EC screening of 17093 freshmen,173 were positive(1.01%),and 18 M.tuberculosis infection cases were detected(10.53/10000).Multivariate Logistic regression analysis showed that the freshmen in central region[odds ratio(OR)=2.31,95%confidence interval(CI):1.22-4.37]and western region(OR=5.99,95%CI:3.07-11.68)had higher risk for M.tuberculosis infection compared with those in eastern region.The detection possibility of pulmonary TB was higher in the freshmen in western region(OR=18.31,95%CI:2.43-138.05)than in eastern region.Previous history of TB(OR=7.47,95%CI:1.43-39.00)and TB case contact history(OR=6.79,95%CI:2.13-21.72)were risk factors for M.tuberculosis infection in the freshmen.The students with TB history(OR=31.77,95%CI:3.50-288.60)and TB case contact history(OR=13.62,95%CI:1.63-113.66)had higher possibility of TB detection.Conclusion The application of EC test for TB screening is an important way to find the source of M.tuberculosis infection in school or college freshmen in Yangzhou.It is suggested to take appropriate prevention and control measures targeting M.tuberculosis infection and pulmonary TB cases to effectively reduce the risk of TB transmission in schools or colleges in Yangzhou.Freshmen from central and western regions and with TB history of and TB exposure history are the key population for TB screening.