2019—2022年苏州市高新区学校结核病流行病学特征分析及基于ARIMA模型的趋势预测

Analysis on epidemiological characteristics of tuberculosis in schools and trend prediction based on ARIMA model in Suzhou high-tech district from 2019 to 2022

目的探讨苏州市高新区学校结核病流行病学特征,构建ARIMA模型预测短期发病风险,完善学校疫情监测布局及控制策略。方法基于中国疾病预防控制信息系统收集2019—2022年苏州市高新区学校结核病疫情资料,进行回顾性分析及趋势预测。结果2019—2022年苏州市高新区报告学生肺结核病例95例,聚集性疫情2起、散发疫情79起,年报告发病率为8.88/10万~27.91/10万;病例高发学段为大专院校、大学,高发时间集中于第3季度,占39.00%,男女患病比例为1.64∶1,因症就诊来源居多,占42.11%。筛查密接者3803名,结核菌素皮肤(purified protein derivatives,PPD)试验强阳率为10.70%,聚集性疫情病例班级PPD强阳率高于扩大筛查班级及散发疫情(χ^(2)=30.553,P<0.05);潜伏感染者预防性服药率逐年上升。ARIMA模型预测2023年大专院校、大学类学校季度发病率依次为1.42/10万、2.98/10万、6.10/10万、3.74/10万。结论学生肺结核潜伏感染及发病风险较高,应准确识别密接者及一般接触者,逐级扩大筛查对象,对潜伏感染者采取有效预防措施,科学预警,遏制学校结核病的蔓延。

Objective To explore the epidemiological characteristics of tuberculosis in schools in Suzhou High-tech District,build an ARIMA model to predict the short-term incidence risk,and improve the school epidemic monitoring layout and control strategies.Methods Based on the the China Disease Prevention and Control Information System,the data of tuberculosis epidemic situation in schools of Suzhou High-tech District from 2019 to 2022 were collected,and the retrospective analysis and trend prediction were carried out.Results From 2019 to 2022,Suzhou High-tech District eported 95 cases of pulmonary tuberculosis among students,2 clustered epidemics and 79 sporadic epidemics,with an annual reported incidence rate of 8.88/100000 to 27.91/100000.The high incidence stage of cases was in colleges and universities,with the high incidence time concentrated in the third quarter,accounting for 39.00%.The male to female prevalence ratio was 1.64∶1,and the majority of patients seek medical treatment due to symptoms,accounting for 42.11%.3803 close contacts were screened,and the strong positive rate of PPD was 10.70%.The PPD strong positive rate in the class with clustered epidemic cases was higher than that in the expanded screening class and sporadic epidemic(χ^(2)=30.553,P<0.05).The rate of preventive medication for latent infections was increasing year by year.The ARIMA model predicted that the quarterly incidence rates of colleges and universities in 2023 will be 1.42/100000,2.98/100000,6.10/100000,and 3.74/100000.Conclusion The risk of latent infection and incidence of pulmonary tuberculosis in students is high.It is necessary to accurately identify the close contacts and general contacts,expand the screening objects step by step,take effective preventive measures for the latent infected,scientific early warning,and curb the spread of tuberculosis in schools.