2013—2022年湖北省恩施土家族苗族自治州学校肺结核流行特征分析

Analysis of epidemiological characteristics of pulmonary tuberculosis in schools in Enshi Tujia and Miao Autonomous Prefecture of Hubei Province from 2013 to 2022

目的分析湖北省恩施土家族苗族自治州(以下简称"恩施州")学校肺结核的流行特征,为制定学校肺结核防控策略提供参考依据。方法从结核病信息管理系统导出2013—2022年恩施州学生和教师患者病案信息,应用描述性流行病学方法进行统计描述。利用Excel 2021年和SPSS 20.0软件,分别计算学生、教师肺结核报告发病率、季节指数,10年的报告发病率的趋势变化采用趋势卡方检验,以P<0.05为差异有统计学意义。结果2013—2022年恩施州报告学生肺结核2989例,教师355例。学生年平均报告发病率为64.97/10万,教师年平均报告发病率为117.46/10万,均呈上升趋势(χ^(2)趋势=45.48和4.32,P均<0.05);学生病例男性占比多于女性,教师病例中女性占比多于男性。每年2月份报告病例数较少(季节指数为67.45),3、4月份报告病例数较多(季节指数分别为114.30,136.52)。全州8个县市以学生病例年均报告发病率最高的是利川市(8.29/10万),来凤县最低(3.29/10万)。结论恩施州学校肺结核年均报告发病率整体呈波动上升趋势,学校肺结核疫情仍然严重,需要高度重视学校结核病的防控工作,重点关注利川市及高中学生群体,加强学前筛查。

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis(PTB)in schools in Enshi Tujia and Miao Autonomous Prefecture(Enshi Prefecture),Hubei Province,and to provide reference basis for formulating school tuberculosis prevention and control strategies.Methods The medical records of students and teachers in Enshi Prefecture from 2013 to 2022 were derived from the Tuberculosis Information Management System,and were statistically described by descriptive epidemiological methods.Using Excel 2021 and SPSS 20.0 software,the reported incidence rate and seasonal index of pulmonary tuberculosis of students and teachers were calculated,respectively.The trend changes of incidence rate in 10 years were tested by trend Chisquare test,and the difference was statistically significant with P<0.05.Results From 2013 to2022,Enshi Prefecture reported 2989 cases of pulmonary tuberculosis among students and 355cases among teachers.The reported average annual incidence rate of students was 64.97/10^(5),and the reported average annual incidence rate of teachers was 117.46/10^(5),both showing an upward trend.The reported proportion of cases among male students was higher than femals students,and the reported proportion of cases among female teachers was higher than male teachers.The number of reported cases was relatively smaller in February each year(seasonal index:67.45),while the number of reported cases was relatively higher in March and April(seasonal index:114.30 and136.52,respectively).Among the eight counties and cities in the prefecture,Lichuan City had the highest reported average annual incidence rate of students(8.29/10^(5)),and Laifeng County had the lowest rate(3.29/10^(5)).Conclusions The reported annual average incidence rate of pulmonary tuberculosis in schools in Enshi Prefecture showd a fluctuating upward trend on the whole,and the epidemic situation of pulmonary tuberculosis in schools was still serious.We need to attach great importance to the prevention and control of tuberculosis in schools,focus on Lichuan City and high school students and strengthen preschool screening.