柳州市校园结核病聚集性疫情的监测与处置调查分析

发布时间：2018-02-04 12:16

本文关键词： 校园结核病聚集性疫情处置分析　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的对柳州市高校结核病聚集性疫情进行监测、处置,并分析结核病聚集性疫情发生、发展、处置的情况,进而探讨高校结核病聚集性疫情爆发流行的高危因素、防控薄弱环节以及防范措施,为今后预防和控制学校聚集性结核病疫情的发生和流行提供参考依据。方法疫情监测用以主动监测方式每日由指定疫情管理人员登录结核病专报系统进行监控(要求每天至少登录2次),现场流行病学调查采用直接观察法,密切接触者筛查和诊断运用结核菌素试验(PPD试验)、影像学诊断以及实验室检查(痰涂片、痰培养),聚集性疫情危险因素及知晓率调查采用自行设计的调查表进行访谈,聚集性疫情分析采用现况调查以及描述性流行病学统计分析,患病率、感染率、知晓率以及危险因素比例之间的差异用卡方检验,检验水准为0.05.结果本次共监测到8起高校结核病疫情,其中7起散发疫情以及1起聚集性疫情。聚集性疫情中密切接触者PPD强阳性率显著高于散发疫情(2c=23.5,P0.05)。该起聚集性疫情发现8例结核病患者,患者以首发病例性别(男性)为主,年龄在20~22岁,集中分布在该校2013级经济系(6/8)和南五宿舍(6/8),其中2013级经济系男生患病率率均高于女生(2c=4.55,P=0.03)。该起聚集性疫情发生学校防控措施不到位、宿舍卫生环境差、相对拥挤且通风不佳,密切接触者结核病核心知识知晓率较低(43.30%),其中城市学生知晓率高于农村学生(2c=4.61,P=0.03)。结论能否及时发现并隔离传染源是遏制校园结核病发生发展的重要原因,首发病例因担心休学、受歧视等原因隐瞒病情导致传染源长期存在是该起高校内聚集性肺结核疫情发生和流行的主要原因,学校结核病疫情发现、报告等环节落实不到位并缺乏监管是该聚集性疫情长时间未被发现的主要原因,环境卫生不理想、通风条件欠佳为呼吸道传播疾病提供了可靠的传播途径。对于高校内结核病疫情防控,加强监管,督促各级部门责任落实,改善学校、宿舍卫生环境,提高学生就诊以及定点医院医务审核报病的主动性、及时性,加强学校结核病防控宣传教育(尤其是农村学生)等针对性措施能够较好地控制疫情发生。
[Abstract]:Objective to monitor, deal with, and analyze the occurrence, development and treatment of tuberculosis agglomeration in Liuzhou. Furthermore, the high risk factors, the weak links of prevention and control and the preventive measures for the outbreak of concentrated tuberculosis epidemic in colleges and universities were discussed. To provide reference for the prevention and control of the occurrence and prevalence of clustered tuberculosis in schools in the future. Methods epidemic surveillance is carried out on a daily basis by designated epidemic managers by logging into the TB reporting system (. Log in at least twice a day. Direct observation was used to screen and diagnose close contacts PPD test imaging diagnosis and laboratory examination (sputum smear sputum culture). The investigation of risk factors and awareness rate of aggregated epidemic situation was conducted with self-designed questionnaire. The prevalence rate and infection rate were analyzed by current survey and descriptive epidemiological statistical analysis. The difference between awareness rate and risk factor ratio was tested by chi-square test and the test level was 0.05. Results there were 8 cases of tuberculosis epidemic in colleges and universities. The positive rate of PPD in close contacts was significantly higher than that in sporadic cases. P0.05. 8 cases of tuberculosis were found in this case. The main sex of the first case (male) was 20 to 22 years old. The prevalence rate of male students in 2013 economics department was higher than that of girls, and the prevalence rate of male students was higher than that of girls. The prevention and control measures were not in place, the sanitary environment of dormitory was poor, relatively crowded and ventilated. The awareness rate of tuberculosis core knowledge in close contacts was 43.30%, and the awareness rate of urban students was higher than that of rural students (43.30%). Conclusion whether to find and isolate the source of infection in time is an important reason to curb the occurrence and development of campus tuberculosis, and the first case is worried about school suspension. The long-term existence of infection source caused by discrimination and other reasons is the main reason for the occurrence and prevalence of concentrated tuberculosis in this university. The lack of implementation of the report and lack of supervision are the main reasons why the aggregated epidemic has not been detected for a long time, and environmental hygiene is not ideal. Poor ventilation conditions provide a reliable way to spread respiratory tract diseases. To prevent and control tuberculosis in colleges and universities, strengthen supervision, urge departments at all levels to implement their responsibilities, improve the health environment of schools and dormitories. Improving the initiative and timeliness of medical examination and reporting in designated hospitals and strengthening the propaganda and education of tuberculosis prevention and control in schools (especially rural students) can better control the outbreak of the disease.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R52;R181.3

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