某学校出现结核病例后密切接触者筛查结果分析

发布时间：2018-02-15 12:19

本文关键词： 结核结果评价学生　出处：《中国学校卫生》2015年08期 　论文类型：期刊论文

【摘要】：目的对一起学校结核病疫情进行回顾,为学校结核病防控工作提供借鉴。方法对与病例所在学校高一、高二年级学生进行结核病筛查以确定新发病例及高危人群;自行设计访谈提纲及调查问卷,对校方及既往病例开展流行病学调查,追溯事件发展过程。结果学生胸部X线小片荧光缩影筛查率为99.86%(802/803),其中2例确定为活动性病变。PPD筛查率为94.40%(758/803),强阳性率为15.96%(121/758);高二年级强阳性率(19.91%)明显高于高一年级(9.25%),差异有统计学意义(χ2=23.750,P0.05)。在高二同一班级新发现2例活动性肺结核病人,且病例来源于同一班级的PPD强阳性率(82.22%,37/45)明显高于其他班级,差异具有统计学意义(P0.05)。流行病学调查发现,病例所在年级先后出现7例学生结核病人且病例间有密切接触史,除首发病例外,其余病例没有明确的校外接触史;除1例密接筛查病例外,其余病例均出现过结核病相应症状且存在就诊及/或确诊延误。结论对结核病人家庭中的学生成员及学生结核病人的密切接触者开展主动筛查,建立、落实包括入学体检及症状监测在内的学校病例主动发现机制,同时加强全民健康教育及医务人员专业培训,协同做好学校结核病疫情控制。
[Abstract]:Objective to review an epidemic situation of tuberculosis in schools and provide reference for the prevention and control of tuberculosis in schools. Self-designed interview outline and questionnaire to carry out epidemiological investigation on school and past cases, Results the results showed that the rate of fluorescence microcosmogram screening of chest X-ray films was 99.862 / 803 / 803 / 803%, and the screening rate of PPD was 94.4040 / 758 / 803G, and the strong positive rate was 15.96 / 121.758 / 758; the strong positive rate of grade 2 was 19.911respectively) and the positive rate was significantly higher than that of 9.25% in grade one. The difference was statistically significant (蠂 ~ 2 = 23.750, P 0.05). Two new active pulmonary tuberculosis patients were found in the same class in the second year of senior high school. The strong positive rate of PPD in the same class was significantly higher than that in other classes (P 0.05). The epidemiological investigation showed that there were 7 cases of tuberculosis patients in the same class and the cases had close contact with each other. Except for the first case, the other cases did not have a clear history of out-of-school contact. The other cases all had the corresponding symptoms of tuberculosis, and there was a delay in seeing a doctor and / or diagnosis. Conclusion the active screening of the student members in the family and close contacts of the student TB patient was carried out. We should implement the active detection mechanism of school cases including physical examination and symptom monitoring, and strengthen the health education and professional training of medical personnel to control the epidemic situation of tuberculosis in schools.
【作者单位】：天津市结核病控制中心研究室;
【分类号】：R521

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