分级接触者筛查在一起大学生肺结核聚集性发病调查中的应用

发布时间：2018-05-02 09:40

本文选题：学生 + 发病率　；参考：《中国学校卫生》2015年05期

【摘要】：目的探讨分级接触者筛查方法在大学生肺结核聚集性发病调查中的应用效果,为有效控制聚焦性疾病蔓延提供依据。方法对天津市某大学首发肺结核病例的接触者分级筛查,开展流行病学调查、症状筛查、PPD试验、TBSA检测和胸部DR检查。结果本次调查逐步筛查了3级接触者,共934名师生。在1~3级接触者中,肺结核可疑症状发生率分别为7.1%,0.4%和0.2%,PPD强阳性率分别为62.5%,30.7%和26.7%,TB-SA阳性率分别为45.5%,22.3%和17.4%,DR胸片可疑阴影发生率分别为16.7%,4.4%和0.6%,各项检查的阳性率均呈递减(χ2值分别为36.32,23.02,7.03,52.22,P值均0.05)。最终在接触者中确诊17例学生肺结核病例,从1~3级接触者的肺结核检出率分别为14.3%,3.1%和0.6%,差异有统计学意义(χ2=43.97,P0.01)。在宿舍楼层分布上,女生43号楼3层的肺结核罹患率为11.6%,高于男生4层的2.0%及其他楼层的0.8%,差异有统计学意义(χ2=45.97,P0.05);专业分布上,10级动画专业、10级环艺专业和其他专业罹患率分别为18.9%,6.8%和0.6%,差异有统计学意义(χ2=72.30,P0.05)。结论分级接触者筛查方法适用于学校内结核病疫情调查,可以明确疫情波及人群。调查发现病例间有流行病学关联,疫情主要在宿舍楼层及专业内传播。
[Abstract]:Objective to explore the effect of the screening method of graded contacts in the investigation of the incidence of pulmonary tuberculosis among college students, and to provide evidence for the effective control of the spread of focused diseases. Methods the first pulmonary tuberculosis cases in a university in Tianjin were screened by grade, epidemiological investigation, PPD test, TBSA test and chest Dr examination were carried out. Results in this survey, 934 teachers and students were gradually screened for level 3 contacts. Among those who are in contact with level 1 or 3, The incidence of suspected symptoms of pulmonary tuberculosis was 7.4% and 0.2%, respectively. The positive rates of PPD were 62.5% and 26.7%, respectively. The positive rates of TB-SA and TB-SA were 45.5% and 17.4%, respectively. The incidence of suspicious shadows in chest radiographs were 16.74.4% and 0.6, respectively. The positive rates of each examination were decreased (蠂 ~ 2 = 36.32, 23.02, 7.032, 7.032, P = 0.05, P = 0.05, respectively). Finally, 17 cases of pulmonary tuberculosis were diagnosed in the contact group. The positive rate of pulmonary tuberculosis from grade 1 to grade 3 was 14. 3% and 0. 6%, respectively. The difference was statistically significant (蠂 2, 43.97, P 0. 01, P < 0. 01, P < 0. 01). In the dormitory floor distribution, The incidence rate of tuberculosis in girls on the third floor of Building 43 was 11.6, which was higher than that of boys on the 4th floor and 0.8% of the other floors (蠂 2 / 45.97 / P0.05), and the incidence rates of students in the 10 ~ (th) level of animation and other majors were 18.998% and 6.8%, respectively. The difference was statistically significant (蠂 2, 72.30, P 0.05). Conclusion the method of graded contact screening is suitable for the investigation of tuberculosis epidemic in schools and can be used to identify the epidemic and the population. The investigation found that there was an epidemiological link between the cases, the epidemic mainly spread within the dormitory floor and professional.
【作者单位】：天津市结核病控制中心;
【分类号】：R521

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