摘要
目的 探讨结核分枝杆菌潜伏感染(LTBI)者预防性治疗的效果,为学校聚集性疫情处置及预防性治疗工作提供借鉴。方法 收集重庆市开州区一所学校寄宿制高中2016级师生在2017年6月至2018年3月发生的学校肺结核疫情资料进行调查分析,并对发病情况、LTBI者及预防性治疗后发病情况追踪随访5年。结果 该校2017年6月至2018年3月共确诊34例肺结核患者。6次集中接触者筛查中共筛查1 357人,筛查确诊结核率为2.43%,结核菌素皮肤试验(TST)阳性率为27.41%,TST强阳性率为7.39%。其中,首发病例班级确诊率、TST阳性率远高于其他班级,差异均有统计学意义(χ^(2)值分别为286.30,98.59,P值均<0.01)。发现LTBI者88例,有31例进行预防性治疗(35.23%),其中28例完成预防性治疗(90.32%)。经5年追踪随访,该校高中部2016级共确诊肺结核患者73例,发病率为0.98/102(人/人年)。88例LTBI者有15例确诊肺结核,发病率为3.33/102(人/人年),其中完成预防性治疗组发病率[0.7/102(人/人年)]低于医学观察组[4.5/102(人/人年)],差异有统计学意义(χ^(2)=4.31,P<0.05)。结论 TST阳性率、强阳性率越高的班级发病率越高,提高LTBI者预防性治疗率可有效降低结核发病率。
Objective To explore the effectiveness of preventive treatment for latent tuberculosis infection(LTBI)patients,so as to provide reference for the management and preventive treatment of clustered epidemic in schools.Methods Data came from the school tuberculosis outbreak of a boarding high school in Kaizhou District,Chongqing,which occurred between June 2017 and March 2018 among 2016 grade high school teachers and students for investigation and analysis.The total incidence,LTBI patients,and the incidence after preventive treatment for 5 years were followed up.Results A total of 34 cases of pulmonary tuberculosis from June 2017 to March 2018.A total of 1357 individuals were screened for 6 concentrated contact screenings,with a confirmed tuberculosis rate of 2.43%,a tuberculosis skin test(TST)positive rate of 27.41%,and a strong TST positive rate of 7.39%.Among them,the confirmed tuberculosis rate and TST positive rate in the first case class were much higher than those in other classes,with statistically significant differences(χ^(2)=286.30,98.59,P<0.01).88 cases of LTBI were found,with 31 cases receiving preventive treatment(35.23%),of which 28 completed preventive treatment(90.32%).After five years of follow-up,73 cases of pulmonary tuberculosis were diagnosed in 2016 by the school senior high school,with a incidence rate of 0.98/102(person/person years).Fifteen of the 88 LTBI patients were diagnosed with pulmonary tuberculosis,and the incidence rate was 3.33/102(person/person years).The incidence rate of the preventive treatment group was 0.7/102(person/person years)lower than that of the medical observation group 4.5/102(person/person years),with a statistically significant difference(χ^(2)=4.31,P<0.05).Conclusion The classes with higher TST positive rate and strong positive rate have higher incidence rate.Improving the preventive treatment rate of LTBI patients can effectively reduce the incidence rate of tuberculosis.
作者
秦林蓉
刘彬
王江
杨静
罗春燕
向登峰
张婷
庞艳
QIN Linrong;LIU Bin;WANG Jiang;YANG Jing;LUO Chunyan;XIANG Dengfeng;ZHANG Ting;PANG Yan(Department of Tuberculosis Prevention,Chongqing Kaizhou District Center for Disease Control and Prevention,Chongqing(405400),China;不详)
出处
《中国学校卫生》
CAS
北大核心
2023年第10期1564-1567,共4页
Chinese Journal of School Health
关键词
结核
肺
疾病暴发流行
随访研究
发病率
学生
Tuberculosis
pulmonary
Disease outbreaks
Follow-up studies
Incidence
Students
作者简介
秦林蓉(1987-),女,重庆开州人,大学本科,主治医师,主要从事结核病预防控制工作;张婷(1984-),女,重庆酉阳人,硕士,副主任医师,主要从事结核病预防控制工作;通讯作者:刘彬,E-mail:281530261@qq.com。
