毕节市中学结核病疫情处置状况

刘瑶; 熊猛; 陈慧娟; 杨婕; 陈璞; 洪峰; 李进岚

doi:10.16835/j.cnki.1000-9817.2021.01.032

毕节市中学结核病疫情处置状况

doi: 10.16835/j.cnki.1000-9817.2021.01.032

刘瑶^{1, 2},
熊猛³,
陈慧娟⁴,
杨婕⁴,
陈璞⁴,
洪峰²,
李进岚^4, ,

1.
贵州省铜仁市疾病预防控制中心公共卫生科，554300
2.
贵州医科大学公共卫生学院
3.
毕节市疾病预防控制中心
4.
贵州省疾病预防控制中心

详细信息

作者简介:
刘瑶(1993-)，女，贵州铜仁人，硕士，医师，主要研究方向为疾病预防与控制

熊猛(1972-)，男，贵州毕节人，大学专科，副主任医师，主要研究方向为结核病防治

通讯作者:
李进岚，E-mail：740820442@qq.com

刘瑶与熊猛为共同第一作者。
中图分类号: R 181.3 R 183 R 521
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- 被引次数: 0
出版历程
- 收稿日期: 2020-07-11
- 修回日期: 2020-08-02
- 网络出版日期: 2021-04-01
- 刊出日期: 2021-01-25

Management of tuberculosis outbreaks in middle schools of Bijie City

LIU Yao^{1, 2},
XIONG Meng³,
CHEN Huijuan⁴,
YANG Jie⁴,
CHEN Pu⁴,
HONG Feng²,
LI Jinlan^{4
, ,}

1.
Public Health Department, Center for Disease Control and Prevention of Tongren, Tongren(554300), Guizhou Province, China

摘要

摘要: 目的了解毕节市中学结核病疫情处置措施实施情况，为提升学校结核病疫情处置质量提出建议。方法采用统一调查问卷，对毕节市2018年8月27日—2019年1月6日结核病信息管理系统上报的中学肺结核疫情处置情况进行调查。结果密切接触者筛查开展率为69.72%(99/142)，不同县(区)间开展率差异有统计学意义(P < 0.01)。患者确诊之日至属地疾病预防控制机构开展密切接触者筛查工作的时间为3(1~10.5)d。年龄≥15岁密切接触者的流程规范率(0)小于 < 15岁密切接触者(23.08%)(P < 0.01)。3 462名密切接触者开展了症状筛查，发现可疑症状者进行胸片筛查(流程1);2 439名密切接触者同时进行症状筛查与结核菌素(PPD)试验，对可疑症状者以及PPD强阳性者进行胸片筛查(流程2)。Ⅰ级密切接触者筛查肺结核检出率流程1(28.89/10万)小于流程2(328.00/10万)(χ²=6.56，P=0.01)，Ⅰ级密切接触者潜伏感染率(6.39%)大于Ⅱ级密切接触者(1.93%)(χ²=54.86，P < 0.01)。结论毕节市2018年中学结核病疫情处置开展度较高、较及时，但规范性有待提高。
- 结核 /
- 疾病暴发流行 /
- 结核菌素试验 /
- 公共卫生管理
Abstract: Objective To understand the management of tuberculosis outbreaks in middle schools in Bijie City, and to put forward suggestions to improve the quality of tuberculosis epidemic situation in schools. Methods A unified questionnaire was used to investigate the management of tuberculosis outbreaks in middle schools reported by tuberculosis information management system from August 27, 2018 to January 6, 2019 in Bijie City. Results The screening rate of close contacts was 69.72%(99/142), which significantly varied by counties(P < 0.01). The time from the date of diagnosis of patients to screening of close contacts by local CDC was 3(1-10.5) days. Rate of standardized management process for close contacts aged 15 years or older (0) was lower than that for close contacts aged younger than 15 years old (23.08%)(P < 0.01). 3 462 close contacts were screened for TB symptom, and chest X-ray among those suspected individuals(process 1), and 2 439 close contacts were screened with TB symptom, PPD test, and chest X-ray among those suspected individuals or those with strong positive in PPD test(process 2). The detection rate of pulmonary tuberculosis in close contacts of Grade I was lower in Process 1 (28.89/100 000) than in Process 2 (328.00/100 000)(χ²=6.56, P=0.01). The latent infection rate of the first-class close contacts (6.39%) was higher than that of the second-class close contacts(1.93%)(χ²=54.86, P < 0.01). Conclusion Management of tuberculosis outbreaks in middle schools in Bijie City in 2018 is effective and timely, but the standardization needs to be improved.
- Tuberculosis /
- Disease outbreaks /
- Tuber culin test /
- Public health and administration
注释:

1) 刘瑶与熊猛为共同第一作者。

HTML全文

表 1 毕节市不同组别中学肺结核密切接触者筛查开展率比较

Table 1. Comparison of rates of tuberculosis close contacts screening of tuberculosis among different groups of middle schools in Bijie City

组别	选项	疫情响应病例数	筛查病例	χ²值	P值
学校性质	公办	123	86(69.92)	0.02	0.90
	民办	19	13(68.42)
是否寄宿	寄宿制	129	91(70.54)	0.13	0.72
	非寄宿制	13	8(61.54)
地区	城区	81	56(69.14)	0.03	0.86
	农村	61	43(70.49)
区县	大方	17	15(88.24)		< 0.01^*
	赫章	15	13(86.67)
	金沙	9	6(66.67)
	纳雍	20	11(55.00)
	七星关	18	16(88.89)
	黔西	11	10(90.91)
	威宁	43	20(46.51)
	织金	9	8(88.89)
注： ()内数字为开展率/%，*采用Fisher确切概率法。

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表 2 毕节市不同组别中学肺结核疫情处置及时性比较

Table 2. Comparisons of timely management of tuberculosis outbreaks in different groups of middle schools in Bijie City

组别	选项	筛查病例数	处置时间 ≤7 d疫情数	处置时间 >7 d疫情数	χ²值	P值
学段	初中	34	24	10	0.03	0.86
	高中	65	47	18
学校性质	公办	86	62	24	0.00	1.00
	民办	13	9	4
是否寄宿	寄宿制	91	65	26	0.00	1.00
	非寄宿制	8	6	2
地区	城区	56	42	14	0.69	0.41
	农村	43	29	14
患者痰菌	涂阴	88	61	27	1.31	0.25
状态	涂阳	11	10	1

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