摘要:
探讨合肥市学校结核病聚集性疫情发生的因素及应急处置措施的适宜性,为采取更有效的应对措施提供参考.方法 回顾性分析合肥市2011-2016年7起学校结核病聚集性疫情发生情况,开展密切接触者筛查,了解感染者、患者等处置情况.结果 2011-2016年合肥市共发生结核病聚集性疫情7起,其中突发公共卫生事件5起.首诊患者最短延误时间43 d,最长231 d;延误时间中位数最长的是诊断延误34 d,最短的是处置延误4d.密切接触者中患者检出率为5.05%,一般接触者中检出率为0.98%,差异有统计学意义(X2=52.115,P<0.01),随访发现患者16例.PPD筛查发现各校密切接触者PPD阳性率为5.51%~29.41%;扩大筛查PPD阳性率为0~11.19%,平均4.21%,差异有统计学意义(x2=52.117,P<0.01).7起疫情均采取了相应措施,5起疫情邀请专家组会诊并开展预防性治疗.结论 肺结核患者早期发现是控制结核病聚集性疫情发生的基本手段,暴露关系与PPD试验相结合是评价结核潜伏感染的有效手段;建立必要的疫情会诊制度,有助于尽早控制学校结核病聚集性疫情的扩散和蔓延.
Abstract:
Objective To investigate the e fectiveness of school tuberculosis outbreak emergency response measures in Hefei.Methods Retrospective analysis was conducted on 7 school-based tuberculosis(TB) outbreaks in Hefei during 2011-2016.Active tuberculosis screening of close contacts,as well as infected patients were carried out.Results During 2011-2016,7 cases of school tuberculosis outbreaks in Hefei were reported,including 5 cases of public health emergencies.The shortest period from initial diagnosis to close contacts screening was 43 d,the longest of which was 231 d.The average delay time in diagnosing was 43 d,and the average delay time in disposition was 4 d.The difference between the average positive rates of close contacts and general contacts was of statistical significance(x2 =52.115,P<0.01).Sixteen cases were diagnosed.In the PPD screening,the positive rate was 5.51%-29.41%,with an average of 12%;after expanded screening,PPD positive rate was 0-11%,with an average of 4.21%,with significant difference(X:=52.117,P<0.01).Five patients received experts consulting and preventive treatment.Conclusion Early detection of pulmonary tuberculosis cases is the fundamental approach of tuberculosis outbreak control.Patient's history of TB exposure and tuberculin skin test(TST) helps assess latent tuberculosis infection.It is necessary to establish consultation system to control school tuberculosis outbreak and transmission.