贵阳市云岩区中学新生结核潜伏感染现状与预防性治疗意愿

彭晓唯; 张江萍; 罗鹏; 陈思银; 徐孟群; 王群

doi:10.16835/j.cnki.1000-9817.2025007

贵阳市云岩区中学新生结核潜伏感染现状与预防性治疗意愿

doi: 10.16835/j.cnki.1000-9817.2025007

彭晓唯¹,
张江萍^{1, 2, ,},
罗鹏¹,
陈思银¹,
徐孟群¹,
王群¹

1.
贵州医科大学公共卫生与健康学院/环境污染与疾病监控教育部重点实验室，贵阳 561113
2.
贵阳市云岩区卫生健康局

基金项目:

贵阳市云岩区科学计划项目云项科字[2024]9号

详细信息

作者简介:
彭晓唯(1997-)，女，贵州贵阳人，在读硕士，初级医师，主要研究方向为疾病预防与控制

通讯作者:
张江萍，E-mail：Em646385@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R181.3⁺² R52
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- 被引次数: 0
出版历程
- 收稿日期: 2024-08-28
- 修回日期: 2024-11-13
- 网络出版日期: 2025-01-25
- 刊出日期: 2025-01-25

Prevalence of latent tuberculosis infection among freshmen in middle schools and their willingness of preventive treatment in Yunyan District of Guiyang

1.
School of Public Health and Health Services, Guizhou Medical University/Key Laboratory of Environmental Pollution and Disease Surveillance, Ministry of Education, Guiyang(561113), Guizhou Province, China

摘要

摘要: 目的了解贵阳市云岩区中学新生结核潜伏感染(LTBI)情况和结核潜伏感染新生预防性治疗意愿，为学校结核病防控工作提供参考依据。方法对2023年贵阳市云岩区公办中学13 915名入学新生，采用结核菌素皮肤试验(TST)和X线胸片检查筛查LTBI情况，并对确诊的LTBI新生进行预防性治疗意愿问卷调查。组间率的比较采用χ²检验或Fisher确切概率法。结果筛查新生中LTBI检出率为3.29%。不同性别(男生：2.87%，女生：3.81%)、年龄段(12~15岁：3.31%，16~17岁：3.92%，18~20岁：1.91%)、学段(初中：3.52%，普通高中：5.96%，职业高中：2.29%)新生的LTBI检出率差异均有统计学意义(χ²值分别为9.59，13.08，54.30，P值均 < 0.01)。共356例LTBI新生完成预防性治疗意愿问卷调查，其中299例(83.99%)愿意接受预防性治疗，但实际进行预防性治疗者为0。接种过卡介苗的LTBI者愿意进行预防性治疗报告率(86.97%)高于未接种过卡介苗的LTBI者(75.79%)，差异有统计学意义(χ²=6.48，P < 0.05)。不愿意预防性治疗最主要的原因为担心药物不良反应及副作用(80.70%)，最需要的是社会的接纳和社会机构的支持(85.96%)。结论贵阳市云岩区中学新生结核感染处于较高水平；虽然LTBI新生对预防性治疗的接受意愿较高，却无人进行预防性治疗。还需采取相应措施提高LTBI新生预防性治疗率。
- 结核 /
- 感染 /
- 预防和防护用药 /
- 态度 /
- 学生
Abstract: Objective To investigate the status of latent tuberculosis infection(LTBI)among freshmen in middle schools and their willingness of preventive treatment in Yunyan District of Guiyang, so as to provide a reference for the prevention and control of tuberculosis in schools. Methods The tuberculin skin test (TST) and X-ray scans were used to screen the TB infection of 13 915 freshmen in middle schools in Yunyan District of Guiyang in 2023, and a questionnaire survey on the willingness of accepting tuberculosis preventive treatment was conducted to LTBI patients. The χ² test and Fisher exact probability was conducted for the comparison of the rates among the groups. Results Among the freshmen screened, the detection rate of LTBI was 3.29%. There were statistically significant difference in LTBI rates among freshmen of different genders (boys: 2.87%, girls: 3.81%), age groups (12-15 years old: 3.31%, 16-17 years old: 3.92%, 18-20 years old: 1.91%), and school stages (junior high school: 3.52%, ordinary high school: 5.96%, vocational high school: 2.29%)(χ²=9.59, 13.08, 54.30, P < 0.01). A total of 356 LTBI freshmen completed questionnaire survey, and 299(83.99%) were willing to accept tuberculosis preventive treatment, but the actual number of LIBI freshman who underwent preventive treatment was zero. Those LTBI who had received Bacille Calmette-Guérin(BCG) vaccine(86.97%) was higher in the reporting rates of being willing to accept preventive treatment than that of LTBI who had not received BCG vaccine(75.79%), the differences were statistically significant(χ²=6.48, P < 0.05). The main reasons for refusing preventive treatment was worry about adverse drug reactions(80.70%), social acceptance and the support of social institutions were needed most(85.96%). Conclusion The LTBI rate among freshmen in Yunyan District of GuiYang is higher. Although the freshmen with LTBI have a higher willingness to accept preventive treatment, however, no one has undergone preventive treatment. Corresponding measures need to be taken for improving the preventive treatment rate of LIBI freshmen.
- Tuberculosis /
- Infection /
- Protecitve agents /
- Attitude /
- Students
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表 1 贵阳市云岩区不同组别中学新生LTBI检出率比较

Table 1. Comparison of LTBI detection rates among middle school freshmen in different groups in Yunyan District of Guiyang

组别	选项	人数	结核潜伏感染人数	χ²值	P值
性别	男	7 639	219(2.87)	9.59	< 0.01
	女	6 276	239(3.81)
年龄/岁	12~15	9 310	308(3.31)	13.08	< 0.01
	16~17	3 083	121(3.92)
	18~20	1 522	29(1.91)
学段	初中	6 657	234(3.52)	54.30	< 0.01
	普高	1 577	94(5.96)
	职高	5 681	130(2.29)
寄宿	是	7 156	228(3.19)	0.51	0.47
	否	6 759	230(3.40)
注：()内数字为检出率/%。

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表 2 不同组别LTBI中学新生预防性治疗意愿报告率

Table 2. Comparison of willingness reporting rates of preventive treatment among middle school freshmen with LTBI in different groups

组别	选项	人数	愿意进行预防性治疗人数	χ²值	P值
性别	男	167	136(81.44)	1.52	0.22
	女	189	163(86.24)
年龄/岁	12~15	241	207(85.89)	2.25^a	0.33
	16~17	88	70(79.55)
	18~20	27	22(81.48)
民族	汉族	243	203(83.54)	0.12	0.73
	少数民族	113	96(84.96)
年级	初中	205	175(85.37)	5.99	0.05
	普高	56	51(91.07)
	职高	95	73(76.84)
父亲文化程度	小学及以下	70	60(85.71)	2.77	0.43
	初中	127	102(80.31)
	高中及中专	72	60(83.33)
	大专及以上	87	77(88.51)
母亲文化程度	小学及以下	84	72(85.71)	5.65	0.13
	初中	137	115(83.94)
	高中及中专	65	49(75.38)
	大专及以上	70	63(90.00)
是否寄宿	是	147	119(80.95)	1.72	0.19
	否	209	180(86.12)
是否接种过卡介苗	是	261	227(86.97)	6.48	0.01
	否	95	72(75.79)
注：()内数字为报告率/%；a为Fisher确切概率法。

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参考文献(25)

[1]	WHO. Global tuberculosis report 2023[EB/OL]. (2023-11-03)[2024-07-03]. https://www.who.int/publications/i/item/9789240083851.
[2]	高磊, 张慧, 胡茂桂. 全国结核分枝杆菌潜伏感染率估算专家共识[J]. 中国防痨杂志, 2022, 44(1): 4-8. GAO L, ZHANG H, HU M G. Expert consensus on the estimation of the national burden on latent tuberculosis infection[J]. Chin J Antituberc, 2022, 44(1): 4-8. (in Chinese)
[3]	曹红, 钱冰, 吴金菊. 学校结核病疫情现状及防控工作研究进展[J]. 结核与肺部疾病杂志, 2024, 5(1): 88-92. CAO H, QIAN B, WU J J. Current situation of tuberculosis epidemic in schools and research progress in prevention and control[J]. J Tuberc Lung Dis, 2024, 5(1): 88-92. (in Chinese)
[4]	陈卉, 张灿有, 张慧, 等. 2004—2021年全国学校肺结核疫情分析[J]. 中国防痨杂志, 2022, 44(8): 768-776. CHEN H, ZHANG C Y, ZHANG H, et al. Analysis on the epidemic situation of pulmonary tuberculosis in schools in China from 2004 to 2021[J]. Chin J Antituberc, 2022, 44(8): 768-776. (in Chinese)
[5]	ZENNER D, BEER N, HARRIS R J, et al. Treatment of latent tuberculosis infection: an updated network Meta-analysis[J]. Ann Intern Med, 2017, 167(4): 248-255. doi: 10.7326/M17-0609
[6]	袁叶敏, 李士雪, 周成超, 等. 结核分枝杆菌潜伏感染治疗接受性及影响因素[J]. 中国公共卫生, 2023, 39(7): 942-947. YUAN Y M, LI S X, ZHOU C C, et al. Acceptance and influencing factors of preventive treatment for latent tuberculosis infection: a review[J]. Chin J Public Health, 2023, 39(7): 942-947. (in Chinese)
[7]	中华人民共和国国家卫生健康委办公厅, 中华人民共和国教育部办公厅. 中国学校结核病防控指南(2020版)[EB/OL]. (2020-10-16)[2023-06-16]. http://www.nhc.gov.cn/jkj/s7923/202012/5f40b53827ae41c5ab7827507d584cab.shtml.
[8]	中华人民共和国国家卫生和计划生育委员会. 肺结核诊断标准(WS 288—2017)[J]. 新发传染病电子杂志, 2018, 3(1): 59-61. doi: 10.3877/j.issn.2096-2738.2018.01.017 National Health and Family Planning Commission of the PRC. Diagnostic for pulmonary tuberculosis standard (WS 288-2017)[J]. Electron J Emerg Infect Dis, 2018, 3(1): 59-61. (in Chinese) doi: 10.3877/j.issn.2096-2738.2018.01.017
[9]	赵雁林, 陈明亭. 中国结核病防治工作技术指南[M]. 北京: 人民卫生出版社, 2021. ZHAO Y L, CHEN M T. Technical guidelines for tuberculosis prevention and control in China[M]. Beijing: People's Medical Publishing House, 2021. (in Chinese)
[10]	中国疾病预防控制中心结核病预防控制中心. 结核病防治核心信息及知识要点(2016年版)[EB/OL]. (2016-03-04)[2023-10-19]. . https://tb.chinacdc.cn/xxjlg/201603/t20160324_128054.htm.
[11]	马志. 新疆伊宁市初高中及大中专院校新生结核潜伏感染状况及随访研究[D]. 乌鲁木齐: 新疆医科大学, 2022. MA Z. The status and follow-up study of tuberculosis latent infection among freshmen in junior middle school, senior high school, university and college in Yining City, Xinjiang[D]. Urumqi: Xinjiang Medical University, 2022. (in Chinese)
[12]	中华人民共和国国家卫生和计划生育委员会. 结核病分类: WS 196—2017[EB/OL]. (2017-11-09)[2022-02-10]. http://www.nhc.gov.cn/wjw/s9491/201712/0d3c52de984b4bc4add047f19ccd51b9.shtm1.
[13]	陈同, 贺天锋, 于梅, 等. 浙江省宁波市16 795名入学新生结核菌素试验结果分析[J]. 疾病监测, 2023, 38(9): 1043-1047. CHEN T, HE T F, YU M, et al. Analysis on tuberculin skin test results in 16 795 freshmen in Ningbo, Zhejiang[J]. Dis Surveill, 2023, 38(9): 1043-1047. (in Chinese)
[14]	张永强, 杨欢欢, 王亚亚, 等. 保定市156所学校入学新生结核病筛查情况[J]. 中国感染控制杂志, 2024, 23(1): 95-99. ZHANG Y Q, YANG H H, WANG Y Y, et al. Screening of tuberculosis among freshmen in 156 schools in Baoding City[J]. Chin J Infect Control, 2024, 23(1): 95-99. (in Chinese)
[15]	夏岚, 肖月, 陈闯, 等. 四川省2022年入学新生结核分枝杆菌潜伏感染与肺结核患病情况分析[J]. 中国防痨杂志, 2024, 46(6): 664-671. XIA L, XIAO Y, CHEN C, et al. Analysis of latent tuberculosis infection and active pulmonary tuberculosis diprevalence among newly admitted students of Sichuan Province for the year 2022[J]. Chin J Antituberc, 2024, 46(6): 664-671. (in Chinese)
[16]	朱嘉睿, 范月玲, 商亚丽, 等. 山西省高中新生结核潜伏感染影响因素[J]. 热带医学杂志, 2024, 24(2): 276-279, 298. ZHU J R, FAN Y L, SHANG Y L, et al. The influencing factors of latent tuberculosis infection among high school freshmen in Shanxi Province[J]. J Trop Med, 2024, 24(2): 276-279, 298. (in Chinese)
[17]	唐逾鸿, 秦毅, 易本菊, 等. 高二年级学生结核分枝杆菌潜伏感染的影响因素分析[J]. 结核与肺部疾病杂志, 2023, 4(6): 463-467. TANG Y H, QIN Y, YI B J, et al. Analysis of factors influencing latent mycobacterium tuberculosis infection among high school sophomores[J]. J Tuberc Lung Dis, 2023, 4(6): 463-467. (in Chinese)
[18]	赵鑫, 张亚楠, 闫银锁, 等. 2020—2022年北京市大学和高中学段新生结核菌素皮肤试验反应特征分析[J]. 中国防痨杂志, 2024, 46(1): 40-44. ZHAO X, ZHANG Y N, YAN Y S, et al. Analysis of the characteristics of tuberculin skin test reactions among college and high school freshmen in Beijing from 2020 to 2022[J]. Chin J Antituberc, 2024, 46(1): 40-44. (in Chinese)
[19]	腾子豪, 蒋远东, 王玥, 等. 新疆某职业院校新生结核潜伏感染的影响因素分析[J]. 预防医学, 2022, 34(11): 1156-1160. TENG Z H, JIANG Y D, WANG Y, et al. Factors affecting latent tuberculosis infection among freshmen in a vocational college in Xinjiang Uygur Autonomous Region[J]. China Prev Med J, 2022, 34(11): 1156-1160. (in Chinese)
[20]	黄宝杨, 韦概龙. 2016—2020年柳州市新生入学结核病筛查与学生结核病发病情况分析[J]. 右江医学, 2022, 50(10): 790-793. HUANG B Y, WEI G L. Tuberculosis screening among freshmen and incidence of tuberculosis among students in Liuzhou from 2016 to 2020[J]. Chin Youjiang Med J, 2022, 50(10): 790-793. (in Chinese)
[21]	马聪兴, 张秀芝, 王鹛, 等. 2019年北京市朝阳区高中及以下阶段新生入学肺结核筛查结果分析[J]. 现代预防医学, 2020, 47(21): 3908-3910. MA C X, ZHANG X Z, WANG M, et al. Tuberculosis screening results among new students of high schools and below in Chaoyang district of Beijing, 2019[J]. Mod Prev Med, 2020, 47(21): 3908-3910. (in Chinese)
[22]	王展, 李忠奇, 丁晓艳, 等. 江苏省学生结核潜伏感染者预防性治疗意愿现状及其影响因素[J]. 中国热带医学, 2024, 24(3): 244-251. WANG Z, LI Z Q, DING X Y, et al. The current situation of willingness to receive prophylactic treatment among students with latent tuberculosis infection and its influencing factors in Jiangsu Province[J]. China Trop Med, 2024, 24(3): 244-251. (in Chinese)
[23]	呼景飞, 周鸿让, 周喆, 等. 上海市青浦区不同类别高中肺结核密接感染及预防治疗现况分析[J]. 中国初级卫生保健, 2023, 37(12): 78-81. HU J F, ZHOU H R, ZHOU Z, et al. Analysis of tuberculosis infection and preventive treatment among close contacts in different types of high schools in Qingpu District of Shanghai[J]. Chin Prim Health Care, 2023, 37(12): 78-81. (in Chinese)
[24]	玛依沙·达肯, 陈阳贵, 李德洋, 等. 2021—2022年乌鲁木齐市肺结核家庭密切接触者预防性治疗意愿的影响因素分析[J]. 预防医学情报杂志, 2023, 39(8): 918-925. MAYISHA D K, CHEN G Y, LI D Y, et al. Analysis of influencing factors of intention to preventive treatment among close contacts of families with pulmonary tuberculosis in Urumqi City from 2021 to 2022[J]. J Prev Med Inf, 2023, 39(8): 918-925. (in Chinese)
[25]	MASKIT B, GALI P, AYAL R, et al. Identifying factors affecting latent tuberculosis treatment acceptance among healthcare workers: a retrospective analysis in a tertiary care centre[J]. BMJ Open, 2021, 11(9): 1-5.