济南某高校肺结核聚集性疫情调查分析  

Epidemiological Survey of a Clustering Infection with Pulmonary Tuberculosis in a University in Jinan

作　　者：高春梅[1] 李海燕[1] 马欲晓[1] 景中军[1] 王鲁奎 秦风菊 刘元东[2] 佟立波[2] GAO Chunmei;LI Haiyan;MA Yuxiao;JING Zhongjun;WANG Lukui;QIN Fengju;LIU Yuandong;TONG Libo(School Hospital of University of Jinan,Jinan 250022,China)

机构地区：[1]济南大学医院,济南250022 [2]济南军区联勤部疾病预防控制中心

出　　处：《解放军预防医学杂志》2018年第10期1231-1234,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

摘　　要：目的了解学校肺结核聚集性发病的原因和流行病学特征,为学校肺结核防控提供依据。方法对肺结核患者开展个案调查。对其密切接触人群开展症状筛查、PPD试验、胸部X线检查。采用描述性流行病学方法进行统计分析。结果该校共确诊肺结核患者50例,罹患率为0.15%。2起聚集性发病分别确诊肺结核患者29例和9例,其余为散发。密切接触人群PPD试验阳性率为31.48%。诊断为肺结核和结核性胸膜炎的患者密切接触人群PPD阳性率分别为31.79%和26.09%(χ~2=0.67,P=0.41)。因症就诊和密接筛查发现患者的密切接触人群PPD阳性率分别为58.27%和31.18%(χ~2=38.09,P<0. 01)。与患者同宿舍、同班级、密接宿舍、其他方式密切接触人群PPD阳性率分别为51. 85%、35.95%、27.40%、35.26%,同宿舍人群PPD阳性率高于同班级和其他密切接触人群(χ~2=7.81,P<0.01),同班级和其他密切接触人群PPD阳性率高于密切接触人群(χ~2=6.68,P<0.01)。结论传染源隔离不及时和共用有菌教室是此次聚集性疫情传播蔓延和扩散的主要原因,预防性服药落实不到位造成肺结核患者密切接触人群持续发病。加强学校对传染病管理的同时,要注重结核病防治知识的宣传。Objective To find out about the causes and epidemiological characteristics of pulmonary tuberculosis in a school in order to facilitate prevention and control of tuberculosis in schools.Methods Cases of pulmonary tuberculosis were investigated. The symptoms were screened and PPD test,chest X-ray examination were conducted among the close-contact populations. Descriptive epidemiology was used for analysis. Results A total of 50 cases of tuberculosis were diagnosed in this school,with an incidence of 0.15%. Two cases of clustering infection were confirmed that involved 29 cases and 9 cases of pulmonary tuberculosis respectivley,and the rest were sporadic. The positive rates of PPD in patients with tuberculosis and tuberculous pleurisy were 31.79% and 26.09% respectively（ χ~2= 0.67,P = 0.41）. The positive rates of PPD in close-contact populations among the symptomatic clients and the screened were 58.27% and 31.18% respectively（ χ~2= 38. 09,P〈0. 01）. The positive rates of PPD were 51.85%,35.95%,27.40% and 35.26% respectively among those living in the same dormitories,studing in the same class,living in the neighboring dormitories and among those in close contact otherwise. The positive rate of PPD among students in the dormitories was higher than that of the same class and other close-contact populations（ χ~2= 7.81,P〈0.01）. The positive rate of PPD among students in the same class and other close-contact populations was higher than among those in close contact（ χ~2= 6.68,P〈0.01）.Conclusion Delayed isolation from sources of infections and the sharing of bacterium-infected classrooms are the main causes of the epidemic. Poor implementation of preventive medicine causes the persistent exposure of patients to tuberculosis. While tightening the control of infectious diseases,we should try to make the knowledge of tuberculosis prevention more accessible.

关 键 词：肺结核 聚集性疫情 高校 

分 类 号：R195.4[医药卫生—卫生统计学]