2017—2019年贵港市学校结核病聚集性疫情调查  

Survey on cluster epidemic of tuberculosis in schools in Guigang City from 2017-2019

作　　者：韦光[1] 朱刚劲 覃雄林[1] 陆雪兰 覃春伟[1] 韦金凤[1] 姚伟华 WEI Guang;ZHU Gang-jin;QIN Xiong-lin;LU Xue-lan;QIN Chun-wei;WEI Jin-feng;YAO Wei-hua(Tuberculosis Control Division,Guigang City Center for Disease Control and Prevention,Guigang Guangxi,537100,China)

机构地区：[1]贵港市疾病预防控制中心结核病防制科,广西贵港537100

出　　处：《职业与健康》2020年第22期3134-3137,共4页Occupation and Health

基　　金：广西卫健委自筹经费课题项目(Z20201337)。

摘　　要：目的探讨贵港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,为贵港市开展学校结核病聚集性疫情乃至突发公共卫生事件应急处置提供科学依据。方法收集2017—2019年贵港市发生的6起学校聚集性疫情病例资料,分析疫情发生的原因、传染源的发现、密切接触者筛查、新病例的发现以及疫情处置情况等。结果 6起学校聚集性疫情中指示病例就诊延迟时间最长为E中学(174 d),最短为A中学(7 d),就诊延迟平均时间为52.83 d;诊断延迟时间最长的学校为D中学(2019年)(32 d),诊断延迟平均时间为7.33 d(44/6 d);6起密切接触者结核菌素试验(PPD)阳性率最低为贵港市A中学(17.02%),最高的学校为D中学(2018年)(91.25%)。密切接触者PPD筛查数为512人,阳性数为283例,平均阳性率为55.27%;一般接触者PPD阳性率最低为贵港市A中学(2.29%),最高为2019年发生在D中学的疫情(14.64%);6所学校密切接触者PPD平均阳性率与一般接触者PPD平均阳性率比较,差异有统计学意义(χ^(2)=1 312.27,P<0.01)。结论传染源没有被及时发现、隔离、治疗,密切接触者人群没有得到及时规范处置,学校日常监测措施落实不到位是造成学校结核病聚集性疫情发生的主要原因,应加强学校结核病健康教育,严格落实新生入学健康检查,加强疾病预防控制系统的主动监测和规范对聚集性疫情中密切接触者的管理,及时发现和治疗肺结核患者,有效控制学校结核病聚集性疫情的蔓延和传播。Objective To explore the occurrence factors of tuberculosis cluster epidemic in schools of Guigang City and the suitability of emergency measures,provide scientific basis for carrying out emergency response to school tuberculosis cluster epidemic and public health emergencies. Methods The case data of six school cluster epidemics in Guigang City from 2017-2019 were collected,to analyze the causes of epidemic,the discovery of infectious source,the screening of close contacts,the discovery of new cases and the treatment of epidemic. Results In six school cluster epidemics,the longest treatment delay time of the index case was E Middle School(174 days),the shortest was A Middle School(7 days),and the average treatment delay time of was(52.83 days). The longest diagnosis delay time was D Middle School(2019)(32 days),and the average diagnosis delay time was7.33 days(44/6 days). Among the close contacts in six events,the positive rate of tuberculin test(PPD) in A Middle School of Guigang City was the lowest(17.02%),and that in D Middle School was the highest(2018)(91.25%). The PPD screening was performed on 512 close contacts,and 283 were positive with the average positive rate of 55.27%. The lowest positive rate of PPD among the general contacts was the lowest in A Middle School of Guigang City(2.29%),and the highest was 14.64% in D Middle School in 2019. The difference in the average positive rate of PPD was statistically significant between the close contacts and the general contacts in six schools(χ^(2)=1 312.27,P<0.01). Conclusion The main causes of tuberculosis cluster epidemic in schools are the source of infection has not been found,isolated and treated in time,the close contact population has not been dealt with in a timely and standardized manner,and the daily surveillance measures in schools are not in place. It is necessary to strengthen the school tuberculosis health education,strictly implement the health examination of freshmen,strengthen the active monitoring of disease prevention and control system an

关 键 词：结核病 聚集性 学生 贵港市 

分 类 号：R181.81[医药卫生—流行病学]