新疆维吾尔自治区喀什地区活动性肺结核密切接触者发病及影响因素分析  

Analysis of the incidence and risk factors of activepulmonary tuberculosis among close contacts in Kashgar,Xinjiang Uygur Autonomous Region

作　　者：彭孝旺 樊晓蕾 向阳[2] 买吾拉江·依马木 胡鹏远 王艳杰[2] 腾子豪 Peng Xiaowang;Fan Xiaolei;Xiang Yang;Maiwulajiang·Yimamu;Hu Pengyuan;Wang Yanjie;Teng Zihao(Tuberculosis Prevention and Control Department,Kashgar Region Center for Disease Control and Prevention,Xinjiang Uygur Autonomous Region,Kashgar 844099,China;School of Public Health,Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆维吾尔自治区喀什地区疾病预防控制中心结核病防治科,喀什844099 [2]新疆医科大学公共卫生学院,乌鲁木齐830054

出　　处：《中国防痨杂志》2023年第6期601-606,共6页Chinese Journal of Antituberculosis

基　　金：后疫情时代肺结核潜伏风险计量预警及其新型防控模式构建与应用(7217040654)。

摘　　要：目的:分析新疆维吾尔自治区喀什地区活动性肺结核患者密切接触者的发病情况及影响因素,为制定密切接触者筛查策略提供科学依据。方法:通过“中国疾病预防控制信息系统”子系统“结核病管理信息系统”收集2018年1—6月新疆维吾尔自治区喀什地区登记报告的11411例活动性肺结核患者病案资料,排除死亡、无密切接触者及信息不全者58例,实际纳入11353例活动性肺结核患者作为指示病例。通过入户访谈、面对面问卷调查等方式识别密切接触者,建立队列,获取一般人口学资料,并进行肺结核可疑症状筛查、胸部X线摄片检查及痰涂片检查等,由结核病定点医疗机构专家组进行综合诊断,对未诊断为活动性肺结核的密切接触者进行3年随访观察(每年1次)。采用多因素logistic回归分析密切接触者发生活动性肺结核的影响因素。结果:11353例指示病例共发现密切接触者25577名,平均每例指示病例约追踪到2.25名密切接触者。在3年随访期内检出活动性肺结核2106例,发病率为8.26%。多因素logistic回归分析显示,指示病例为男性[OR(95%CI)=1.396(1.260~1.546)]、初治[OR(95%CI)=1.605(1.413~1.824)],以及年龄为15~34岁[OR(95%CI)=1.318(1.033~1.682)]和35~54岁[OR(95%CI)=3.054(2.717~3.432)]均是其密切接触者发生活动性肺结核的独立危险因素。密切接触者有既往结核病病史[OR(95%CI)=22.447(18.570~27.134)]、年龄≤14岁[OR(95%CI)=2.792(2.224~3.507)]和≥55岁[OR(95%CI)=2.089(1.777~2.457)],以及与指示病例的社会关系为父母[OR(95%CI)=6.521(4.284~9.926)]、配偶[OR(95%CI)=6.311(4.478~8.894)]、子女[OR(95%CI)=6.708(4.739~9.495)]、祖孙[OR(95%CI)=10.003(6.702~14.930)]、兄弟姐妹[OR(95%CI)=4.851(3.171~7.422)]、祖父母[OR(95%CI)=9.976(4.083~24.375)]、亲戚[OR(95%CI)=2.456(1.363~4.428)]、村医[OR(95%CI)=7.166(2.110~16.339)]均为其发生活动性肺结核的独立危险因素。结论:喀什地区活动性肺结核Objective:To analyze the incidence and influencing factors of close contacts of active pulmonary tuberculosis patients in Kashgar,Xinjiang Uygur Autonomous Region,and to provide a scientific basis for the development of close contact screening strategies.Methods:Data of 11411 active pulmonary tuberculosis(TB)patients registered and reported in Kashgar,Xinjiang Uygur Autonomous Region were collected,excluding 58 deaths,no close contacts,and incomplete information,11353 active TB patients were actually included as indicated cases,from January to June 2018 reported in the“Tuberculosis Management Information System”,a subsystem of the“China Disease Prevention and Control Information System”.Close contacts were identified through household interviews and face-to-face questionnaires,cohorts were established,general demographic information were obtained,and screening for suspicious symptoms of TB,chest X-ray and sputum smear,etc..The comprehensive diagnosis was made by a team of experts from the designated TB medical institution,and close contacts not diagnosed with active TB were followed up for three years(once a year).Multifactorial logistic regression was used to analyze the risk factors of the occurrence of active TB in close contacts.Results:A total of 25577 close contacts were identified in 11353 indicated cases,with an average of approximately 2.25 close contacts traced per indicated case.Active TB was detected in 2106 cases during the 3-year follow-up period,with an incidence rate of 8.26%.Multifactorial logistic regression analysis showed that male(OR(95%CI):1.396(1.260-1.546)),primary treatment(OR(95%CI):1.605(1.413-1.824)),and age 15-34 years(OR(95%CI):1.318(1.033-1.682))or 35-54 years(OR(95%CI):3.054(2.717-3.432))were independent risk factors for the development of active TB in the close contacts.Close contacts with a history of previous TB disease(OR(95%CI):22.447(18.570-27.134)),age≤14 years(OR(95%CI):2.792(2.224-3.507))and≥55 years(OR(95%CI):2.089(1.777-2.457)),and social relationships with t

关 键 词：结核 肺 接触者追踪 因素分析 统计学 

分 类 号：R52[医药卫生—内科学] R45[医药卫生—临床医学]