2018-2022年四川省病原学阳性肺结核患者密切接触者筛查情况分析  

Analysis of screening of close contacts of pathogenic positive pulmonary tuberculosis patients in Sichuan Province from 2018 to 2022

作　　者：夏岚[1] 刘双 李婷[1] 逯嘉[1] 王丹霞[1] 张灵麟[1] Xia Lan;Liu Shuang;Li Ting;Lu Jia;Wang Danxia;Zhang Linglin(Institution of Tuberculosis Prevention and Control,Sichuan Provincial Center for Disease Control and Prevention,Chengdu 610041,China)

机构地区：[1]四川省疾病预防控制中心结核病预防控制所,成都610041

出　　处：《中国防痨杂志》2024年第2期178-182,共5页Chinese Journal of Antituberculosis

摘　　要：目的:分析2018-2022年四川省病原学阳性肺结核患者密切接触者的结核病筛查情况,为密切接触者的筛查和管理工作开展提供理论依据。方法:选取“结核病管理信息系统”中登记日期在2018年1月1日至2022年12月30日期间的病原学阳性肺结核患者及其密切接触者(与病原学阳性肺结核患者在确诊3个月至开始抗结核治疗后14 d内直接接触的人员)作为调查对象,其中,2018年1月1日至2022年12月30日登记的病原学阳性肺结核患者的密切接触者均为筛查对象;2022年登记的病原学阳性肺结核患者的密切接触者为随访对象。分析不同时间、不同类型密切接触者结核病筛查及活动性肺结核检出情况。结果:2018-2022年四川省共报告病原学阳性肺结核患者99 273例,登记其密切接触者260 661名,其中260 291名密切接触者进行了结核病可疑症状筛查,症状筛查率为99.86%,共检出活动性肺结核患者2623例,平均检出率为1.01%。有结核病可疑症状的密切接触者的结核病检查率(98.50%,6425/6523)和检出率(4.54%,292/6425)均明显高于无结核病可疑症状密切接触者的结核病检查率(86.40%,219 247/253 768)和检出率(1.06%,2331/219 247),差异均有统计学意义(χ^(2)值分别为807.587和658.621,P值均<0.001)。家庭外密切接触者结核病检查率(96.53%,82 173/85 129)明显高于家庭内密切接触者(81.92%,143 499/175 162),差异有统计学意义(χ^(2)=10 595.710,P<0.001);家庭内密切接触者活动性肺结核检出率(1.58%,2264/143 499)明显高于家庭外密切接触者(0.44%,359/82 173),差异有统计学意义(χ^(2)=591.968,P<0.001)。对2022年新登记的42 078名病原学阳性肺结核患者密切接触者在患者诊断时开展症状筛查,39 056名(92.82%)开展了结核病检查,检出719例(1.84%)活动性肺结核患者;35.39%(9705/27 423)完成第2次随访(首次筛查6个月后),55.31%(5368/9705)接受结核病检查,检出2例(0.04%)活动性肺结核患者;�Objective:To analyze the tuberculosis screening of close contacts of pathogenic positive pulmonary tuberculosis patients in Sichuan Province from 2018 to 2022,and to provide a theoretical basis for the screening and management of close contacts.Methods:The pathogenic positive pulmonary tuberculosis patients and the close contacts(those who have direct contact with the pathogenic positive pulmonary tuberculosis patients from within 3 months after the diagnosis to 14 days after the start of anti-tuberculosis treatment)registered in the“Tuberculosis Information Management System”between January 1,2018 and December 30,2022 were selected as the survey objects.Of them,the close contacts were all screened,and the close contacts registered in 2022 were the follow-up subjects.The screening of tuberculosis and the detection of active tuberculosis in close contacts at different times and of different types were analyzed.Results:From 2018 to 2022,a total of 99273 pathogenic positive pulmonary tuberculosis patients were reported in Sichuan Province,and 260661 close contacts were registered,of which 260291(99.86%)were screened for suspected symptoms of tuberculosis,and 2623 active pulmonary tuberculosis patients were detected,with an average detection rate of 1.01%.The tuberculosis inspection rate(98.50%,6425/6523)and detection rate(4.54%,292/6425)of close contacts with suspected tuberculosis symptoms were significantly higher than those of close contacts without suspected tuberculosis symptoms(86.40%,219247/253768)and detection rate(1.06%,2331/219247),with a statistically significant difference(χ^(2) values were 807.587 and 658.621,respectively,both P<0.001).The examination rate of tuberculosis in close contacts outside the family(96.53%,82173/85129)was significantly higher than that in close contacts inside the family(81.92%,143499/175162),with a statistically significant difference(χ^(2)=10595.710,P<0.001).The detection rate of active pulmonary tuberculosis in close contacts within the family(1.58%,2264/143499)was sig

关 键 词：结核 肺 接触者追踪 人群监测 传染病控制 

分 类 号：R521[医药卫生—内科学] R183[医药卫生—临床医学] R824