2018—2021年如皋市高中新生结核病筛查情况分析  

Screening of tuberculosis among freshmen in senior high schools in Rugao City from 2018 to 2021

作　　者：郭晓军 刘巧[2] GUO Xiao-Jun;LIU Qiao(Rugao Municipal Center for Disease Control and Prevention,Nantong Jiangsu 226500,China;不详)

机构地区：[1]如皋市疾病预防控制中心,江苏南通226500 [2]江苏省疾病预防控制中心

出　　处：《江苏预防医学》2024年第2期182-184,共3页Jiangsu Journal of Preventive Medicine

基　　金：国家自然科学基金(82003516);江苏省卫健委医学科研项目(M2020020)。

摘　　要：目的分析如皋市高中新生结核病筛查情况和干预效果,为开展学校结核病防控工作提出科学依据。方法收集如皋市2018—2021年高中新生的结核病筛查资料,按照性别、年龄、问诊情况、结核菌素皮肤试验(PPD)或γ干扰素释放试验(IGRA)筛查结果、胸部X线检查结果、临床表现和预防性服药情况等进行描述分析。结果2018—2021年共有35253名高中新生接受结核病筛查,潜伏感染率为3.66%,PDD强阳性率为1.00%,IGRA筛查153名、阳性率29.41%;筛查出PPD强阳性或IGRA阳性397人,总体阳性率1.12%。4年间高中新生潜伏感染率、PDD强阳性率差异均有统计学意义(χ^(2)=11.94、25.76,P值均<0.05)。潜伏感染率和强阳性率均为男生(4.10%,1.33%)高于女生(3.22%,0.66%),市区学校潜伏感染率(0.52%)低于农村学校(3.42%)、市区学校强阳性率(1.13%)高于农村学校(0.86%),以上差异均有统计学意义(χ^(2)值为19.56、39.28、5.81、6.56,P值均<0.05)。共确诊肺结核病8例,占学校总病例数22.86%,占高中阶段总病例数44.44%。4年间高中新生预防性服药率为38.05%、56.76%、60.63%、63.86%,平均为54.83%(215/397),呈上升趋势(χ_(趋势)^(2)=14.81,P<0.05)。结论规范性开展新生入学结核病筛查能尽早发现患者,并采取干预措施,真正将传染源阻挡在校门之外,保障师生身心健康。Objective To investigate the screening of tuberculosis and effect of tuberculosis control interventions among freshmen in senior high schools in Rugao City,so as to provide insights into school-based tuberculosis control.Methods All data pertaining to tuberculosis screening among freshmen in senior high schools in Rugao City from 2018 to 2021 were collected,and subjects′gender,age,healthcare seeking,purified protein derivative(PPD)test and interferon-gamma release assay(IGRA)screening results,chest X-ray scanning results,clinical manifestations and prophylactic drug uses were descriptively analyzed.Results A total of 35253 fresh-men received tuberculosis screening in senior high schools in Rugao City from 2018 to 2021,with a 3.66% prevalence rate of latent tu-berculosis infections,a 1.00% prevalence rate of strongly positive PPD tests,and a 29.41% prevalence rate of positive IGRAs.There were 397 freshmen tested strongly positive for PPD tests or positive for IGRA,with an overall positive rate of 1.12%.There were signifi-cant differences among freshmen in senior high schools during the 4-year study period in terms of the prevalence of latent tuberculosis infections(χ^(2)=11.94,P<0.05)and prevalence of strongly positive PPD tests(χ^(2)=25.76,P<0.05).The prevalence of latent tubercu-losis infections(4.10% vs.3.22%;χ^(2)=19.56,P<0.05)and strongly positive PPD tests(1.33%vs.0.66%;χ^(2)=39.28,P<0.05)was both higher among males than among females.The prevalence of latent tuberculosis infections was lower among freshmen in urban schools than in rural schools(0.52%vs.3.42%;χ^(2)=5.81,P<0.05),and the prevalence of strongly positive PPD tests was higher among freshmen in urban schools than in rural schools(1.13%vs.0.86%;χ^(2)=6.56,P<0.05).A total of 8 patients were definitively diagnosed with pulmonary tuberculosis,which consisted of 22.86%of all tuberculosis cases in schools and 44.44% of all tuberculosis cases in senior high schools.The proportions of prophylactic drug uses were 38.05%,56.76%,60.63% and 63.86% amo

关 键 词：结核病 高中 新生 筛查 潜伏感染 

分 类 号：R521[医药卫生—内科学]