上海市静安区肺结核患者家庭内儿童青少年密接结核感染筛查情况及医务人员态度调查  

Screening of Latent Infection in Close Contacts of Children and Adolescents in Families of Pulmonary Tuberculosis Patients in Jing’an District and Study on Attitudes of Medical Staff

作　　者：姚晶 李智红 张怀庆[1] 韩志英[1] 顾凯侃[1] Yao Jing;Li Zhihong;Zhang Huaiqing;Han Zhiying;Gu Kaikan(Jingan Center for Disease Control and Prevention,Shanghai,200072,China)

机构地区：[1]上海市静安区疾病预防控制中心,上海200072

出　　处：《中国初级卫生保健》2024年第7期63-66,共4页Chinese Primary Health Care

基　　金：上海市疾病预防控制青年骨干人才培养项目(22QNGG25);上海市静安区卫生健康委员会公共卫生项目(2023GW03)。

摘　　要：目的:了解上海市静安区肺结核患者家庭内密切接触结核病患者(以下简称密接)的儿童青少年潜伏感染筛查开展情况,为相关部门完善儿童青少年密接筛查工作提供参考依据。方法:2019年7月1日—2023年6月30日,选取上海市静安区管理的肺结核患者家庭内的儿童青少年密接78例,动员其进行结核潜伏感染筛查;对15名基层结核病防治医务人员进行问卷调查及访谈,了解其对结核潜伏感染的知晓情况及对潜伏感染检测、预防性服药的认识和态度等;对4名结核病领域专家进行访谈,了解其对于潜伏感染筛查及预防性服药具体问题的看法。结果:78例儿童青少年中,进行潜伏感染筛查者为26例,筛查率为33.33%;潜伏感染阳性者为4例,总潜伏感染率为15.38%;基层医生对潜伏感染结核发病概率、预防性治疗基本药物、疗程时间及判定是否应服药的影响因素等知晓率相对较低;有3位专家认为开展家庭内儿童青少年密接筛查及预防性服药有意义,应以阳性患者的儿童青少年密接为筛查和服药的重点人群。结论:上海市静安区肺结核患者家庭内儿童青少年密接潜伏感染筛查及预防性服药有意义,但是目前还存在筛查推广困难,需要政策及经费支持,应通过完善筛查流程、开展医务人员培训和加大社会宣传及推广力度等方式,争取早期干预潜伏感染者,最终减少结核病的发生。OBJECTIVE To understand the screening situation of latent infection among close contacts of children/adolescents in families of pulmonary tuberculosis patients(hereinafter referred to as close contacts)in Jing’an District,so as to to provide a reference for improving the close contact screening of children and adolescents.METHODS From July 1st,2019 to June 30th,2023,78 children and adolescents in the families of tuberculosis patients managed by Jing’an District of Shanghai were selected and closely connected to mobilize them to carry out detection of latent tuberculosis infection.Questionnaire survey and interview were conducted among 15 primary tuberculosis medical workers to understand their knowledge of latent tuberculosis infection,their attitude towards latent infection detection and preventive medication.Four TB experts were interviewed for their views on specific issues of screening for latent infection and prophylactic medication.RESULTS Among 78 children and adolescents,26(33.33%)were screened for latent infection.4 cases were positive for latent infection,and the total latent infection rate was 15.38%.The awareness rate of primary doctors about the incidence rate of latent tuberculosis infection,the essential drugs of preventive treatment,the duration of treatment course and the influencing factors of deciding whether to take drugs was relatively low.Three experts believe that it is meaningful to carry out close screening and preventive medication for children and adolescents in the family,and should focus on the close screening and medication for children and adolescents in positive patients.CONCLUSION In Jing’an district of Shanghai,it is meaningful to screen children and adolescents with close latent infection in the families of tuberculosis patients and take preventive medication.However,there are still difficulties in screening and promotion,and policy and financial support are needed.Through improving the screening process,training medical personnel and increasing social publicity and promot

关 键 词：结核潜伏感染 预防性服药 密切接触者 儿童青少年 医务人员 态度 

分 类 号：R521[医药卫生—内科学]