肺结核密切接触学生结核分枝杆菌潜伏感染的影响因素分析  

Influencing factors for latent tuberculosis infection among student close contacts of pulmonary tuberculosis

作　　者：吕阳[1] 乐博昕 胡伟宏[1] 刘园 陈昶[1] 刘效峰[2] LÜYang;LE Boxin;HU Weihong;LIU Yuan;CHEN Chang;LIU Xiaofeng(Department of Chronic Infectious Disease Control and Prevention,Baoshan District Center for Disease Control and Prevention,Shanghai 201901,China;Baoshan District Center for Disease Control and Prevention,Shanghai 201901,China)

机构地区：[1]上海市宝山区疾病预防控制中心慢性传染病防制科,上海201901 [2]上海市宝山区疾病预防控制中心,上海201901

出　　处：《预防医学》2024年第8期658-662,共5页China Preventive Medicine Journal

基　　金：上海市加强公共卫生体系建设三年行动计划(2023—2025年)学科人才建设项目(GWVI-11.1-06);上海市宝山区医学重点专科A类项目(BSZK-2023-A20);上海市宝山区科学技术委员会科技创新专项资金项目(20-E-57)。

摘　　要：目的了解上海市宝山区肺结核密切接触学生结核分枝杆菌潜伏感染(LTBI)情况及影响因素,为学生肺结核防制提供依据。方法选择2021年4月—2023年11月通过中国疾病预防控制信息系统监测报告管理系统、学校报告、疾病预防控制中心通知职业为学生或教职员工的肺结核病例为指示病例,其同校的肺结核密切接触学生为研究对象,收集社会人口学信息、生活方式和结核分枝杆菌检测结果等资料;以结核分枝杆菌检测阳性且排除活动性肺结核为LTBI判定标准。采用多因素logistic回归模型分析肺结核密切接触学生LTBI的影响因素。结果调查肺结核密切接触学生1212人,其中男生651人,女生561人,男女比1.16∶1。年龄为(18.48±4.33)岁。检出LTBI 32例,检出率为2.64%。与肺结核病例同宿舍、民办学校、住校和三餐获取途径为外卖的肺结核密切接触学生LTBI检出率较高,分别为9.26%、5.54%、3.54%和6.52%。多因素logistic回归分析结果显示,与肺结核病例同宿舍(OR=3.604,95%CI:1.256~10.338)、学校性质为民办(OR=2.327,95%CI:1.083~5.003)、三餐获取途径为食堂(OR=9.561,95%CI:2.029~45.057)和外卖(OR=19.222,95%CI:3.528~104.732)的肺结核密切接触学生LTBI风险较高。结论宝山区肺结核密切接触学生存在LTBI感染风险,主要受到与肺结核病例关系、学校疫情防控力度和饮食习惯的影响。Objective To investigate the prevalence and influencing factors of latent tuberculosis infection(LTBI)among students close contacts diagnosed with pulmonary tuberculosis in Baoshan District,Shanghai,so as to provide the basis for the prevention and control of pulmonary tuberculosis among students.Methods Pulmonary tuberculosis cases identified among students or teaching staff were selected as index cases through the Surveillance System of Chinese Disease Prevention and Control Information System,school reports,notification of Centers for Disease Control and Prevention from April 2021 to November 2023,and student close contacts in their schools were selected as research subjects.Demographic information,lifestyle and Mycobacterium tuberculosis test results were collected through questionnaires surveys and pulmonary tuberculosis screening.LTBI was defined as a positive Mycobacterium tuberculosis test result with the exclusion of active pulmonary tuberculosis.The influencing factors for LTBI among student close contacts were identified using a multivariable logistic regression model.Results A total of 1212 student close contacts were included,with 651 males and 561 females,resulting in a gender ratio of 1.16︰1.The mean age was(18.48±4.33)years.Among them,32 cases were detected with LTBI,yielding a detection rate of 2.64%.Higher LTBI detection rates were observed among students who shared the same dormitory with pulmonary tuberculosis cases(9.26%),attended private schools(5.54%),lived on campus(3.54%),and obtained meals through take-out services(6.52%).Multivariable logistic regression analysis showed that sharing the same dormitory with pulmonary tuberculosis cases(OR=3.604,95%CI:1.256-10.338),attending a private school(OR=2.327,95%CI:1.083-5.003),and three meals a day through canteens(OR=9.561,95%CI:2.029-45.057)or through take-out services(OR=19.222,95%CI:3.528-104.732)were associated with a higher risk of LTBI.Conclusion The close contacts of students with pulmonary tuberculosis in Baoshan District are at risk

关 键 词：学生 肺结核 密切接触者 结核分枝杆菌潜伏感染 

分 类 号：R521[医药卫生—内科学]