2022年南京市高中新生结核潜伏感染状况及影响因素分析  

Analysis of latent tuberculosis infection status and influencing factors among high school freshmen in Nanjing in 2022

作　　者：王雪晴 王荣 苗瑞芬[2] 方良梅 徐斐[1,2] WANG Xueqing;WANG Rong;MIAO Ruifen;FANG Liangmei;XU Fei(School of Public Health,Nanjing Medical University,Nanjing,Jiangsu 211166,China;Department of Chronic Infectious Diseases,Nanjing Municipal Center for Disease Control and Prevention Afiliated to Nanjing Medical University,Nanjing,Jiangsu 210003,China)

机构地区：[1]南京医科大学公共卫生学院,江苏南京211166 [2]南京医科大学附属南京市疾病预防控制中心慢传科,江苏南京210003

出　　处：《职业与健康》2024年第21期2982-2987,共6页Occupation and Health

基　　金：南京市卫生科技发展专项资金资助项目(ZKX22059)。

摘　　要：目的了解南京市2022年高中入学新生结核潜伏感染现状,分析结核潜伏感染的影响因素,为学校结核病防控提供理论依据。方法采用分层随机整群抽样方法,从南京市主城区和非主城区共选取3所高中共计1800名高中新生,于2022年8—9月对上述人群开展调查。采用结核菌素纯蛋白衍生物(purified protein derivative of tuberculin,PPD)进行结核潜伏感染的筛查,并通过《学校结核菌素皮肤试验检查记录表》收集新生筛查结果,采用《学生健康调查问卷》收集新生一般人口学信息、临床信息、其他可能与结核潜伏感染有关的影响因素以及结核病核心知识知晓情况。采用χ2检验和logistic回归模型分析高中新生结核潜伏感染的影响因素。结果纳入研究分析1644人,其结核潜伏感染率为13.63%。多因素logistic回归模型分析显示,非主城区(OR=1.681,95%CI:1.236~2.285,P<0.01)、近3个月内出现咳嗽症状(OR=1.705,95%CI:1.044~2.785,P<0.05)和喜欢吃动物内脏(OR=1.678,95%CI:1.029~2.737,P<0.05)是结核潜伏感染发生的危险因素。户外平均运动时间1~2 h/d(OR=0.689,95%CI:0.506~0.940,P<0.05)是结核潜伏感染发生的保护因素。结论南京市高中新生结核潜伏感染率处于较高水平,需重点关注非主城区的学生。做好健康宣教,落实好新生入学结核病筛查,做好晨、午检和症状监测,有利于及早发现结核潜伏感染人群和进一步发展为结核病患者。饮食方面要避免摄于过量的动物内脏,并保持适当的户外运动,增强体质,可能是预防高中新生结核潜伏感染的有效途径。Objective To understand the status of latent tuberculosis infection(LTBI)among high school freshmen in Nanjing in2022,and analyze the influencing factors of LTBI,in order to provide theoretical basis for tuberculosis prevention and control in schools.Methods A stratified random cluster sampling method was used to select 1800 high school freshmen from three high schools in the main urban area and non-main urban area of Nanjing from August to September 2022.The purified protein derivative of tuberculin(PPD)was used to screen for LTBI,and the screening results were collected through the"School Tuberculin Skin Test Record Form".The student health survey questionnaire was used to collect general demographic information,clinical information,other potential factors related to LTBI,and awareness of core knowledge about tuberculosis.Chi-square test and logistic regression model were used to analyze the influencing factors of LTBI among high school freshmen.Results A total of1644 participants were included in the study,and the LTBI rate was 13.63%.Multivariate logistic regression model analysis showed that non-main urban area(OR=1.681,95%CI:1.236-2.285,P<0.01),cough symptoms in the past 3 months(OR=1.705,95%CI:1.044-2.785,P<0.05),and liking to eat animal organs(OR=1.678,95%CI:1.029-2.737,P<0.05)were risk factors for LTBI,while outdoor exercise time of 1-2 hours per day(OR=0.689,95%CI:0.506-0.940,P<0.05)was a protective factor for LTBI.Conclusion The LTBI rate among high school freshmen in Nanjing is at a relatively high level,and attention should be paid to students in non-main urban areas.Health education should be conducted and tuberculosis screening for freshmen should be implemented.Morning and afternoon check-ups and symptom monitoring should be done to detect LTBI and prevent progression to active tuberculosis.Excessive consumption of animal organs should be avoided,and appropriate outdoor exercise should be maintained to enhance physical fitness,which may be an effective way to prevent LTBI among high school freshme

关 键 词：结核潜伏感染 结核重点人群 高中新生 结核筛查 

分 类 号：R183.3[医药卫生—流行病学]