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目的了解淮安市高校学生肺结核密切接触者筛查情况,为高校结核病防控工作提供依据。方法对2013—2015年淮安市高校学生肺结核密切接触者进行肺结核可疑症状调查、结核菌素(PPD)试验、X线胸片和结核分枝杆菌检查。结果 2013—2015年淮安市登记高校学生肺结核密切接触者682例,密切接触者肺结核可疑症状筛查率为100%,PPD筛查率为97.21%(663/682),X线胸片筛查率为70.23%(479/682);涂阳肺结核密切接触者PPD强阳性率及X线胸片异常率(30.1%,3.5%)均高于涂阴肺结核密切接触者(16.6%,0.6%)(χ~2值分别为14.570,4.087,P值均<0.05);筛查发现的6例涂阴肺结核患者均由定点医院收治,但其他符合预防性服药条件的密切接触者无人接受预防性治疗。结论学校出现结核病疫情时,应及时规范开展密切接触者筛查工作,减少疫情的播散,同时应有效落实预防性服药,减少感染者发病风险。
Objective To understand the screening of close contacts of pulmonary tuberculosis among college students in Huaian city and provide basis for the prevention and control of tuberculosis in colleges and universities. Methods Suspected symptoms of tuberculosis, tuberculin (PPD) test, X-ray and Mycobacterium tuberculosis were examined in close contacts of college students with pulmonary tuberculosis from 2013 to 2015 in Huaian city. Results 682 cases of close contacts of pulmonary tuberculosis among registered university students in Huaian from 2013 to 2015 were screened. The screening rate of suspicious symptoms in close contacts was 100%, and the PPD screening rate was 97.21% (663/682). The X-ray screening rate (70.23%, 479/682). The positive rate of PPD and the abnormal rate of X-ray (30.1%, 3.5%) in close contact with smear positive pulmonary tuberculosis were higher than those in close contact with smeared pulmonary tuberculosis (16.6% and 0.6% χ ~ 2 values were 14.570 and 4.087, P <0.05 respectively). Six cases of smear-negative pulmonary tuberculosis detected by screening were admitted to designated hospitals. However, other close contacts who met the criteria of prophylactic medication did not receive prophylactic treatment . Conclusions When tuberculosis epidemic occurs in schools, it is necessary to regulate the screening of close contacts in a timely manner so as to reduce the spread of the epidemic and effectively implement preventive medication to reduce the risk of infection.