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目的分析学校结核病疫情中接触者患病情况,为进一步做好学校结核病防控工作提供理论依据。方法回顾性分析北京市西城区2014—2016年发生的5起学校结核病疫情的接触者筛查资料。结果 5起疫情共划定接触者1 142人,PPD强阳性反应295人,发现续发病例37例,PPD强阳性率为25.8%,患病率为3.2%。其中Ⅰ级接触者417人,PPD强阳性反应138人,发现续发病例25例,PPD强阳性率为33.1%,患病率为6.0%;Ⅱ级接触者725人,PPD强阳性反应157人,发现续发病例12例,PPD强阳性率为21.7%,患病率为1.7%。Ⅰ级接触者的PPD强阳性率和总患病率均高于Ⅱ级接触者(χ~2值分别为17.866,15.839,P值均<0.05)。结论学校聚集性疫情的接触者感染结核菌和患结核病的风险较高。在学校聚集性疫情的处置过程中要加强Ⅰ级接触者的流行病学调查和筛查,对Ⅱ级接触者的结核病筛查也不容忽视。
Objective To analyze the prevalence of contacts among school tuberculosis cases and provide a theoretical basis for further prevention and control of tuberculosis in schools. Methods A retrospective analysis was conducted on contact screening data of five school tuberculosis outbreaks in Xicheng District of Beijing from 2014 to 2016. Results A total of 1 142 contactors were identified in the five outbreaks and 295 were positive for PPD. A total of 37 cases were found to have recurrence. The positive rate of PPD was 25.8% and the prevalence was 3.2%. There were 417 grade Ⅰ contacts with strong positive PPD 138 and 25 cases with recurrence. The positive rate of PPD was 33.1% and the prevalence was 6.0%. There were 725 Ⅱ level contacts and 157 positive PPD positive reactions , Found that 12 cases of recurrence, PPD strong positive rate was 21.7%, the prevalence of 1.7%. The positive rates of PPD and the overall prevalence of grade Ⅰ contacts were higher than those of grade Ⅱ contacts (χ ~ 2 values were 17.866 and 15.839, respectively, P <0.05). CONCLUSIONS The contacts with school-based outbreaks have a higher risk of contracting TB and tuberculosis. Epidemiological investigation and screening of Grade I contacts should be stepped up in the process of gathering school-based epidemic disease, and screening of tuberculosis patients of Grade II contact should not be overlooked.