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目的了解学生肺结核患者疫情传播及播散的促发因素,为提出相应的防治对策提供依据。方法对首发病例及疫情前期处理进行回顾调查,并通过现场流行病学调查进一步探讨疫情扩大的影响因素。结果共发现肺结核44例,2014年发病28例,其中与2013年首发病例同班的占57.14%,同宿舍的占28.57%;44例肺结核病例中,共有25例来自同一班级,该班级的学生患肺结核风险是来自其他班级学生的60.31倍(χ2=638.00,P<0.05);首发病例延误诊断、密切接触者缺乏后续监测和随访、年级分班及学生居住环境恶劣是疫情扩散的影响因素。结论及早发现和控制传染源,合理确定开展结核菌素试验的时间和次数,加强针对密切接触者的后续监测,改善学生居住环境,是预防学校结核病疫情聚集性发生的重要措施。
Objective To understand the factors contributing to the spread and spread of the epidemic in students with pulmonary tuberculosis and provide the basis for the corresponding prevention and treatment measures. Methods The first case and pre-outbreak treatment were retrospectively investigated and the influencing factors of epidemic situation were further explored through field epidemiological investigation. Results A total of 44 cases of pulmonary tuberculosis were found in 2014, with 28 cases in 2014, of which 57.14% were in same class as the first case in 2013 and 28.57% in same quarters. Of the 44 cases of tuberculosis, 25 cases were from the same class, The risk of tuberculosis was 60.31 times higher than that of other classes (χ2 = 638.00, P <0.05). Delayed diagnosis of first case, lack of follow-up monitoring and follow-up of close contacts, grade placement and poor living conditions of students were the influencing factors of epidemic spread. Conclusion The early detection and control of sources of infection, the reasonable determination of the time and frequency of tuberculin testing, the follow-up monitoring of close contacts and the improvement of student living environment are important measures to prevent the occurrence of tuberculosis epidemic in school.