摘要
目的分析学校结核病聚集性疫情中潜伏感染和预防性治疗情况,为学校结核病防控工作提供理论和技术支持。方法选择2023年1—12月湖南省省级现场处置的5起学校结核病聚集性疫情,收集相关的潜伏感染、预防性治疗和结核病发病情况等资料。采用χ^(2)检验和Fisher确切概率法进行统计分析。结果密切接触者肺结核罹患率(7.69%)、结核分枝杆菌潜伏感染率(31.87%)均高于非密切接触者(0.12%,6.29%),差异均有统计学意义(P值均<0.01)。潜伏感染的密切接触者后续发病率(8.62%)高于非密切接触者(0),应预防性治疗的密切接触者接受预防性治疗率(63.30%)高于非密切接触者(47.37%),接受预防性治疗的密切接触者接受化学预防性治疗方案比例(68.12%)高于非密切接触者(45.56%),差异均有统计学意义(P值均<0.05)。大学生结核分枝杆菌潜伏感染率(13.58%)高于中学生(7.08%)(χ^(2)=37.77,P<0.01)。接受预防性治疗的大学生接受化学预防性治疗方案比例(100.00%)高于中学生(40.34%),潜伏感染的大学生后续发病率(6.67%)高于中学生(0.54%);应预防性治疗的中学生接受预防性治疗率(70.41%)高于大学生(30.77%),接受预防性治疗的中学生完成预防性治疗率(100.00%)高于大学生(62.50%),差异均有统计学意义(P值均<0.01)。潜伏感染者中144名完成预防性治疗者均未发病;177名未完成预防性治疗者有10例发病,发病率为5.65%,密切接触者发病率(19.23%)高于非密切接触者(0)(P<0.01)。未完成预防性治疗的潜伏感染者后续肺结核发病率在大学(8.18%)和中学(1.49%)间差异无统计学意义(P=0.09)。结论对潜伏感染者尤其是密切接触者积极推广预防性治疗,尽可能做到应治尽治,可降低学校结核病发病率,有利于控制学校结核病疫情规模。
Objective To analyze the latent tuberculosis infection and preventive treatment in the school tuberculosis epidemic,so as to provide theoretical and technical support for tuberculosis prevention and control in schools.Methods Information on latent infection,preventive treatment and tuberculosis incidence were collected from five tuberculosis outbreaks in schools in Hunan Province from January to December 2023.Statistical analysis was conducted by using Chi-square test and Fisher's exact test.Results The prevalence of tuberculosis patients in close contacts(7.69%)and the latent infection rate of Mycobacterium tuberculosis(31.87%)were higher than those in non-close contacts(0.12%,6.29%),and the differences were statistically significant(P<0.01).The subsequent incidence of close contacts with latent infection was higher(8.62%)than that of non-close contacts(0),the rate of close contacts receiving prophylactic treatment(63.30%)was higher than that of non-close contacts(47.37%),and the proportion of close contacts receiving prophylactic treatment(68.12%)was higher than that of non-close contacts(45.56%),and the differences were statistically significant(P<0.05).The latent infection rate of Mycobacterium tuberculosis in college students(13.58%)was higher than that in middle school students(7.08%)(χ^(2)=37.77,P<0.01).The proportion of college students receiving preventive treatment(100.00%)was higher than that of middle school students(40.34%),and the subsequent incidence of latent infection(6.67%)was higher than that of middle school students(0.54%);the rate of middle school students who should receive preventive treatment(70.41%)was higher than that of college students(30.77%),and the rate of middle school students who received preventive treatment(100.00%)was higher than that of college students(62.50%),and the differences were statistically significant(P<0.01).Among the latent infected persons,144 who completed preventive treatment did not get sick,and 10 of the 177 who did not complete preventive treatment got sick,with an incidence rate of 5.65%.The incidence rate of close contacts(19.23%)was higher than that of non-close contacts(0)(P<0.01).There was no significant difference in the incidence of pulmonary tuberculosis between university(8.18%)and middle school(1.49%)among latent infected persons who did not complete preventive treatment(P=0.09).Conclusion Actively promoting preventive treatment for latent infections,especially among close contacts,and ensuring that all eligible individuals receive treatment can reduce tuberculosis incidence in schools and help control the scale of school tuberculosis outbreaks.
作者
张传芳
梁军
徐祖辉
范江静
ZHANG Chuanfang;LIANG Jun;XU Zuhui;FAN Jiangjing(TB Control Department,Hunan Institute for Tuberculosis Control,Changsha(410013),Hunan Province,China)
出处
《中国学校卫生》
北大核心
2025年第4期584-587,共4页
Chinese Journal of School Health
