2017—2020年广州市主动发现学生肺结核情况分析

doi:10.19983/j.issn.2096-8493.20220055

摘要/Abstract

摘要：

目的:分析2017—2020年广州市主动发现学生肺结核状况,为学校结核病防控提供建议。方法:从《中国疾病预防控制信息系统》子系统《结核病管理信息系统》中,收集2017—2020年学生肺结核患者总例数,以及患者性别、年龄、学校分布、疾病分类、发病时间、发现方式等资料。采用描述性流行病学方法对来源为健康体检和密切接触者筛查两种主动发现方式的学生肺结核检出率、分布特征和发现延迟情况进行统计分析。结果:广州市2017—2020年通过健康体检和密切接触者筛查主动发现肺结核患者分别为316例和175例,其检出率分别为29.92/10万(316/1055991)和135.40/10万(175/129242),均高于同期总体学生肺结核检出率[16.76/10万(2054/12258359)],差异均有统计学意义(χ²=94.731,P<0.001;χ²=1000.774,P<0.001)。健康体检发现病例学校类型分布为小学及以下5例(1.58%,5/316)、初中44例(13.92%,44/316)、高中157例(49.68%,157/316)和大学及以上110例(34.81%,110/316),密切接触者筛查分布为小学及以下6例(3.43%,6/175)、初中10例(5.71%,10/175)、高中61例(34.86%,61/175)和大学及以上98例(56.00%,98/175)。健康体检和密切接触者筛查发现病例的发现延误时间中位数(四分位数)分别为24.00(10.00,55.75)d和18.00(6.00,40.00)d;发现延误率分别为31.01%(98/316)和25.71%(45/175),均低于总体学生肺结核发现延误率[40.56%(833/2054)],差异均有统计学意义(χ²=11.424,P<0.01;χ²=15.708,P<0.01)。结论:采用健康体检和密切接触者筛查的学生肺结核主动发现方式检出率高、发现时间短,应积极推进和完善相关措施。

关键词: 结核,肺, 学生, 横断面研究

Abstract:

Objective: To analyze the the status of active detection of pulmonary tuberculosis among students in Guangzhou from 2017 to 2020, and provide suggestions for pulmonary tuberculosis prevention and control in schools. Methods: The total number of pulmonary tuberculosis patients in schools were collected from 2017 to 2020, as well as the gender, age, school distribution, disease classification, time of onset, detection methods and other data of the patients were collected from “Tuberculosis Information Management System”, the sub-systems of “China Disease Control and Prevention Information Management System”. Descriptive analysis was used to analyze the detection rate, distribution characteristics and delay of pulmonary tuberculosis in students from two active detection methods, physical examination and close contact screening. Results: From 2017 to 2020, 316 and 175 cases of pulmonary tuberculosis were found through physical examination and close contact screening in Guangzhou, the detection rates were 29.92/100000 (316/1055991) and 135.40/100000 (175/129242) respectively, which were significantly higher than the overall detection rate among student in the same period (16.76/100000 (2054/12258359))(χ²=94.731, P<0.001; and χ²=1000.774, P<0.001, respectively). The school type distribution of cases were 5 (1.58%, 5/316) at primary school or below, 44 (13.92%, 44/316) at junior middle schools, 157 (49.68%, 157/316) at senior middle schools and 110 (34.81%, 110/316) at college or above found in health examination, and were 6 (3.43%, 6/175), 10 (5.71%, 10/175), 61 (34.86%, 61/175) and 98 (56.00%, 98/175) found by close contact screening. The median delay time of cases found in physical examination and close contact screening were 24.00 (10.00, 55.75) d and 18.00 (6.00, 40.00) d, respectively. The delay rates were 31.01% (98/316) and 25.71% (45/175), respectively, both were significantly lower than the overall delay rate (40.56% (833/2054);χ²=11.424, P<0.01; χ²=15.708, P<0.01). Conclusion: The high detection rate and short detection time of tuberculosis were found in the active detection method of physical examination and close contact screening. The implementation of relevant measures should be actively promoted and improved.

Key words: Tuberculosis,pulmonary, Students, Cross-sectional studies

中图分类号:

R521
G455

雷宇, 吴桂锋, 王挺, 林莹, 杜雨华. 2017—2020年广州市主动发现学生肺结核情况分析[J]. 结核与肺部疾病杂志, 2022, 3(3): 231-235. doi: 10.19983/j.issn.2096-8493.20220055

LEI Yu, WU Gui-feng, WANG Ting, LIN Ying, DU Yu-hua. Analysis of active detection of pulmonary tuberculosis among students in Guangzhou from 2017 to 2020[J]. Journal of Tuberculosis and Lung Disease, 2022, 3(3): 231-235. doi: 10.19983/j.issn.2096-8493.20220055

图/表 1

参考文献 19

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病例特征	总登记患者 [例,构成比(%)]	健康体检 [例,构成比(%)]	密切接触者筛查 [例,构成比(%)]	χ²值	P值
年份				13.676	0.013
2017	474(23.08)	44(13.92)	50(28.57)
2018	635(30.92)	88(27.85)	50(28.57)
2019	538(26.19)	91(28.80)	35(20.00)
2020	407(19.81)	93(29.43)	40(22.86)
性别				0.022	0.881
男性	1187(57.79)	182(57.59)	102(58.29)
女性	867(42.21)	134(42.41)	73(41.71)
学校类型				24.443	<0.001
小学及以下	51(2.48)	5(1.58)	6(3.43)
初中	165(8.03)	44(13.92)	10(5.71)
高中	697(33.93)	157(49.68)	61(34.86)
大学及以上	1141(55.55)	110(34.81)	98(56.00)
病原学检查				7.062	0.008
阳性	741(36.08)	101(31.96)	77(44.00)
阴性	1313(63.92)	215(68.04)	98(56.00)
症状(咳嗽、咳痰)				111.110	<0.001
有	1142(55.60)	88(27.85)	55(31.43)
无	912(44.40)	228(72.15)	120(68.57)
合计	2054(100.00)	316(15.38)	175(8.52)