结核病与肺部健康杂志 ›› 2015, Vol. 4 ›› Issue (1): 13-17.doi: 10.3969/j.issn.2095-3755.2015.01.003

• 论著 • 上一篇    下一篇

大连市高校结核病疫情特征分析

曹淑霞,周颖,杨连军,杨蕴轶,路希维,姜洪波   

  1. 116033 大连市结核病医院
  • 收稿日期:2014-12-16 出版日期:2015-03-14 发布日期:2015-03-14
  • 通信作者: 姜洪波,Email:dlyyjhb@163.com

Analysis of the characteristics of TB epidemic situation in colleges in Dalian

CAO Shu-xia,ZHOU Ying, YANG Lian-jun, YANG Yun-yi, LU Xi-wei,JIANG Hong-bo   

  1. Dalian Tuberculosis Hospital, Dalian 116033, China
  • Received:2014-12-16 Online:2015-03-14 Published:2015-03-14
  • Contact: JIANG Hong-bo,Email:dlyyjhb@163.com

摘要: 目的 对大连市高校结核病疫情特征进行分析,为今后高校结核病防治措施调整提供依据。方法 2010—2014年,大连市开展了高校新生结核病健康体检、密切接触者筛查、结核潜伏感染者预防性治疗等工作。通过观察2010—2014年5年来高校新生结核病患病率及在校学生的结核病发病率趋势变化,对大连市高校结核病流行状况进行评估。采用趋势性卡方检验,评价疫情的趋势性变化,以P<0.05为差异有统计学意义。结果 2010—2014年,大连市高校入学新生结核病患病率依次为:73.4/10万(34/46 290)、53.9/10万(27/50 050)、66.0/10万(35/53 030)、96.3/10万(52/53 986)和75.4/10万(41/54 383),在趋势变化上无统计学意义(χ2</sub><sub>趋势=0.028,P>0.05);PPD强阳性率依次为:5.2%(2428/46 290)、7.8%(3925/50 050)、7.5%(3953/53 030)、6.0%(3243/53 986)和5.8%(3134/54 383),PPD强阳性率在趋势变化上无统计学意义(χ2</sub><sub>趋势=1.301,P>0.05)。2010—2014年高校结核病发病率依次为54.9/10万(154/280 399)、55.1/10万(161/291 974)、43.1/10万(130/301 307)、41.9/10万(132/314 708)和44.7/10万(146/326 326),发病率在趋势变化上无统计学意义(χ2</sub><sub>趋势=2.648,P>0.05)。涂阳肺结核发病率依次为7.1/10万(20/280 399)、9.9/10万(29/291 974)、3.7/10万(11/301 307)、5.4/10万(17/314 708)和5.2/10万(17/326 326),在趋势变化上无统计学意义(χ2</sub><sub>趋势=1.232,P>0.05)。2011—2014年通过密切接触者筛查共发现80例肺结核患者,检出率为228.3/10万(80/35 042),显著高于新生体检[73.3/10万(189/257 739)]的检出率(χ2=77.537,P<0.05)。将结核病发病根据传播关系分为散发和聚集性续发,分别统计各自发病率,2010—2014年散发发病率依次为49.9/10万(140/280 399)、47.3/10万(138/291 974)、41.8/10万(126/301 307)、35.6/10万(112/314 708)和34.6/10万(113/326 326),呈显著的递降趋势(χ2</sub><sub>趋势=3.838,P<0.05);而聚集性续发发病率依次为5.0/10万(14/280 399)、7.9/10万(23/291 974)、1.3/10万(4/301 307)、6.4/10万(20/314 708)和10.1/10万(33/326 326)(χ2</sub><sub>趋势=0.695,P>0.05),呈波动性,且与总体发病率波动趋势基本吻合。结论 大连市学校结核病防控工作取得一些进展;但在聚集性患者防控方面仍面临严峻挑战,需要创新策略。

Abstract: Objective To analyze the characteristics of TB epidemic situation in colleges in Dalian, provide the basis for the future TB control. Methods From 2010 to 2014, Dalian city carried out freshmen TB health check, the screening of TB close contacts and the preventive treatment for LTBI, and so on. The trends of TB pre-valence in freshmen and TB incidence in colleges were observed by trend Chi-square test, and P<0.05 was consi-dered statistically significant. Results The TB prevalence of freshmen in colleges between 2010 and 2014 were 73.4/105 (34/46 290), 53.9/105 (27/50 050), 66.0/105 (35/53 030), 96.3/105 (52/53 986) and 75.4/105 (41/54 383) (χ2</sub><sub>trend=0.028, P>0.05) respectively. The proportion of TST≥15 mm were 5.2% (2428/46 290), 7.8% (3925/50 050), 7.5% (3953/53 030), 6.0% (3243/53 986) and 5.8% (3134/54 383) among freshmen (χ2</sub><sub>trend=1.301, P>0.05). The TB incidence between 2010 and 2014 were 54.9/105 (154/280 399), 55.1/105 (161/291 974), 43.1/105 (130/301 307), 41.9/105 (132/314 708) and 44.7/105 (146/326 326) (χ2</sub><sub>trend=2.648, P>0.05). The smear positive TB incidence were 7.1/105 (20/280 399), 9.9/105 (29/291 974), 3.7/105 (11/301 307), 5.4/105 (17/314 708) and 5.2/105 (17/326 326) respectively (χ2</sub><sub>trend=1.232, P>0.05). In the past 4 years, there were 80 TB cases detected by the screening of close contacts, and the detection rate was 228.3/105 (80/35 042), which was significantly higher than 73.3/105 (189/257 739) among freshmen (χ2=77.537, P<0.05). The incidence of sporadic TB was observed by removing secondary cases in clusters. Their incidence were 49.9/105 (140/280 399), 47.3/105 (138/291 974), 41.8/105 (126/301 307), 35.6/105 (112/314 708) and 34.6/105 (113/326 326). It showed a significant decreasing trend (χ2</sub><sub>trend=3.838, P<0.05). The incidence of secondary clustered cases were 5.0/105 (14/280 399), 7.9/105 (23/291 974), 1.3/105 (4/301 307), 6.4/105 (20/314 708) and 10.1/105 (33/326 326) (χ2</sub><sub>trend=0.695, P>0.05), whose characteristic of changes, from 2010 to 2014, was similar to the TB incidence. Conclusion School TB prevention and control work made some progress in Dalian city, but early finding of clustered cases still faces serious challenges which requires innovative strategies.