关键词: 结核,肺, 学生, 接触者追踪, 结核菌素试验, 结果评价(卫生保健), 小地区分析

Abstract:

Objective To investigate the screening results of close contacts of tuberculosis patients in schools in Ji’nan in 2018, and to analyze the epidemic situation and treatment of tuberculosis in schools. Methods The database of tuberculosis incidence and treatment results in schools in Ji’nan City in 2018 was established, including patients who had been reported in the “Infectious Disease Report Information Management System” at the city and county levels in Ji’nan, patients notified by the school and school patients feedback from outside units. In 2018, a total of 197 students or teachers with tuberculosis were found in the city, and 10 patients with internship, graduation or recent screening were excluded. Then, a case-by-case epidemiological investigation was conducted on 187 patients with tuberculosis, and a total of 11617 close contacts were identified. Among them, 2138 were identified as close contacts of 24 patients with positive pathogenic pulmonary tuberculosis, and 2104 were actually screened; 9479 were identified as close contacts of 163 patients with tuberculosis negative and non-pathogenic results, and 9384 were actually screened. The close contacts were screened for tuberculin skin test (PPD test) using the BCG pure protein derivative reagents uniformly distributed throughout the city. Results In 2018, the tuberculosis patients in Ji’nan schools were mainly college students, accounting for 81.28% (152/187). Among 11488 close contacts of PPD test results, 8988 were negative (77.45%), 1434 (12.48%) were generally positive, 651 (5.67%) were moderately positive, and 505 (4.40%) were strongly positive. The strong positive rate of PPD test in close contacts of 24 pathogenic positive patients (7.41%, 156/2104) was significantly higher than that in 163 non-pathogenic positive patients (3.72%, 349/9384) (χ²=55.84, P<0.001). Thirty-one patients with tuberculosis were found by screening. Conclusion Some tuberculosis patients can be found through screening of close contacts of tuberculosis patients in schools; and implementation of tuberculosis screening for close contacts of tuberculosis patients can reduce the spread of tuberculosis in schools.

Key words: Tuberculosis, pulmonary, Students, Contact tracing, Tuberculin test, Outcome assessment (health care), Small-area analysis