结核与肺部疾病杂志 ›› 2021, Vol. 2 ›› Issue (4): 370-372.doi: 10.3969/j.issn.2096-8493.20210099

• 短篇论著 • 上一篇    下一篇

安徽省五河县一起初级中学肺结核聚集性疫情调查分析

倪建军, 蒋强, 葛瑞瑞, 丁雅倩, 陈静()   

  1. 233300 安徽省五河县疾病预防控制中心结核病防控科
  • 收稿日期:2021-08-20 出版日期:2021-12-30 发布日期:2022-01-06
  • 通信作者: 陈静 E-mail:chenjingfk@sina.cn

Investigation report on a cluster epidemic of pulmonary tuberculosis in junior middle school in Wuhe, Anhui

NI Jian-jun, JIANG Qiang, GE Rui-rui, DING Ya-qian, CHEN Jing()   

  1. Tuberculosis Prevention and Control Section, Anhui Wuhe County Center for Disease Control and Prevention, Wuhe 233300, China
  • Received:2021-08-20 Online:2021-12-30 Published:2022-01-06
  • Contact: CHEN Jing E-mail:chenjingfk@sina.cn

摘要:

2020年1月23日,安徽省五河县结核病定点医院上报1例学校活动性肺结核患者(指示病例)。因新型冠状病毒肺炎(简称“新冠”)疫情封控,县疾病预防控制中心于学校复课当日(4月13日),按照结核病流行病学筛查流程以该学生为中心分层次逐歩对443名接触者(同班、任课老师、同楼层及周末短训班同学)开展流行病学调查和结核病筛查[结核菌素纯蛋白衍生物试验(PPD试验)、胸部X线摄片检查]。发现该指示病例延迟就诊34d,无结核病密切接触史。本次筛查师生的PPD试验强阳性率为2.7%(12/443),胸部X线摄片异常率为2.1%(9/436);同班级密切接触者的PPD试验强阳性率[7.7%(5/65)]和胸部X线摄片异常率[12.3%(8/65)]均明显高于同楼层其他班级和周末短训班的一般接触者[分别为1.9%(7/378)和0.3%(1/371)],差异均有统计学意义(χ2=5.134,P=0.023;χ2=33.917,P<0.001)。本次疫情共计发现学生结核病患者7例,分属两个班级,发病率分别为10.3%(6/58)和1.8%(1/56)。认为本次疫情发现较晚,又因新冠疫情未能及时筛查,存在结核病播散情况,且密切接触者感染的风险明显高于一般接触者,应提高学校结核病防控意识,加强其与卫生部门的紧密合作以保障防控措施的落实。

关键词: 结核,肺, 疾病暴发流行, 学校

Abstract:

In January 23, 2020, one active pulmonary tuberculosis from school (indicated case) was reported by the tuberculosis designated hospital of Wuhe, Anhui. Due to COVID-19 epidemic control, on the day of school resumption (April 13th), according to the epidemiological screening process of tuberculosis, epidemiological survey and tuberculosis screening (purified protein derivative of tuberculin test (PPD test) and chest X-ray examination) were hierarchically conducted among 443 contacts (centered on the student: classmates, teachers, students on the same floor and extracurricular classmates) by the Center for Disease Control and Prevention of Wuhe County. It was found that the case was delayed for 34 days, and had no close contact history of tuberculosis. The strongly positive rate of PPD test for teachers and students was 2.7% (12/443), and the abnormal rate of chest X-ray was 2.1% (9/436). The strongly positive rate of PPD test (7.7% (5/65)) and the abnormal rate of chest X-ray of close contacts in the same class (12.3% (8/65)) were significantly higher than that of general contacts in other classes on the same floor and weekend extracurricular classes (1.9% (7/378) and 0.3% (1/371))(χ2=5.134, P=0.023; χ 2=33.917, P<0.001). Seven tuberculosis cases were found in two classes, the incidence rates were 10.3% (6/58) and 1.8% (1/56), respectively. It was considered that the epidemic was found late and the screen wasn’t conducted in time because of COVID-19, furthermore, the tuberculosis was disseminated and the risk of infection among the close contacts was significantly higher than that of the general contacts. The awareness of tuberculosis prevention and control in schools should be enhanced, and closer cooperation with the health department should be strengthened to ensure the implementation of the prevention and control measures.

Key words: Tuberculosis,pulmonary, Disease outbreaks, School