Abstract:

Objective To get comprehensive understanding of the tuberculosis epidemic and screen the close contacts in schools in Songjiang, and to provide scientific evidence for the tuberculosis prevention and control in schools.Methods The pulmonary TB (PTB) epidemic information in local schools was collected from the Tuberculosis Information Management System (TBIMS) and cases reported by Center for Disease Control and Prevention (CDC) of other provinces and schools. The monitoring objects include 9 universities, 2 vocational schools, 28 middle schools, 56 elementary schools and 157 kindergartens. The number of students and teachers were 79011 for universities and 261196 for other schools, respectively. The research screened close contacts by suspicious symptoms, chest X-ray and tuberculin (PPD) skin test.Results In 2018, a total of 69 tuberculosis cases were reported in 16 schools of Songjiang with the ratio of male versus female was 1.09∶1 (36/33). The reported incidence was 69.61/100000 (55/79011) in university and 5.36/100000 (14/261196) in other schools, and the difference was significant (χ ²=123.49, P<0.001). The constituent ratios of reported PTB students in four quarters were 17.39% (12/69), 30.43% (21/69), 27.54% (19/69) and 24.64% (17/69) respectively without statistical difference between each quarter (χ ²=2.59, P>0.05). 38 (55.07%) cases registered in TBIMS, 20 cases (28.99%) were identified by information communication with other provinces and 11 cases (15.94%) were reported by school medical clinics. A total of 2617 close contacts were screened, 2235 of whom were screened by chest X-ray and 2 students had abnormalities. Tuberculin skin test was carried out among 2392 students, among whom 735 (30.73%) were positive, 48 (2.01%) were strong positive. 2 new cases were detected by further examination. The positive rates of PPD for close contacts of smear-positive and smear-negative (including tuberculous pleurisy cases) cases were 29.03% (234/806) and 32.85% (521/1586), and the strong positive rates of PPD were 2.48% (20/806) and 1.77% (28/1586), respectively. Both had no statistical difference (χ ²=3.61, P>0.05; χ ²=1.39, P>0.05).Conclusion In 2018, the incidence of tuberculosis in schools in Songjiang district is mainly among college students, with the highest incidence ratio in the second quarter. Timely and effective screening of close contacts can prevent outbreaks of tuberculosis in schools.

Key words: Tuberculosis, pulmonary, Epidemics, Universities, Student health services, Contact tracing, Multiphasic screening, Small-area analysis