Abstract:

Objective To analyze the epidemiological characteristics of tuberculosis in schools in Guangxi Zhuang Autonomous Region, and to provide reference for effective prevention and control measures. Methods A retrospective study was conducted. Data of tuberculosis patients classified as “students” and “teachers” in school in Guangxi Zhuang Autonomous Region between 2017 and 2019 were annually derived from the “tracking information management” of Tuberculosis Management Information System of China Center for Disease Control and Prevention. From the Tuberculosis Prevention and Control Institute, GuangXi Zhuang Autonomous Region Center for Disease Prevention and Control, the registration form of tuberculosis epidemic situation in schools, the questionnaire of tuberculosis patients, the initial report, process report and closing report of tuberculosis epidemic situation in Guangxi (each city, districts or county) from 2017 to 2019 were consulted to collect the number of tuberculosis outbreaks (including aggregated epidemic situation and public health emergencies), number of patients, year of the outbreak, location of the school, nature of the school, disposal of the epidemic, screening of close contacts, and the prevention and control measures of tuberculosis in the school. The epidemiological characteristics of the epidemic situation was descriptively analyzed, and differences of indicators of the characteristics of the clustered epidemic situation and public health emergencies were compared. Results From 2017 to 2019, a total of 70 outbreaks of tuberculosis in schools in Guangxi were reported, the number of patients was 415, and accounted for 7.6% (116/1535), 8.9% (169/1896) and 12.9% (130/1009) of the tuberculosis cases in schools in Guangxi every year, respectively, showing an increasing trend year by year ( {\chi }_{\mathrm{trend}}^2 =18.969, P=0.000). Among them, there were 65 clustered outbreaks (331 cases) and 5 public health emergencies (84 cases). In south, southwest and northeast of Guangxi, patients accounted for 66.7% (277/415) of the total cases, clustered outbreaks accounted for 70.0% (49/70) of the total outbreaks; and patients aged 15-19 years accounted for 73.5% (305/415) of all the patients. Compared indicators of characteristics between the clustered epidemic situation and the public health emergencie, spring, secondary school, male indicated cases, delayed treatment in indicated cases, delayed investigation in indicated cases, positive etiological results in indicated cases, delay screening of close contacts nonstandard screening of close contacts, no tuberculosis screening for physical examination of staff, no tuberculosis screening for freshmen, morning and afternoon inspection system not implemented, ventilation system not implemented in dormitories and classrooms and so on in public health emergencies were significantly more than in clustered epidemic situation (69.0% (58/84) vs. 54.7% (181/331),χ ²=5.660, P=0.017; 83.3% (70/84) vs. 72.5% (240/331), χ ²=4.155, P=0.042; 62.6% (61/84) vs. 50.5% (167/331), χ ²=13.297, P=0.000; 100.0% (84/84) vs. 60.4% (200/331), Fisher test, P=0.000; 44.0% (37/84) vs. 13.3% (44/331), χ ²=40.341, P=0.000; 57.1% (48/84) vs. 43.8% (145/331), χ ²=4.790, P=0.029; 40.5 (34/84) vs. 29.0% (96/331), χ ²=4.100, P=0.043; 88.1% (74/84) vs. 49.5% (164/331), χ ²=40.702, P=0.000; 72.6% (61/84) vs. 57.1% (189/331), χ ²=6.737, P=0.009; 72.6% (61/84) vs. 40.2% (133/331), χ ²=28.318, P=0.000; 88.1% (74/84) vs. 9.4% (31/331), χ ²=219.726, P=0.000; 47.6% (40/84) vs. 11.2% (37/331), χ ²=58.874, P=0.000; respectively). Conclusion The proportion of tuberculosis patients in schools in Guangxi increased year by year. The epidemic mainly occurred in the south, southwest and northeast of Guangxi, and the incidence was high in those who aged 15-19 years. Early detection and early screening should be strengthened in spring, secondary schools, male students and indicated cases, and the implementation of standardized management measures of tuberculosis in schools should be strictly monitored.

Key words: Tuberculosis, Schools, Incidence, Epidemiologic study characteristics as topic