| 2010—2019年北京市大兴区某中学高中部青海藏族集体来京学生肺结核疫情处置分析 |
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| 引用本文： | 李春,郑海伦,罗萍,李亚敏,赵淑娟,郭金红,张丽,徐静,屠霞. 2010—2019年北京市大兴区某中学高中部青海藏族集体来京学生肺结核疫情处置分析[J]. 中国防痨杂志, 2020, 42(12): 1318-1322. DOI: 10.3969/j.issn.1000-6621.2020.12.013 |
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| 作者姓名： | 李春 郑海伦 罗萍 李亚敏 赵淑娟 郭金红 张丽 徐静 屠霞 |
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| 作者单位： | 102600.北京市大兴区结核病预防控制中心门诊部(李春、赵淑娟、郭金红);北京结核病控制研究所门诊部(郑海伦、罗萍、徐静、屠霞),预防控制科(李亚敏); 北京师范大学大兴附属中学校医务室(张丽) |
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| 基金项目： | 北京市科技重大专项(D181100000418004) |
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| 摘 要： | 目的分析北京市大兴区某中学高中部青海省玉树藏族自治州(西部结核病高发地区)集体来京藏族学生肺结核疫情及处置情况,为学校结核病防控工作提供参考依据。方法回顾性分析2010—2019年大兴区某中学高中部在校学生肺结核疫情及处置情况;其中83.19%(10687/12847)为本地学生,16.81%(2160/12847)为青海省玉树藏族自治州集体来京的藏族学生。对青海藏族学生开展入(返)校胸部X线摄影(简称胸片)和单纯结核菌素皮肤试验(简称PPD试验)中度及以上阳性学生预防性治疗情况进行总结与分析。采用SPSS 21.0软件对数据进行统计学分析。计数资料采用χ2检验,当理论频数<1,或者分析总数<40时,采用Fisher确切概率法,以P<0.05为差异有统计学意义。结果2010—2019年该校高中部报告活动性肺结核31例,其中青海藏族学生患者23例,报告发病率为1064.81/10万(23/2160);本地学生肺结核8例,报告发病率为74.86/10万(8/10687),差异有统计学意义(Fisher确切概率法,P=0.000)。23例青海藏族患者全部为住宿生,其中男13例(56.52%),女10例(43.48%),男∶女=1.3∶1。截至2019年9月,对1518名青海藏族学生进行了胸片检查,经临床综合评估确诊肺结核9例,检出率为0.59%(9/1518),占10年间全部青海藏族学生肺结核患者的39.13%(9/23);其中2017年2月在返校藏族学生筛查中,经临床综合评估确诊肺结核6例,检出率为3.03%(6/198)。2016—2019年单纯PPD试验中度及以上阳性学生91名,预防性服药者的发病率[4.17%(3/72)]低于未接受预防性服药者的发病率[10.53%(2/19)],但差异无统计学意义(Fisher确切概率法,P=0.280)。5例患者均于筛查后或服药后1年内发病。2019年1月至2020年5月本报告完稿时未再出现学生肺结核患者。结论学生是结核病防控的重点人群,对西部结核病高发地区集体来京学生开展入(返)校胸片检查,能够实现关口前移,是预防和控制结核病在校园传播的有效手段。
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| 关 键 词： | 学生 结核,肺 结核菌素试验 多相筛查 数据说明,统计 预防和防护用药 对比研究 |
| 收稿时间： | 2020-06-12 |
Analysis on epidemic and management of tuberculosis among senior middle school students from Qinghai Tibetans in a school of Daxing District of Beijing from 2010 to 2019 |
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| LI Chun,ZHENG Hai-lun,LUO Ping,LI Ya-min,ZHAO Shu-juan,GUO Jin-hong,ZHANG Li,XU Jing,TU Xia. Analysis on epidemic and management of tuberculosis among senior middle school students from Qinghai Tibetans in a school of Daxing District of Beijing from 2010 to 2019[J]. The Journal of The Chinese Antituberculosis Association, 2020, 42(12): 1318-1322. DOI: 10.3969/j.issn.1000-6621.2020.12.013 |
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| Authors: | LI Chun ZHENG Hai-lun LUO Ping LI Ya-min ZHAO Shu-juan GUO Jin-hong ZHANG Li XU Jing TU Xia |
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| Affiliation: | Outpatient Department of Daxing District Tuberculosis Prevention and Control Center, Beijing 102600, China |
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| Abstract: | 【Abstract】 Objective To analyze the epidemic and management of tuberculosis among students coming to Beijing from Yushu Tibetan Autonomous Prefecture, Qinghai Province (a region with a high prevalence of tuberculosis in western China) in a senior middle school in Daxing District, so as to provide information for tuberculosis prevention and control in schools. Methods Pulmonary tuberculosis epidemic in a middle school in Daxing District from 2010 to 2019 and relevant management were retrospectively analyzed. Students of this school included 83.19% (10687/12847) of local residents and 16.81% (2160/12847) from Qinghai Tibetan. Preventive measures for this group of Tibetan students consisted of Chest X-ray photography (referred to as “chest radiograph”) on their entering (returning after holidays) to school and preventive medications for those with moderate or above positive PPD tests. The above data was analyzed using SPSS 21.0 software. The enumeration data was tested by χ2 or Fisher’s exact test when the theoretical frequency was less than 1, or the total number of analyses was less than 40. P<0.05 was considered as statistically significant. Results From 2010 to 2019, 31 cases of active pulmonary tuberculosis were reported in these senior middle school students, including 23 cases of Tibetan students, with a reported incidence of 1064.81/100000 (23/2160), and eight cases of local students, with a reported incidence of 74.86/100000 (8/10687) (Fisher exact probability method, P=0.000). All 23 Tibetan patients lived in school dormitory, including 13 males (56.52%), 10 females (43.48%) with a male to female ratio of 1.3∶1. As of September 2019, chest X-ray examination was carried out in 1518 Tibetan students among whom 9 were diagnosed as pulmonary tuberculosis after comprehensive clinical evaluation giving a detection rate of 0.59% (9/1518), and accounting for 39.13% (9/23) of all Tibetan students with tuberculosis within the 10 years. Among the 9 students, 6 were diagnosed in February 2017 when returning to school after winter holidays, with a detection rate of 3.03% (6/198). Among the 91 students who were moderate or above positive in PPD test from 2016 to 2019, the incidence of tuberculosis in those received preventive medications (4.17% (3/72)) was lower than those did not (10.53% (2/19)) (Fisher exact probability method, P=0.280). While all the above 5 patients developed symptoms within 1 year after screening or preventive medications. From January 2019 to May 2020, there were no new reported tuberculosis cases among these school students. Conclusion Students are an important population for the prevention and control of tuberculosis. Chest radiograph for students coming or back to Beijing from high prevalent areas of tuberculosis in western China are a proactive measure for prevention and control of the spread of tuberculosis on campus. |
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| Keywords: | Students Tuberculosis pulmonary Tuberculin test Multiphasic screening Data interpretation statistical Protective agents Comparative study |
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