三省市医疗卫生机构工作人员结核病患病及影响因素分析

目的 了解医疗卫生机构工作人员结核病患病情况及影响因素。 方法 于2010年10月至12月，采用《医务人员结核感染控制调查问卷》，按照目的抽样方法，对抽取的北京市、内蒙古自治区和上海市22家医疗卫生机构的5235名医疗卫生机构工作人员进行调查，收集相关信息并分析。 结果 参加调查的5235名医疗卫生机构工作人员肺结核的年均患病率为664.76/10万(174/26 175)，涂阳肺结核的年均患病率191.02/10万(50/26 175)。经多元素分析，可认为男性（调整OR=1.9, 95%CI=1.3~2.7, P<0.05）、单位为结核病防治机构（调整OR=1.8, 95%CI=1.1~2.8,P<0.05）或专科医院（调整OR=2.5,95%CI=1.1~3.6,P<0.05）、科室为结核门诊（调整OR=2.3, 95%CI=1.3~4.1,P<0.05）、与结核病患者近距离接触时间15 h及以上（调整OR=2.2, 95%CI=1.1~4.3,P<0.05）、科室无结核病感染控制制度（调整OR=1.7, 95%CI=1.2~2.3,P<0.05）、吸烟（调整OR=2.8, 95%CI=1.2~2.9,P<0.05）可增加医疗卫生机构工作人员患结核病风险。 结论 所调查医疗卫生机构工作人员结核病患病率高，结核感染控制工作不到位,需加强落实结核病感染控制措施，减少结核分枝杆菌感染。

Analysis of the prevalence of tuberculosis disease among health care workers in three regions and its associated factors

Objective This study aims to summarize the evidence on the prevalence of tuberculosis(TB) disease among health care workers(HCWs),and to evaluate its associated factors.Methods According to purposive sampling method,select 22 health institutions in Beijing,Inner Mongolia and Shanghai.Analyze data collected from HCWs who were investigated by questionnaires about TB infection control status between October and December in 2010.Results A total of 5235 HCWs were investigated,the annual TB prevalence is 664.76/100 000(174/26 175) and the annual prevalence of smear-positive TB is 191.02/100 000(50/26 175).The result of logistic regression analysis indicates that male(Adjusted OR=1.9,95%CI=1.3-2.7,P<0.05)、working in TB institutions(Adjusted OR=1.8,95%CI=1.1-2.8,P<0.05)or lung hospitals(Adjusted OR=2.5,95%CI=1.1-3.6,P<0.05)、working in TB out-patient(Adjusted OR=2.3,95%CI=1.3-4.1,P<0.05)、the time of close contact with TB patients up to 15 hours per week(Adjusted OR=2.2,95%CI=1.1-4.3,P<0.05)、without the system of TB infection control(Adjusted OR=1.7,95%CI=1.2-2.3,P<0.05)、smoke(Adjusted OR=2.8,95%CI=1.2-2.9,P<0.05) can increase the risk of Mycobacterium tuberculosis infection.Conclusion The prevalence of TB in HCWs investigated was high,which indicates that the TB infection control measures are not enough.There is a need to strengthen the TB infection control practice to lower the Mycobacterium tuberculosis infection.