2017—2019年合肥市学校肺结核患者密切接触者筛查分析

目的 了解全市学校肺结核疫情发生时对密切接触者筛查情况，查找和解决筛查存在问题，以便更好处理学校疫情。方法 按照《学校结核病防控工作规范（2017版）》开展筛查，每季度逐级上报筛查结果。结果 2017—2019年，全市学校肺结核患者的密切接触者人数有40 825人，规范筛查率为84.38%。15岁以下规范筛查率为97.62%，15岁及以上规范筛查率为82.98%，差异有统计学意义（χ2 = 573.32，P＜0.01)。2017年规范筛查率为61.66%；2019年规范筛查率为94.84%，呈上升趋势（χ2趋势 = 4 721.55，P＜0.01)。2017—2019年，规范筛查率前3的地区为:庐阳区、长丰县和庐江县；后3位为肥西县、瑶海区和巢湖市。学校肺结核密切接触者筛查患者发现率为0.18%。PPD试验强阳性率为3.61%，最高为初中（4.40%），最低为幼儿园、小学（1.31%）。预防性服药率为7.94%，且不同类型学校之间有差异。结论 合肥市学校肺结核疫情处置日趋规范，但依然存在一些问题，需要教育和卫生部门共同努力。

Screening analysis of close contacts of school tuberculosis patients in Hefei from 2017 to 2019

To investigate the screening of close contacts in schools in Hefei during tuberculosis epidemic to identify and solve screening problems for better response to school epidemic. Methods Screening was conducted in accordance with the Code of Practice for the Prevention and Control of Tuberculosis in Schools(2017 version), and screening results were reported quarterly. Results From 2017 to 2019, the number of close contacts of school tuberculosis patients in Hefei was 40 825, and the standardized screening rate was 84.38%. The standardized screening rate was 97.62% for those under 15 years old and 82.98% for those above 15 years old, with statistically significant differences(χ2=573.32, P<0.01). The standardized screening rate in 2017 was 61.66% and 94.84% in 2019, showing an increasing trend(χtrend2=4 721.55, P<0.01).From 2017 to 2019, the top three districts in terms of standardized screening rate were Luyang district, Changfeng county and Lujiang county, and the bottom three were Feixi county, Yaohai district and Chaohu city. The detection rate of school tuberculosis patients identified by close contact screening was 0.18%. The strong positivity rate of PPD test was 3.61%, with the highest being in middle schools(4.40%) and the lowest in kindergartens and elementary school(1.31%). The preventive drug administration rate was 7.94%, and variances were found between different types of schools. Conclusion The management of school tuberculosis in Hefei is becoming standardized, but there are still some problems that require joint efforts of education and health departments.