重庆市2017年学校结核病聚集性疫情处置分析

目的分析重庆市学校结核病聚集性疫情发生、发展、处置等防控措施落实现状,为今后预防和控制学校结核病聚集性疫情的发生提供参考依据。方法收集2017年重庆市发生学校结核病聚集性疫情资料,分析疫情发现、首发病例诊治延误、接触者筛查、预防性治疗等防控措施实施情况。结果 2017年重庆市报告发现学校结核病聚集性疫情12起,高中5起、大学3起、中等职业学校4起,主要以疾病预防控制中心主动监测并对疑似病例调查核实发现,占66.7%。首发患者发病到疫情处置合计延误最长484 d,最短4 d,中位数32.5 d。密切接触者筛查患者检出率为8.60%,一般接触者患者检出率为0.24%,差异有统计学意义(P<0.05)。476名学生PPD强阳性者有45人接受预防性治疗,接受率9.45%。结论学校应提高日常监测发现结核病疫情的能力,教育、医疗与疾控机构应进一步规范和完善沟通协调机制,分级开展密切接触者筛查,对潜伏感染者应采取有效的预防性治疗措施,防止学校聚集性疫情的发生。

Disposal measures of school tuberculosis outbreak in Chongqing

Objective To analyze the current situation of clustering tuberculosis in Chongqing school, including incidence, development and treatment, and to provide the reference for the prevention and control of tuberculosis clustering outbreaks in schools in the future. Methods The information on the school-borne tuberculosis clustering outbreak of Chongqing in 2017 was collected to analyze the implementation of prevention and control measures including detection, delay of diagnosis and treatment, contact screening and preventive treatment. Results There were 12 incidents of school clustering tuberculosis, 5 in high-school, 3 in university, and 4 in secondary vocational schools. CDC proactively monitors and validates was the main way to find outbreak, accounting for 66.7%. The longest period from the onset to disposal was 484 d, the shortest was 4 d, the median was 32.5 d. The average positive rates of close contacts was 8.60% versus 0.24% of general-contacts (P<0.05). 45 out of 476 vigorous purified protein derivative (PPD) positive patients received preventive treatment, with an acceptance rate of 9.45%. Conclusions To prevent the school clustering infection of tuberculosis, schools should increase their ability to routinely detect tuberculosis outbreaks. Educational institutions, medical institutions and the CDC should further standardize and improve the communication and coordination mechanism. Screening for close contacts should be graded, the latent infection should be taken effective preventive treatment.