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目的对台州某高校一起结核病聚集性疫情进行流行病学分析,为早期发现和控制此类疫情提供参考依据。方法通过传染病报告信息管理系统收集2014年3—9月该校结核病发病资料和流行病学调查资料,开展接触者筛查,包括X线胸片检查、痰涂片检测及卡介菌纯蛋白衍生物(PPD)试验。采用描述性流行病学方法,分析聚集性疫情流行特征、发生原因和防控措施及效果。结果 2014年3—9月该校共发生结核病13例,发病率为747.99/10万;其中3、6、7和8月各1例,9月密切接触者筛查发现9例;所有病例集中在电气专业班级,其中1232班11例,1231班2例,均为大二年级男生,年龄20~23岁;这13例病例临床症状均不明显,仅4例有咳嗽、发热、胸痛及盗汗表现,其余9例均无明显症状;痰涂片检测仅首发病例为抗酸杆菌阳性。对172名接触者进行PPD试验,阳性105例,阳性率61.05%;强阳性34例,强阳性率19.77%;其中涂阳密切接触者阳性率97.06%,强阳性率52.94%,均高于涂阴密切接触者和一般接触者(P<0.01)。结论该起学校结核病聚集性疫情发生的主要原因为首发病例就诊延迟;建议对15岁以上密切接触者进行X线胸片检查。
Objective To analyze the epidemiology of tuberculosis epidemic in a university in Taizhou and provide a reference for early detection and control of such outbreak. Methods The data of infectious diseases and epidemiological survey of tuberculosis in this school from March to September in 2014 were collected through infectious disease reporting information management system to carry out screening of contacts, including X-ray examination, sputum smear test and pure protein of BCG Derivatives (PPD) test. Descriptive epidemiological methods were used to analyze the epidemic characteristics of aggregated epidemic, the causes and prevention and control measures and their effects. Results From March to September 2014, there were 13 cases of tuberculosis in the school, with an incidence rate of 747.99 / 100 000, of which 1 case was found in March, June, July and August, 9 cases were screened by close contacts in September, and all cases were concentrated Among the electrical majors, there were 11 cases in 1232 classes and 2 cases in 1231 classes, both of them were sophomores, aged 20-23 years old. The clinical symptoms of these 13 cases were not obvious. Only 4 cases had cough, fever, chest pain and night sweats Performance, the remaining 9 cases were no obvious symptoms; sputum smear test only the first case of acid-fast bacilli positive. PPD test was carried out on 172 contact subjects, with a positive rate of 61.05%, positive rate of 61.05%, strong positive rate of 19.77%, positive rate of smear positive contact 97.06% and strong positive rate of 52.94% Negative close contacts and general contacts (P <0.01). Conclusions The main reason for the outbreak of tuberculosis epidemic in schools is the delayed onset of first visit. It is recommended to conduct X-ray examination of close contacts over the age of 15 years.