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目的:通过对2013年一起学校肺结核疫情的调查处置,分析学校肺结核聚集性疫情发生发展规律,为进一步做好学校结核病防控工作提供经验。方法:对肺结核患者的密切接触者进行PPD及X线胸片检查,对患病学生进行个案调查和暴露因素调查,描述病例的三间分布,对非密切接触者进行胸片检查,以作对照。结果:PPD阳性率首发班级18.18%,同楼层其他3个班级分别是18.75%、13.04%、28.26%,首发班级和其他班级PPD阳性率差异无统计学意义(χ2=2.365,P>0.05);密切接触者5人发病,罹患率2.21%,非密切接触者2人发病,罹患率0.16%,二者罹患率差异有统计学意义(P<0.01)。结论:采取有效措施减少密切接触者发病,并及时主动发现无症状患者,从而减少学校聚集性肺结核疫情的发生。
OBJECTIVE: To investigate the occurrence and development of tuberculosis epidemic in schools by investigating and disposing of an outbreak of tuberculosis in a school in 2013, and provide experiences for further prevention and control of tuberculosis in schools. Methods: PPD and X-ray examination were conducted on close contacts of patients with pulmonary tuberculosis. The sick students were investigated by investigation of the case and exposure factors. The three distributions of the cases were described. The chest X-ray examination of non-close contacts was performed as control . Results: The positive rate of PPD was 18.18%. The other three classes on the same floor were 18.75%, 13.04% and 28.26% respectively. No significant difference was found in the positive rate of PPD between the first and the other classes (χ2 = 2.365, P> 0.05). There were 5 cases of close contacts with attack rate of 2.21%, 2 cases of non-close contact and the attack rate of 0.16%. There was significant difference in the attack rates between the two groups (P <0.01). CONCLUSION: Effective measures should be taken to reduce the incidence of close contacts and take the initiative to identify asymptomatic patients, thereby reducing the incidence of school-acquired tuberculosis outbreaks.