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目的调查处置东海县某中学肺结核聚集性疫情,分析流行因素,为制定学校肺结核防控策略提供依据。方法按照《学校结核病防治工作手册》进行流行病学调查及密切接触者筛查。结果东海县某中学高二年级学生发生了肺结核聚集性疫情,罹患率0.39%;密切接触者筛查结核菌素试验学生强阳性反应率为12.2%;涂阳肺结核同班接触者PPD强反应率显著高于涂阴肺结核同班接触者(=9.742,P=0.002)及肺结核同一楼层接触者(=16.241,P<0.001)。结论此次学生肺结核聚集性疫情主要原因为未及时发现和处置传染性患者、学校卫生设施和保健措施不到位。通过强化肺结核防控知识的宣传教育,隔离治疗患者,加强教室和宿舍通风消毒等措施有效控制了疫情的蔓延。
Objective To investigate and deal with the tuberculosis epidemic in a middle school in Donghai County, analyze the epidemic factors and provide the basis for the development of the school tuberculosis prevention and control strategy. Methods According to “TB Handbook of School Tuberculosis Prevention and Control” for epidemiological investigation and close contact screening. Results High school sophomore in a secondary school in Donghai County had a cluster of epidemic of tuberculosis with a prevalence rate of 0.39%. Strong positive reaction rate was 12.2% in close contact with tuberculin test students. The strong response rate of PPD in the same class of smear positive tuberculosis patients was significantly higher (= 9.742, P = 0.002) and contacts on the same floor of tuberculosis (= 16.241, P <0.001) among smear-negative tuberculosis cohorts. Conclusions The main reason for the clustering of tuberculosis among students is that the infectious diseases were not discovered and treated promptly. School health facilities and health care measures were not in place. Measures such as publicity and education on strengthening tuberculosis prevention and control knowledge, isolation and treatment of patients, and enhancement of classroom ventilation and dormitory ventilation and disinfection have effectively controlled the spread of the epidemic.