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目的掌握山东省某监狱某监区劳教人员结核病的传播流行以及潜伏结核感染情况。方法对某监区314名劳教人员进行了结核病筛查,筛查者同时作胸透、HIV试验、结核菌素试验、ELISPOT试验,并对每个人进行了有关资料调查,对筛查人群中有咳嗽咳痰症状者以及已确诊的结核病患者,进行分枝杆菌培养,培养阳性的分枝杆菌进行菌种鉴定和药物敏感试验,结核分枝杆菌进行基因分型。结果314名筛查者HIV结果全部为阴性;3例分枝杆菌培养阳性都是结核分枝杆菌,A患者分离的结核杆菌是非北京家族,B患者和C筛查者分离的结核杆菌是北京家族,菌株成簇,312人同时有2种试验T-SPOT.TB试验阳性率为27.9%,PPD反应硬结平均直径≥10mm,阳性率为81.7%,2种试验结果的符合率为42.3%(95%CI,36.8%～47.8%)。结论以T-SPOT.TB试验结果阳性为结核感染的参考标准,该监区潜伏结核感染率为27.6%(86/312);结核病患病率为0.93%;结核病人部分是内源性复燃引起,部分是在狱内由于新近感染结核菌而引起,监狱内结核病存在局部范围内的传播,该监区在结核病治疗、预防和控制工作方面需要进一步采取措施。
Objective To understand the prevalence of tuberculosis and the latent tuberculosis infection among reeducation-through-staff in a prison in a prison in Shandong Province. Methods A total of 314 reeducation-through-labor (TB) workers in a prison area were screened for tuberculosis. HIV screening, tuberculin test, and ELISPOT were also performed in the screening area. Data were also collected for each individual. Cough and sputum symptoms and confirmed tuberculosis patients, mycobacterial culture, culture of positive mycobacteria identification and drug susceptibility testing, Mycobacterium tuberculosis genotyping. Results The results of HIV screening were negative in all 314 samples. Mycobacterium tuberculosis was positive in all 3 mycobacterium cultures. Mycobacterium tuberculosis isolated in group A was non-Beijing family. Mycobacterium tuberculosis isolated in group B and C was Beijing family , The strains were clustered. The positive rate of T-SPOT.TB test was 27.9% in two kinds of test in 312 persons, the average diameter of induration in PPD reaction was ≥10 mm, the positive rate was 81.7%, and the coincidence rate of two test results was 42.3% (95 % CI, 36.8% -47.8%). Conclusion The positive result of T-SPOT.TB test is the reference standard of tuberculosis infection. The infection rate of latent tuberculosis in this surveillance area is 27.6% (86/312). The prevalence of tuberculosis is 0.93%. The tuberculosis patients are partially endogenous Caused, in part, in prisons as a result of the recent infection with tuberculosis and the localized spread of tuberculosis in prisons, which requires further steps in tuberculosis treatment, prevention and control.