常州在校藏族学生中结核分枝杆菌强阳性潜伏感染状况调查-现代医学

常州在校藏族学生中结核分枝杆菌强阳性潜伏感染状况调查

单位：1. 常州市疾病预防控制中心慢性传染病防治科, 江苏常州 213003;
2. 南京市疾病预防控制中心慢性传染病防治科, 江苏南京 210003;
3. 南京医科大学公共卫生学院, 江苏南京 211166;
4. 常州市第三人民医院药事科, 江苏常州 213001;
5. 常州市钟楼区疾病预防

关键词：结核菌潜伏感染藏族学生影响因素

分类号：R181.3

出版年·卷·期（页码）：2024·52·第四期（581-586）

摘要：

目的：了解常州地区藏族初高中学生结核潜伏感染(LTBI)的流行现状，为探索学校内高负担地区学生的结核病管理以及实施防控措施提供依据。方法：采用结核分枝杆菌素纯化蛋白衍生物(PPD)皮内注射法(Mantoux法)进行结核菌潜伏感染检测，收集2023年常州市西藏民族中学和奔牛高中两所学校内的藏族学生进行筛查获得相关资料，并进行统计描述。结果：本次筛查共调查500例，获得480份有效数据，有效率为96%。共筛查出PPD强阳性学生58例，强阳性率12.08%。男性PPD强阳性率高于女性，农村学生PPD阳性率较高，有既往结核病史的学生筛查出PPD强阳性率高于既往无结核病史的学生，差异具有统计学意义(P＜0.05)。结论：藏族学生的结核病潜伏感染负担较重，应将结核病高发地区的学生作为筛查的重点对象。

Objective: To investigate the prevalence of latent tuberculosis infection(LTBI) among middle and high school Tibetan students in Changzhou, and to provide evidence for the management of tuberculosis in high burden areas and the implementation of prevention and control measures. Methods: Mycobacterin purified protein derivative(PPD) intradermal injection method(Mantoux method) was used to detect latent tuberculosis infection，collect Tibetan students' relevant data from 2 schools in Changzhou in 2023,and describe the data statistically. Results:This investigation involved 500 people, 480 valid data were obtained, with an effective rate of 96%. A total of 58 students were found to be strongly positive for PPD, with a strong positive rate of 12.08%. The strong positive rate of PPD in males was higher than that in females, and the positive rate of PPD in rural students was lower，students with a history of tuberculosis had a higher positive rate of PPD than students without a history of tuberculosis(P<0.05). Conclusion: Tibetan students have a heavy burden of latent TB infection, and students in areas with high incidence of TB should be selected as the key targets for screening.

参考文献：

[1] World Health Organization.Global Tuberculosis Report 2022[R/OL].Geneva:World Health Organization,2022.https://www.who.int/teams/global-tuberculosis-programme/tb-reports.
[2] World Health Organization.Global tuberculosis report 2018[R/OL].Geneva:World Health Organization,2019.https://www.who.int/tb/publications/global_ report/en/.
[3] 宋月萍,张光赢.中国流动人口慢性病患者公共卫生服务利用现状及其影响因素[J].中国公共卫生,2021,37(2):198-202.
[4] World Health Organization.Global tuberculosis report 2018[R/OL].Geneva:World Health Organization,2018.https://www.who.int/teams/global-tuberculosis-programme/tb-reports.
[5] CUI X,GAO L,CAO B.Management of latent tuberculosis infection in China:exploring solutions suitable for high-burden countries[J].Int J Infect Dis,2020,92S:S37-S40.
[6] COHEN A,MATHIASEN V D,SCHÖN T,et al.The global prevalence of latent tuberculosis:a systematic review and meta-analysis[J].Eur Respir J,2019,54(3):1900655.
[7] HOUBEN R M G J,DODD P J.The global burden of latent tuberculosis infection:a re-estimation using mathematical modelling[J].PLoS Med,2016,13(10):e1002152.
[8] MIRZAZADEH A,KAHN J G,HADDAD M B,et al.State-level prevalence estimates of latent tuberculosis infection in the United States by medical risk factors,demo graphic characteristics and nativity[J].PLoS One,2021,16(4):e0249012.
[9] CHEN Q,YU S,RUI J,et al.Transmissibility of tuberculosis among students and non-students:an occupational-specific mathematical modelling[J].Infect Dis Poverty,2022,11(1):117.
[10] 方益荣,牛文柯,卢巧玲,等.应用移动平均法预警学校结核病疫情的分析[J].疾病监测,2017,32(5):418-422.
[11] XIAO X,CHEN J,JIANG Y,et al.Prevalence of latent tuberculosis infection and incidence of active tuberculosis in school close contacts in Shanghai,China:baseline and follow-up results of a prospective cohort study[J].Front Cell Infect Mi,2022,12:1000663.
[12] JIA J,CHEN D,LIU L,et al.Prevalence of latent tuberculosis infection among healthy young children and adolescents and a two-step approach for the diagnosis of tuberculosis infection in Chengdu,China[J].Pediatr Infect Dis J,2022,41(1):6-11.
[13] 梁瑞英,徐伟,魏云芳.2013-2017年北京市朝阳区高校新生结核菌潜伏感染情况分析[J].现代预防医学,2020,47(14):2534-2537.
[14] ZHOU G,LUO Q,LUO S,et al.Interferon-γ release assays or tuberculin skin test for detection and management of latent tuberculosis infection:a systematic review and meta-analysis[J].Lancet Infect Dis,2020,20(12):1457-1469.
[15] ZHOU G,LUO Q,LUO S,et al.Positive rates of interferon-γ release assay and tuberculin skin test in detection of latent tuberculosis infection:a systematic review and meta-analysis of 200,000 head-to-head comparative tests[J].Clin Immunol,2022，245:109132.
[16] XU J,WANG G,ZHANG Y,et al.An outbreak of tuberculosis in a middle school in Henan,China:epidemiology and risk factors[J].PLoS One,2019,14(11):e0225042.
[17] YOU N N,ZHU L M,LI G L,et al.A tuberculosis school outbreak in China,2018:reaching an often overlooked adolescent population[J].Epidemiol Infect,2019,147:e303.
[18] 何树梅,梁贵年,马丽霞,等.西藏民族大学新生2016-2017年结核菌素试验结果分析[J].中国学校卫生,2018,39(4):627-629.
[19] XIN H,ZHANG H,YANG S,et al.5-year follow-up of active tuberculosis development from latent infection in rural China[J].Clin infect Dis,2020,70(5):947-950.
[20] HUANG W,FANG Z,LUO S,et al.The effect of BCG vaccination and risk factors for latent tuberculosis infection among college freshmen in China[J].Int J Infect Dis,2022,122:321-326.
[21] NGUIPDOP-DJOMO P,HELDAL E,RODRIGUES L C,et al.Duration of BCG protection against tuberculosis and change in effectiveness with time since vaccination in Norway:a retrospective population-based cohort study[J].Lancet Infect Dis,2016,16(2):219-226.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录