重庆市某高校一起肺结核聚集性疫情调查

目的 对重庆市某高校一起肺结核聚集性疫情进行分析,探讨疫情发生原因、总结疫情处置经验教训,为提高学校结核病防控能力提供科学依据。方法 收集重庆市某高校一起肺结核疫情资料,梳理疫情处置过程并探讨疫情发生原因。结果 本起疫情共发现学生肺结核患者23例,其中C专业22例,该专业罹患率为31.43%（22/70）,男生44.44%（8/18）高于女生26.92%（14/52）,但差异无统计学意义（χ²=1.91, P>0.05）。22例患者病原学阳性率为22.73%（5/22）,7例有可疑症状,仅2例主动就诊。确定接触者609人,其中密切接触者69人,一般接触者540人。密切接触者中发现PPD强阳性11例,PPD强阳性率为15.94%;一般接触者中开展PPD筛查517人,发现PPD强阳性25例,PPD强阳性率为4.84%。密切接触者PPD强阳性率较一般接触者高,差异具有统计学意义（χ²=13.02, P<0.05）。36例PPD强阳性者中5例诊断为患者,其余31例预防性治疗率为3.23%（1/31）。结论 日常防控措施落实不到位、就诊延迟和潜伏感染者管理不到位可能是导致本起疫情发生的主要原因,因此应加强日常防控,规范疫情处置,畅通联系机制,加强健康教育,提高学校人群防病意识,预防疫情发生与扩散。

Investigation of a tuberculosis epidemic at a college in Chongqing

Objective To analyze a tuberculosis epidemic in one college in Chongqing, explore the causes of the epidemic, summarize the experience and lessons of epidemic treatment, and we provide basis for improving the tuberculosis prevention and control ability of the school. Methods Data of a tuberculosis epidemic in a university in Chongqing were collected to explore the treatment process and causes of the epidemic. Results In this outbreak, a total of 23 patients were found among students, 22 patients were found in C major, with a incidence rate of 31.43% (22/70), 44.44% (8/18) in boys and 26.92% (14/52) in girls, but the difference was not statistically significant (χ²=1.91, P>0.05). Among the 22 patients, the etiological positive rate was 22.73%(5/22), 7 patients had suspicious symptoms, and only 2 cases sought medical treatment voluntarily. And 609 contacts were confirmed, including 69 close contacts and 540 general contacts; 11 close contacts were found to be strongly positive for PPD, with a strong positive rate of 15.94%. Among general contacts, 517 were screened for PPD, and 25 were found to be strongly positive for PPD, with a strong positive rate of 4.84%. The strongly PPD positive rate of close contacts was higher than that of general contacts, and the difference was statistically significant (χ²=13.02, P<0.05). Among the 36 PPD positive cases, 5 cases were diagnosed as patients, and preventive treatment rate in the remaining 31 cases was 3.23% (1/31). Conclusions Inadequate implementation of daily prevention and control measures, patient delay and poor management in latent infection may be the main reasons for the outbreak of the epidemic. Therefore, daily prevention and control should be strengthened, epidemic treatment should be standardized, communication mechanism should be unblocked, and awareness of disease prevention should be improved among school people to avoid the spread of the epidemic.