长沙市城区中学生结核病筛查感染情况分析

目的 了解长沙市城区中学生结核感染情况,为制定有针对性筛查策略提供参考。 方法 选取长沙市城区三所中学,筛查初一、高一入学新生及新高三学生结核病感染情况。对调查对象询问肺结核可疑症状、结核病史,进行结核菌素皮肤试验,对结核菌素皮肤试验强阳性的学生进行X线胸片检查。统计描述学生不同组别的结核感染情况,用χ²检验感染率差异,用趋势χ²检验结核感染的年龄分布趋势。 结果 共筛查中学生3 557例,经结核菌素试验判定为结核感染204例,总体感染率5.74%,其中男性结核感染率5.64%(102/1 808),女性结核感染率5.83%(102/1 749),差异无统计学意义(χ²=0.060,P=0.807)。年龄为11、12、13、14、15、16、17、18岁的学生感染率分别为0.0%、3.19%、3.57%、4.15%、4.30%、8.56%、9.04%、9.38%。各年龄组感染率随年龄增加而升高的趋势有统计学意义(χ²_趋势=32.954,P<0.001)。筛查的三所学校感染率分别为7.70%(62/805)、5.15%(44/854)和5.16%(96/1 898),各学校的感染率比较总体差异有统计学意义(χ²=7.444,P=0.024)。筛查学生中有结核病史者感染率7.27%(4/55);无结核病史者感染率5.71%(200/3 502),两者比较差异无统计学意义(χ²=0.244,P=0.621)。无肺结核相关症状者感染率5.69%(200/3 513);咳嗽咳痰<2周者感染率8.33%(3/36);咳嗽咳痰≥2周者感染率12.50%(1/8),三组间感染率差异无统计学意义(χ²=1.138,P=0.566)。 结论 长沙市中学生结核分枝杆菌总体感染率达5.74%,结核感染率与年龄呈正相关,年龄越大,感染率越高。

Screening of tuberculosis infection among urban middle school students in Changsha City

Objective To understand the status of tuberculosis infection among middle school students in Changsha City, and to provide references for developing targeted screening strategies. Methods Three middle schools in the urban area of Changsha City were selected to screen tuberculosis infection of freshmen enrolled in the first year of junior high school, the first year of senior high school and the third year of senior high school. The investigative subjects were screened for suspicious symptoms of pulmonary tuberculosis, history of tuberculosis and tuberculin skin test, and the students with strong positive reaction to tuberculin skin test were subjected to chest X-ray examination. The status of tuberculosis infection in different groups of students was statistically described. The infection rate was analyzed by Chi-square test, and the age distribution trend of tuberculosis infection by Chi-square test for trend. Results A total of 3,557 middle school students were screened, and 204 students were diagnosed with tuberculosis infection by tuberculin skin test. The overall infection rate was 5.74%, of which the infection rate was 5.64% (102/1,808) in males and 5.83% (102/1,749) in females, without statistically significant difference (χ²=0.060, P=0.807). The infection rates of students aged 11, 12, 13, 14, 15, 16, 17 and 18 years were 0.0%, 3.19%, 3.57%, 4.15%, 4.30%, 8.56%, 9.04% and 9.38%, respectively. The trend that the infection rates of age groups increased with age was statistically significant (χ²_trend=32.954, P<0.001). The infection rates of the three schools surveyed were 7.70% (62/805), 5.15% (44/854) and 5.16% (96/1,898), respectively. There was a statistically significant difference in the infection rate among the schools (χ²=7.444, P=0.024). The infection rates of students with and without tuberculosis history were 7.27 % (4/55) and 5.71% (200/3,502), respectively, and no statistically significant difference was found between the two groups (χ²=0.244, P=0.621).The infection rates in patients without pulmonary tuberculosis symptoms, patients with cough and expectoration for less than 2weeks and patients with cough and expectoration for 2 weeks or more were 5.69% (200/3,513), 8.33% (3/36), and 12.50% (1/8), respectively, and no statistically significant difference was found in the infection rates among the three groups (χ²=1.138, P=0.566). Conclusion The overall infection rate of Mycobacterium tuberculosis among the middle school students in Changsha City was 5.74%. The infection rate of tuberculosis is positively correlated with age. The older the age, the higher theinfection rate.