Analysis of tuberculosis screening for newly enrolled students in Hunan Province from 2018 to 2020

Abstract

Objective To understand tuberculosis screening for newly enrolled students in Hunan Province and to provide reference for scholl-based tuberculosis (TB) prevention and control.

Methods During 2018 to 2020, TB screening was carried out for newly enrolled students in Hunan Province, and the screening results were statistically analyzed by descriptive analysis and χ ² test.

Results In 2018-2020, the average incidence rate of TB among students in Hunan Province was 20.90/100 000, with a decreasing trend by year (χ ² _trend=89.45, P<0.01), the screening rate of TB in schools was 87.30%, and the screening rate for newly enrolled students was 86.81%, with downward trend by year (χ ² _trend=2 843.34, 83 443.77, P<0.01). The proportion of suspicious symptoms, close contact, and active pulmonary TB patients among students were 0.53%, 0.21%, and 1.73/10 000, respectively, with decreasing trends by year (χ ² _trend=8 624.05, 2 215.48, 99.14, P<0.01). The proportion of strong positive PPD/IGRA positive, changes in imaging examination and culture-positive of mycobacterium tuberculosis were 1.52%, 0.20% and 12.40%, with increasing trends by year (χ ² _trend=529.18, 147.65, 25.89, P<0.01). There were statistically significant differences in the proportion of suspicious symptoms, close contact, strong positive PPD/positive IGRA, changes in imaging examination and the proportion of patients with tuberculosis in the regional classification and school classification (χ ²=529.18, 8 823.13, 705.63, 2 068.03, 1 299.00, 4 318.73, 33.12, 2 329.07, 35.80, 1 781.65, P<0.01). There was no statistically significant difference in the proportion of culture-positive of mycobacterium tuberculosis in the regional classification and school classification ( P >0.05).

Conclusion The screening rate of newly enrolled student showed an upward trend, and the incidence rate of tuberculosis among students showed downward trend. Newly enrolled students among fresh students in high school have the highest PPD positive/IGRA positive rate and the proportion of pulmonary tuberculosis in the student population. It is necessary to increase the screening among fresh students in high school. In areas with conditions, tuberculosis screening of senior two students can be considered.

Abstract

【摘要】 目的 了解湖南省人学新生结核病的筛査情况, 为学校结核病控制工作提供参考依据。 方法 对 2018—2020 年 湖南省人学新生开展结核病筛査, 并采用描述性分析、χ ² 检验对筛査结果进行统计学分析。 结果 2018—2020年, 湖南省 在校学生肺结核发病率平均为 20.90/10万, 呈逐年下降的趋势 (χ ² _趋势=89.45, P<0.01), 学校肺结核的筛査率平均为 87.30%, 人学新生肺结核筛査率平均为 86.81%, 均呈逐年下降的趋势 (χ ² _趋势 值分别为 2 843.34, 183 443.77, P 值均<0.01)。人学新生肺结核可疑症状比例、肺结核患者接触史比例、学生人群中活动性肺结核患者比例分别为 0.53%, 0.21%, 1.73/万, 在 3 年间呈逐年下降趋势 (χ ² _趋势 值分别为 8 624.05, 2 215.48, 99.14, P 值均<0.01)。PPD强阳性/IGRA阳性比例、影像学检査疑似肺结核改变比例、病原学阳性比例分别为 1.52%, 0.20%, 12.40%, 在 3 年间呈逐年上升的趋势 (χ ² _趋势 值分 别为 529.18, 147.65, 25.89, P 值均<0.01)。有肺结核可疑症状比例、有肺结核患者接触史比例、胸部影像学检査有疑似肺结 核改变比例、PPD强阳性/IGRA阳性率、学生人群肺结核比例在地区类型和学校类型中差异均有统计学意义 (χ ² 值分别为 529.18,8 823.13, 705.63, 2 068.03, 1 299.00, 4 318.73, 33.12, 2 329.07, 35.80, 1 781.65, P 值均<0.01); 病原学阳性率在地区 类型和学校类型中差异均无统计学意义 ( P 值均>0.05)。 结论 人学新生筛査率呈上升趋势, 学生肺结核发病率呈下降趋 势。髙中人学新生PPD强阳性/IGRA阳性率、学生人群肺结核比例等均最髙, 需加大对髙中新生的筛査力度, 有条件的地 区可考虑开展髙二学生的结核病筛査。