Management of tuberculosis outbreaks in middle schools of Bijie City

Objective To understand the management of tuberculosis outbreaks in middle schools in Bijie City, and to put forward suggestions to improve the quality of tuberculosis epidemic situation in schools. Methods A unified questionnaire was used to investigate the management of tuberculosis outbreaks in middle schools reported by tuberculosis information management system from August 27, 2018 to January 6, 2019 in Bijie City. Results The screening rate of close contacts was 69.72%(99/142), which significantly varied by counties ( P <0.01). The time from the date of diagnosis of patients to screening of close contacts by local CDC was 3 (1-10.5) days. Rate of standardized management process for close contacts aged 15 years or older (0) was lower than that for close contacts aged younger than 15 years old (23.08%) ( P <0.01). 3 462 close contacts were screened for TB symptom, and chest X-ray among those suspected individuals (process 1), and 2 439 close contacts were screened with TB symptom, PPD test, and chest X-ray among those suspected individuals or those with strong positive in PPD test (process 2). The detection rate of pulmonary tuberculosis in close contacts of Grade I was lower in Process 1 (28.89/100 000) than in Process 2 (328.00/100 000) ( χ 2 = 6.56, P = 0.01). The latent infection rate of the first-class close contacts (6.39%) was higher than that of the second-class close contacts (1.93%) ( χ 2 =54.86, P <0.01). Conclusion Management of tuberculosis outbreaks in middle schools in Bijie City in 2018 is effective and timely, but the standardization needs to be improved. 【摘要】 目的 了解毕节市中学结核病疫情处置措施实施情况,为提升学校结核病疫情处置质量提出建议。 方法 采用 统一调查问卷,对毕节市2018年8月27日一2019年1月6日结核病信息管理系统上报的中学肺结核疫情处置情况进行 调查。 结果 密切接触者筛查开展率为69.72%(99/142),不同县（区）间开展率差异有统计学意义（ P <0.01)。患者确诊 之日至属地疾病预防控制机构开展密切接触者筛查工作的时间为3(1〜10.5)d。年龄≥15岁密切接触者的流程规范率 (0)小于<15岁密切接触者(23.08%) ( P <0.01)。3 462名密切接触者开展了症状筛查,发现可疑症状者进行胸片筛查（流 程1);2 439名密切接触者同时进行症状筛查与结核菌素（PPD)试验,对可疑症状者以及PPD强阳性者进行胸片筛查（流 程2)。I级密切接触者筛查肺结核检出率流程1(28.89/10万）小于流程2(328.00/10万）（ χ 2 = 6.56, P =0.01), I 级密切 接触者潜伏感染率(6.39%)大于II级密切接触者（1.93%) ( χ 2 = 54.86, P <0.01)。 结论 毕节市2018年中学结核病疫情处 置开展度较高、较及时,但规范性有待提高。