Analysis Of The Characteristics Of TB Epidemic Situation In School In A City In 2011-2016

Objective: To observe the characteristics of TB epidemic situation in the school students in a city,understand the epidemic situation and characteristic in school at present,evaluate and provide the basis for the future TB prevention and control work.Analyze the influence factors of school tuberculosis outbreak and the problems existing in the field epidemiological investigation work,and provide advice and reference of disposal policy and prevention and control TB outbreak in school.Methods: 1.Retrospectively collected students tuberculosis epidemic situation data in the national TB management information system and TB hospital library in a city.Excel combined with SPSS17.0 software to establish a database and statistical,Analysis the epidemic characteristics and outbreak of tuberculosis in school.2.Screening on site including the tuberculin skin test,X-ray chest radiography examination,direct digital X-ray photography syste,clues questionnaire to close contacts of cases.Analysis the distribution of time and people and spatial of the epide-mic situation by field pidemiological investigation.Discuss the outbreak causes,controllable factors,formulate epidemic disposal countermeasures.Put the information about patients and close contacts into Excel spreadsheet and sort,using SPSS17.0 software for statistical analysis.The entire research include descriptive statistics,chi-square test,P<0.05 for the difference was statistically significant.Results:1.A total of 1938 students cases of TB occurred in a city in 2011-2016,report the morbidity of 34.96/105.6 years the incidence declining trend(40.86/105,38.05/105,34.38/105,35.73/105,31.32/105,29.50/105)year by year(?2=21.656,P<0.05).In the student in the diagnosis of active tuberculosis type composition,mostly bacteria sputum negative cases.Sputum smear positive(5.64/105,4.50/105,4.04/105,3.98/105,3.53/105,2.69/105)tuberculosis incidence rates and sputum negative(25.91/105,25.00/105,23.14/105,22.39/105,21.91 /105,18.63/105)downward trend year by year.TB patients average onset age was 19.23±3.124.According to different age groups,more than 18 years of age is on the decline(?2 =30.496,P<0.05).Student tuberculosis incidence in men and women ratio 1.70:1,the number of cases were male higher than female in six years.The onset time concentrated in March to June.A total of 36 TB clustering outbreak in school in a city between 2011 to 2016.A total of 188 cases of pulmonary tuberculosis patients,there are four outbreak accounted for more than 10 cases of patients,including primary and junior high school stage 2 outbreaks occur,8 outbreaks in the high school and technical secondary school,26 outbreaks in university level and TB infected each year.Patients with disease diagnosis and close contacts screening is the mainly way to discover TB outbreak.2011-2016 students tuberculosis incidence in case in a city was statistically significant downward change trend(37.94/105,36.84/105,29.36/105,29.71/105,28.54/105,27.13 /105)(?2=25.805,P<0.05),students tuberculosis incidence clustering trends without statistical significance(2.93/105,1.2/105,5.02/105,6.03/105,2.78/105,2.37/105)(?2=0.311,P>0.05).2.A total of 7 cases of patients,suffering from a rate of 3.27%(7/216).Analyzing the distribution of the tuberculosis epidemic situation: the crowd distribution: 4 males and 3 females;6 cases are TB patients,1 cases of tuberculous pleurisy.Diagnosis results: for the first time TB,the sputum mycobacterium tuberculosis is negative,and imaging data show the illness is lighter.Time distribution: the onset time is relatively concentrated,the cases are newly infected,and infect period characterized by highly overlapping between case Outbreak is in progress.Spatial distribution: cases gathered together in the same class,the class floor without vent instruction,air circulation is limited seriously,ventilation rate is lower in class.Compared the tuberculin test positive rate of entrance examination to this outbreak,the cases of class results was statistically significant,?2=22.175,P < 0.05;One class non-adjacent comparison results difference was statistically significant,?2=4.458,P<0.05.With no secondary cases of PPD strong class,even though the PPD positive rate is higher,secondary cases occurred opportunity is lower than tuberculin high expose class.Conclusion:The report incidence of tuberculosis,the incidence of smear and the incidence of sputum smear negative were all declining in the 2011 to 2016.There are more men than women in school TB cases.The incidence of TB more than 18 years of age has been consistently higher than at all ages since six years,with a decline in the reported incidence of the disease.The number of cases of student tuberculosis was concentrated in the second quarter.There are frequent clusters of outbreaks in the university stage.The incidence of tuberculosis of the student was decreasing,and the incidence of the cluster was insignificant.Aggregation epidemic in tuberculosis is still not optimistic,it is important that prevention and control aggregation epidemic,innovation the strategy of prevention and control in time.For tuberculosis outbreak,decline the risk early warning value,establish a standardized disposal process and specification,application of molecular biology techniques for molecular epidemiology of tuberculosis bacterium relevant investigation cases.Discover the hidden patients in time,creating a good school environment,attaching importance and continue to strengthen school tuberculosis health education.To make the TB outbreak control and prevention and treatment in school more accurate,effective and execution rapidly.