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目的通过分析一起一般级结核病突发公共卫生事件发生的原因,为学校肺结核病防控提供依据。方法对出现病例所在班级学生进行结核菌素纯蛋白衍生物(以下简称PPD)试验、X线胸部摄片,可疑者CT复查,对X线胸片检查或CT复查异常者给予痰涂片抗酸杆菌检查。结果发现肺结核病11例,罹患率为1.85%(11/593),其中涂阳肺结核1例、涂阴肺结核9例、结核性胸膜炎1例。涂阳肺结核病例虽不是本次事件的首发病例,但其症状出现的早,是此事件的传染源。结论涂阳肺结核病例发现时间晚,是造成此次一般级结核病突发公共卫生事件的主要原因。加强学校疫情监测,落实晨检和症状监测,建立学生及教师因病缺课登记及病因追踪制度,及时对密切接触者进行预防服药等是控制一般级结核病突发公共卫生事件的有效手段。
Objective To analyze the causes of common public health emergencies in tuberculosis in order to provide basis for the prevention and control of tuberculosis in schools. Methods The cases of students in the class where the tuberculin pure protein derivative (hereinafter referred to as PPD) test, X-ray chest radiography, suspicious CT review, X-ray examination or CT abnormalities were given sputum smear antacid Bacillus check. The results showed that 11 cases of pulmonary tuberculosis, the attack rate was 1.85% (11/593), including smear-positive pulmonary tuberculosis in 1 case, smear-negative pulmonary tuberculosis in 9 cases and tuberculous pleurisy in 1 case. Although smear positive pulmonary tuberculosis cases are not the first case of this incident, but the symptoms appear early, is the source of this incident. Conclusion The late discovery of smear-positive pulmonary tuberculosis cases is the main reason for the public health emergencies of general grade TB. Strengthening the monitoring of epidemics in schools, carrying out morning inspections and symptom monitoring, establishing registration systems for student absenteeism and etiology, and timely preventive medication for close contacts are effective measures to control public health emergencies in general-grade tuberculosis.