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新发传染病电子杂志

新发传染病电子杂志 ›› 2026, Vol. 11 ›› Issue (2): 45-50.doi: 10.19871/j.cnki.xfcrbzz.2026.02.009

• 论著 • 上一篇    下一篇

成都市新都区学校肺结核指示病例流行病学特征及密切接触者结核菌素试验强阳性影响因素分析

肖琪瑶1, 逯嘉2, 蒋春梅3, 杜旌畅4   

  1. 1.成都市新都区疾病预防控制中心重大传染病预防控制科,四川 成都 610500;
    2.四川省疾病预防控制中心结核病防治所,四川 成都 610500;
    3.成都市郫都区疾病预防控制中心传染病预防控制科,四川 成都 611730;
    4.成都医学院公共卫生学院,四川 成都 610500
  • 收稿日期:2025-11-12 出版日期:2026-04-30 发布日期:2026-05-18
  • 通讯作者: 杜旌畅,Email：568091093@qq.com
  • 基金资助:
    2025年成都市医学科研项目（2025443）

Analysis of epidemiological characteristics of school pulmonary tuberculosis index cases and influencing factors for strong positivity in tuberculin test among close contacts in Xindu District, Chengdu

Xiao Qiyao1, Lu Jia2, Jiang Chunmei3, Du Jinchang4   

  1. 1. Major Infectious Disease Prevention and Control Section, Xindu Center for Disease Control and Prevention, Sichuan Chengdu 610500, China;
    2. Tuberculosis Institute, Sichuan Provincial Disease Prevention and Control Center, Sichuan Chengdu 610500, China;
    3. Infectious Disease Prevention and Control Department, Pidu Center for Disease Control and Prevention, Sichuan Chengdu 611730, China;
    4. School of Public Health, Chengdu Medical College, Sichuan Chengdu 610500, China
  • Received:2025-11-12 Online:2026-04-30 Published:2026-05-18

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摘要： 目的 分析成都市新都区学校肺结核指示病例流行病学特征及密切接触者结核菌素试验（tuberculin skin test,TST）强阳性的影响因素,为完善学校结核病防控策略提供参考依据。方法 根据2019—2024年成都市新都区学校肺结核指示病例个案调查表及密切接触者现场流行病学调查报告,采用趋势χ2检验分析肺结核病例报告发病率逐年变化趋势;运用描述性流行病学分析方法,分析病例的三间分布特征;通过多因素Logistic回归分析筛选密切接触者TST强阳性的影响因素。结果 2019–2024年成都市新都区共发现学校肺结核病例198例,年均报告发病率为11.97/10万,总体呈逐年下降趋势（χ2=14.674,P<0.05）。中等职业技术学校的年均报告发病率最高（58.44/10万）,高等学校的累计报告发病数最多（86例,占43.43%）。病例报告时间主要集中在每年的3月、4月、9月、11月。新都街道为指示病例报告的持续高发区域。2019—2024年累计判定密切接触者7448例。多因素Logistic回归分析显示,指示病例职业为学生（OR=3.261,95%CI：2.112~5.006）、所在学校类别为初中（OR=4.178,95%CI：2.061~8.472）、高中（OR=4.781,95%CI：2.338~9.776）、中等职业技术学校（OR=3.094,95%CI：1.470~6.512）、高等学校（OR=3.887,95%CI：1.980~7.629）,以及指示病例为病原学阳性（OR=2.550,95%CI：1.605~4.051）和无病原学结果（OR=2.907,95%CI：1.693~4.993）是其密切接触者TST强阳性的危险因素。结论 2019–2024年成都市新都区学校肺结核报告发病率总体呈逐年下降趋势。指示病例职业为学生,学校类别为初中及以上、指示病例诊断为病原学阳性或无病原学结果是其密切接触者TST强阳性的危险因素。建议实施学校分类管理,针对高风险人群落实预防性治疗,以实现学校肺结核的精准防控。

关键词: 肺结核, 学校/新都区, 指示病例, 密切接触者, 结核菌素试验, 筛查

Abstract: Objective To analyze the epidemiological characteristics of index cases of pulmonary tuberculosis (TB) and their close contacts in schools in Xindu District, Chengdu, and to provide reference for improving school TB prevention and control strategies. Method Based on the individual case questionnaires of school TB index cases and on-site epidemiological investigation reports of close contacts in Xindu District, Chengdu from 2019 to 2024, the trend χ2 test was used to analyze the annual change trend of the reported incidence rate of school TB; the descriptive epidemiological analysis method was adopted to explore the three-dimensional distribution characteristics (time, space, and population) of the cases; multivariate Logistic regression analysis was conducted to identify the influencing factors for the occurrence of strong positivity in the tuberculin skin test (TST) among close contacts. Result A total of 198 school TB cases were reported in Xindu District, Chengdu from 2019 to 2024, with an annual average reported incidence rate of 11.97 per 100 000, showing a continuous downward trend (χ2=14.674, P<0.05). Secondary vocational and technical schools had the highest annual average reported incidence rate (58.44/100 000), while colleges and universities had the largest number of cumulative reported cases (86 cases, accounting for 43.43%). The time of case report is mainly concentrated in March, April, September and November every year. Xindu Sub-district is a persistently high-incidence area for reported index cases. A total of 7,448 close contacts were identified during 2019-2024. Multivariate Logistic regression analysis showed that the risk factors for TST strong positivity in close contacts included: the index case being a student (OR=3.261, 95%CI: 2.112-5.006), the school type being junior high school (OR=4.178, 95%CI: 2.061-8.472), senior high school (OR=4.781, 95%CI: 2.338-9.776), secondary vocational and technical school (OR=3.094, 95%CI: 1.470-6.512), or college/university (OR=3.887, 95%CI: 1.980-7.629), as well as the index case having a positive etiological test result (OR=2.550, 95%CI: 1.605-4.051) or no etiological test result (OR=2.907, 95%CI: 1.693-4.993). Conclusion From 2019 to 2024, the reported incidence rate of pulmonary tuberculosis in schools in Xindu District, Chengdu showed an overall decreasing trend year by year. Risk factors for strong positive TST results among close contacts included the index case being a student, the school type (junior high school, senior high school, vocational and technical secondary school, or institution of higher education), and the index case being etiologically positive or having no etiological test results. It is recommended to implement classified school management and implement preventive treatment for high-risk groups to achieve precise prevention and control of pulmonary tuberculosis in schools.

Key words: Pulmonary tuberculosis, Schools/Xindu District, Index cases, Close contacts, Tuberculin Skin Test, Screening

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