2020~2024年重庆市南岸区学生肺结核 流行病学特征分析

Analysis of Epidemiological Characteristics of Tuberculosis among Students in Nan’an District, Chongqing, 2020~2024

摘要: 目的：分析2020~2024年重庆市南岸区学生肺结核流行特征及密切接触者筛查情况，为今后学校结核病的预防控制策略的制定提供依据。方法：通过《中国疾病预防控制信息系统》和重庆市南岸区疾病预防控制中心调查处置的学校结核病资料，收集2020~2024年重庆市南岸区学生结核病例数据。采用描述流行病学方法对学生肺结核流行特征及密切接触者筛查情况进行分析。结果：2020~2024年，重庆市南岸区共报告学生肺结核病例253例，年均报告发病率为20.54/10万，总体呈下降趋势(χ²_趋势 = 9.844, P = 0.002)。3、8月份报告病例数较多(季节指数分别为132.70%、137.44%)；男女性别比为1.18:1；≥19岁年龄组病例数最多(155例，占61.26%)，<13岁年龄组最少(11例，4.34%)；5年间，高中学生患者构成比呈上升趋势(χ²_趋势 = 10.933, P = 0.001)，小学生患者构成比呈下降趋势(χ²_趋势 = 4.84, P = 0.028)。患者来源以因症就诊为主(占75.10%)，诊断结果以病原学阴性为主(53.36%)，海棠溪街道报告病例数最多(126例，49.80%)。共筛查密切接触者9162人，结核菌素皮肤试验强阳性率为3.95%，各年间差异有统计学意义(χ² = 19.971, P = 0.001)；检出活动性肺结核患者11人，检出率0.12%。结论：重庆市南岸区学生肺结核报告发病率虽呈下降趋势，但防控形势依然严峻，需重点关注高中和大学学生群体，强化学校防控措施。进一步强化学校与疾控机构之间的协作，完善信息共享与预警机制，并积极利用新媒体平台拓展宣传途径，提高结核病防治知识覆盖面，有效遏制校园内传播。

Abstract: Objective: To analyze the epidemiologic characteristics of tuberculosis (TB) among students and the outcomes of close-contact screening in Nanan District, Chongqing, from 2020 to 2024, in order to provide evidence for future school-based TB control strategies. Methods: Data on student tuberculosis cases in Nan’an District, Chongqing Municipality from 2020 to 2024 were collected through the “China Disease Prevention and Control Information System” and the investigation and management of school TB outbreaks by the Nan’an District Center for Disease Control and Prevention. The epidemiologic characteristics of TB among students and the outcomes of contact screening were analyzed using descriptive epidemiological methods. Results: A total of 253 student TB cases were notified in Nan’an District of Chongqing from 2020 to 2024, with an average annual notification rate of 20.54 per 100,000 and a significant downward trend (χ²_trend = 9.844, P = 0.002). Higher case numbers were reported in March and August, with seasonal indices of 132.70% and 137.44%, respectively. The male-to-female ratio was 1.18:1. The age group ≥ 19 years had the highest number of cases (155 cases, 61.26%), whereas the age group < 13 years had the lowest number (11 cases, 4.34%). Over the 5 years, the proportion of high-school patients increased significantly (χ²_trend = 10.933, P = 0.001), whereas that of elementary-school patients decreased (χ²_trend = 4.84, P = 0.028). The majority of patients sought treatment for specific symptoms (75.10 %). The diagnostic results were predominantly negative for pathogens (53.36 %). The highest number of reported cases was in Haitangxi Subdistrict (n = 126, 49.80 %). A total of 9162 close contacts were screened, and the tuberculin skin test strongly positive rate was 3.95 %. The difference across years was statistically significant (χ² = 19.971, P = 0.001). Eleven active pulmonary TB patients were detected, yielding a detection rate of 0.12%. Conclusions: Although the reported incidence of TB among students in Nan’an District of Chongqing shows a downward trend, the prevention and control situation remains severe. Special attention should be given to high-school and university students, and school prevention and control measures should be strengthened. Schools and disease control agencies should further strengthen collaboration, improve information-sharing and early-warning mechanisms, and actively leverage new-media platforms to expand outreach. These measures will enhance coverage of TB prevention knowledge and effectively curb transmission on campuses.