【摘要】 目的 分析2019—2023年南昌市青山湖区学校肺结核的流行特征及其密切接触者筛查结果，为学校结核病防控工作提供参考依据。方法 收集2019—2023年南昌市青山湖区学校肺结核指标病例及其密切接触者信息，按照《学校结核病防控工作规范（2017版）》及《学校结核病反馈指南（2020版）》相关要求开展筛查，分析密切接触者结核菌素皮肤试验（PPD）结果、胸部X线检查结果和肺结核检出情况。结果2019—2023年南昌市青山湖区共发现学校肺结核指示病例109例，男女比例为1.14∶1，以高中/中专和大学为主（84.42%）；筛查密切接触者4016例，PPD强阳性率及X线胸片影像异常率分别为3.57%和0.35%，不同学校类型、年龄的指示病例的密切接触者PPD强阳性率比较差异有统计学意义（P<0.05和P<0.001），不同病原学结果的指示病例的密切接触者PPD强阳性率比较差异有统计学意义（χ~2=31.759,P<0.001）；此次筛查肺结核检出率0.15%，预防性服药率为5.51%。结论 青山湖区学校应加强肺结核疫情监测、及时规范开展密切接触者筛查及随访管理。更多还原

【Abstract】 Objective To analyze the epidemiological characteristics of tuberculosis(TB) and screening outcomes of close contacts in schools within Qingshanhu District, Nanchang City from 2019to 2023, thereby providing evidence-based references for optimizing TB prevention and control strategies in educational settings. Methods Data on TB index cases and their close contacts within schools in Qingshanhu District, Nanchang City from 2019 to 2023 were systematically collected.Screening procedures were conducted in strict accordance with the Technical Guidelines for TB Prevention and Control in Schools(2017 Edition) and the School Tuberculosis Management Feedback Guidelines(2020 Edition). Analyses were performed on tuberculin skin test(TST/PPD) results, chest radiography findings, and TB detection rates among close contacts. Results From 2019 to 2023, a total of 109 TB index cases were identified in schools within Qingshanhu District, Nanchang City,demonstrating a male-to-female ratio of 1.14: 1. The predominant case distribution was observed in senior high/vocational schools and universities(84.42%). A total of 4, 016 close contacts were screened,with strongly positive PPD reactions and radiographic abnormalities on chest X-rays observed in 3.57%and 0.35% of cases, respectively. Statistically significant differences in PPD strong positivity rates were observed among close contacts stratified by school type(P<0.05) and age of index cases(P<0.001). Furthermore, close contacts of index cases with differing etiological confirmation statuses exhibited significant variance in PPD strong positivity rates(χ~2 =31.759, P<0.001). The TB detection rate in this screening was 0.15%, and the rate of preventive treatment initiation was 5.51%. Conclusion Enhanced surveillance of TB outbreaks should be warranted, and implementation of standardized close contact screening protocols and rigorous follow-up management strategies should be prioritized to optimize TB control measures in schools within Qingshanhu District.更多还原