CAJ | 학술논문

目的了解上海地区小学生潜伏结核感染的分布情况并分析影响儿童潜伏结核感染的因素.方法以上海市浦东新区和杨浦区四所小学四、五年级在校学生作为研究对象,问卷调查形式收集研究对象的基本信息和结核感染相关信息,结核感染T细胞斑点试验(T-SPOT.TB)技术了解结核感染情况,单因素和多因素分析研究影响小学生结核感染状况的因素.结果本研究共纳入小学生472名,其中有卡介苗接种史者439人,占93.0%,与结核患者既往有过接触的学生10人,占2.1%.472名小学生中16人T-SPOT.TB检测阳性,占3.4%,但无结核相关的临床症状和体征,为潜伏结核感染者.接种卡介苗者潜伏结核感染率为2.7%,未接种者为12.1%(OR:6.972,95% CI:1.834～26.500);有结核接触史者潜伏结核感染率为30.0%,无接触史者为2.8%(OR:16.38,95% CI:3.692～72.700).结论上海市小学高年级学生的潜伏结核感染率为3.4%,卡介苗接种对预防上海学龄儿童潜伏结核感染有保护作用,而日常生活中与结核患者接触增加了儿童潜伏结核感染的危险性.
목적 료해상해지구소학생잠복결핵감염적분포정황병분석영향인동잠복결핵감염적인소.방법 이상해시포동신구화양포구사소소학사、오년급재교학생작위연구대상,문권조사형식수집연구대상적기본신식화결핵감염상관신식,결핵감염T세포반점시험(T-SPOT.TB)기술료해결핵감염정황,단인소화다인소분석연구영향소학생결핵감염상황적인소.결과 본연구공납입소학생472명,기중유잡개묘접충사자439인,점93.0%,여결핵환자기왕유과접촉적학생10인,점2.1%.472명소학생중16인T-SPOT.TB검측양성,점3.4%,단무결핵상관적림상증상화체정,위잠복결핵감염자.접충잡개묘자잠복결핵감염솔위2.7%,미접충자위12.1%(OR:6.972,95% CI:1.834～26.500);유결핵접촉사자잠복결핵감염솔위30.0%,무접촉사자위2.8%(OR:16.38,95% CI:3.692～72.700).결론 상해시소학고년급학생적잠복결핵감염솔위3.4%,잡개묘접충대예방상해학령인동잠복결핵감염유보호작용,이일상생활중여결핵환자접촉증가료인동잠복결핵감염적위험성.
Objective To investigate the prevalence of latent tuberculosis infection(LTBI),and to identify the risk factors in primary schoolchildren from Shanghai through the population-based field investigation combined with the tuberculosis infection enzyme-linked immunospot assay(T-SPOT.TB)assay.Methods The children in grade 4 and 5 were enrolled from four primary schools in Pudong new district and Yangpu district of Shanghai.Questionnaire interview was applied to investigate the soeiodemographic and clinical information related to LTBI.The T-SPOT.TB assay was used to detect LTBI in the enrolled subjects.Univaitate and multivariate analyses were used to identify the risk factors associated with LTBI among the primary schoolchildren.Results Totally 472 schoolchildren were enrolled in the present study,with 439(93.0%)being vaccinated with bacillus calmette-guerin (BCG) and ten (2.1%) having contact history with tuberculosis (TB) patients.Among the 472 eligible subjects,16(3.4%) children were T-SPOT.TB positive,who had no clinical symptoms andsigns relevant to TB and were defined as LTBI.The LTBI prevalence in BCG vaccinated and unvaccinated children were 2.7% and 12.1%,respectively (OR:6.972;95%CI:1.834-26.500);those in TB contacts and children without TB contact history were 30.0% and 2.8%, respectively (OR: 16. 38; 95% CI: 3. 692-72. 700). Conclusions The prevalence of LTBI among senior schoolchildren in Shanghai is 3.4%. BCG vaccination is protective for children from LTBI, while daily contacts with TB patients increases the risk of LTBI in schoolchildren.