Investigation of performance of tuberculosis prevention and control in schools in Jiangxi, 2015−2020
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摘要:
目的 调查“十三五”期间江西省学校结核病防控措施落实及新生入学结核病筛查情况,为优化学校结核病防控工作提供科学依据。 方法 采用分层随机和典型抽样结合的方法抽取江西省的35所初中、37所高中、12所大学,开展现场问卷调查,对数据进行描述性分析和χ2检验。 结果 配置了卫生人员/保健老师的学校比例为75.00%;大学、高中和初中学校卫生人员参加培训比例分别为83.33%、45.95%和65.71%,差异有统计学意义(χ2=6.211,P=0.045);2015 — 2020年期间,各教育阶段学校新生结核病筛查率呈现逐年上升趋势(趋势χ2值分别为21734.383、1054.977、9134.017、492.806;均P<0.001),而各教育阶段新生结核病规范筛查率均出现先下降后上升的趋势(趋势χ2值分别为17914.123、1774.853、16119.091、82321.455;均P<0.001); 结论 江西省入学新生结核病筛查率呈现逐年上升的趋势,但学校结核病防控工作仍存在薄弱环节,争取政策和经费支持、增加学校卫生人员配置并强化知识培训、加强并规范入学新生结核病筛查工作,是未来学校结核病防控工作努力的方向。 Abstract:Objective To investigate the performance of tuberculosis (TB) prevention and control and TB screening in freshmen in schools in Jiangxi province during the 13th Five-Year Plan period and provide scientific basis for the improvement of TB prevention and control in schools. Methods Stratified random sampling and typical sampling methods were used to select 35 junior high schools, 37 senior high schools and 12 universities in Jiangxi to conduct on-site questionnaire surveys. Descriptive analysis and χ2 test were performed on the data. Results Up to 75.00% of the schools had school doctors/health teachers. The proportions of trained health care workers in universities, senior high schools and junior high schools was 83.33%, 45.95% and 65.71%, respectively, the differences were significant (χ2=6.211, P=0.045). From 2015 to 2020, the overall TB screening rate in freshmen showed an increasing trend year by year (Trend χ2=21734.383, 1054.977, 9134.017, 492.806, respectively, all P<0.001), while the standardized screening rate of TB showed a decrease trend first and then an increase trend (Trend χ2=17914.123, 1774.853, 16119.091, 82321.455, respectively, all P<0.001). Conclusion The TB screening rate in freshmen in Jiangxi showed an increase trend year by year, but there are still some problems in the TB prevention and control in schools. Increasing policy and financial supports, improving the allocation and training of school health care workers and strengthening and standardizing the TB screening in freshmen are important for the TB prevention and control in schools and control efforts in the future. -
Key words:
- Tuberculosis /
- School /
- Prevention and control system /
- Jiangxi province
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表 1 2019年江西省各类学校结核病防控措施落实情况
Table 1. Implementation of tuberculosis prevention and control measures in various schools in Jiangxi province in 2019
学校分类 学校数量
(所)建立学校结核病
防控责任制纳入学校年度
工作计划配置卫生人员/
保健老师参加结核病
防治知识培训新生入学体检
结核病筛查因病缺勤和
病因追查初中及以上学校 总体 84 77(91.67) 65(77.38) 63(75.00) 50(59.52) 53(63.10) 76(90.48) 初中 35 31(88.57) 27(77.14) 23(65.71) 23(65.71) 20(57.14) 31(88.57) 高中 37 35(94.59) 27(72.97) 29(78.38) 17(45.95) 21(56.76) 35(94.59) 大学 12 11(91.67) 11(91.67) 11(91.67) 10(83.33) 12(100.00) 10(83.33) χ2值/F值 1.011a 1.811 3.613 6.211 8.190 1.890a P值 0.666 0.404 0.164 0.045 0.017 0.299 公办 64 59(92.19) 48(75.00) 51(79.69) 38(59.38) 42(65.63) 57(89.06) 民办 20 18(90.00) 17(85.00) 12(60.00) 12(60.00) 11(55.00) 19(95.00) χ2值 0.024 0.393 3.150 0.002 0.739 0.125 P值 0.878 0.531 0.076 0.960 0.390 0.724 初、高中学校 总体 72 63(91.67) 54(75.00) 52(72.22) 40(55.56) 41(56.94) 66(91.67) 寄宿制 51 44(93.62) 38(74.47) 36(68.09) 24(48.94) 28(57.45) 46(89.36) 非寄宿制学校 21 19(88.00) 16(76.00) 16(80.00) 16(68.00) 13(56.00) 20(96.00) χ2值 0.010 0.022 0.233 5.113 0.298 0.055 P值 0.922 0.881 0.630 0.024 0.585 0.815 注:a. 该变量采用的是Fisher确切概率法进行检验; 括号外数据为学校数(所),括号内数据为构成比(%) 表 2 2015-2020年江西省不同教育阶段新生入学结核病筛查情况比较
Table 2. Comparison of tuberculosis screening in freshmen in different Educational stage in Jiangxi province from 2015 to 2020
教育阶段 筛查情况 2015年 2016年 2017年 2018年 2019年 2020年 合计 趋势χ2值 P值 非寄宿制初中 新生数(人) 19895 21720 22494 25942 28287 23368 141706 接受筛查 1916(9.63) 2025(9.32) 1947(8.66) 11645(44.89) 13295(47.00) 9621(41.17) 40449(28.54) 21734.383 <0.001 规范筛查 1442(7.25) 1461(6.73) 1345(5.98) 9537(36.76) 11129(39.34) 7499(32.09) 32413(22.87) 17914.123 <0.001 寄宿制初中 新生数(人) 17260 19821 21936 23664 24722 23723 131126 接受筛查 8504(49.27) 9799(49.44) 10997(50.13) 13984(59.09) 14505(58.67) 13755(57.98) 71544 1054.977 <0.001 规范筛查 2984(17.29) 3603(18.18) 2658(12.12) 5374(22.71) 5761(23.30) 6187(26.08) 26567(20.26) 1774.853 <0.001 高中 新生数(人) 29296 30818 34063 35021 37492 37508 204198 接受筛查 7969(27.20) 7476(24.26) 9313(27.34) 16365(46.73) 18314(48.85) 16450(43.86) 75887(37.16) 9134.017 <0.001 规范筛查 2843(9.70) 2786(9.04) 1777(5.22) 8418(24.04) 13422(35.80) 9145(24.38) 38328(18.77) 16119.091 <0.001 大学 新生数(人) 52669 55948 52804 57051 57551 62648 338671 接受筛查 49701(94.36) 51682(92.38) 48736(92.30) 52661(92.31) 52633(91.45) 57092(91.13) 312505(92.27) 492.806 <0.001 规范筛查 45495(86.38) 46653(83.39) 10723(20.31) 19702(34.53) 20884(36.29) 27172(43.37) 170629(50.38) 82321.455 <0.001 公办 新生数(人) 101111 109889 113206 120304 123995 122372 690877 接受筛查 56005(55.39) 59342(54.00) 60069(53.06) 78132(64.95) 80939(65.28) 80735(65.98) 415222(60.10) 9303.011 <0.001 规范筛查 40825(40.38) 42863(39.01) 14497(12.81) 39518(32.58) 44240(35.68) 47040(38.44) 228983(33.14) 27136.483 <0.001 民办 新生数(人) 18009 18418 18091 21374 24057 24875 124824 接受筛查 2085(67.11) 11640(63.20) 10924(60.38) 16523(77.30) 17808(74.02) 16183(65.06) 85163(68.23) 2039.280 <0.001 规范筛查 11939(66.29) 11640(63.20) 2006(11.09) 3513(16.44) 6956(28.91) 2963(11.91) 38954(30.35) 29038.509 <0.001 注:括号外数据为人数(人),括号内数据为构成比(%) 表 3 2015-2020年江西省不同教育阶段的公办、民办学校新生结核病规范筛查率情况
Table 3. Standardized screening rate of tuberculosis in freshmen in public and private schools at different Educational stage in Jiangxi province from 2015 to 2020
学校分类 初中 高中 大学 新生数(人) 规范筛查 新生数(人) 规范筛查 新生数(人) 规范筛查 公办 239037 44839(18.76) 174022 34436(19.79) 277818 149708(53.89) 民办 33795 14141(41.84) 30176 3892(12.90) 60853 20921(34.38) χ2值 9312.478 571.315 7598.944 P值 <0.001 <0.001 <0.001 注:括号外数据为人数(人),括号内数据为构成比(%) -
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