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2024年贵州省黔南布依族苗族自治州12县（市）中学生结核潜伏感染情况及影响因素分析

Latent tuberculosis infection and influencing factors among middle school students in 12 counties(cities) of Qiannan Buyi and Miao Autonomous Prefecture, Guizhou province in 2024

    摘要
  • 摘要:
    目的 分析2024年贵州省黔南布依族苗族自治州（黔南州）中学生结核病筛查数据，获得结核潜伏感染（LTBI）情况及影响因素，为制定和优化贵州省黔南州学校结核病预防性治疗工作策略提供科学依据。
    方法 采用基于普查的横断面调查方法，于2024年对黔南州12县（市）初一、初二、高二和职中二年级学生开展结核感染筛查，并采用加权logistic多因素模型对影响结核潜伏感染率的因素进行分析。
    结果 在142 574名接受感染筛查的学生中，加权感染率约为2.46%（95%CI：2.38～2.54）。 多因素加权分析结果显示，初二、高二和职业中学（职中）二年级学生的LTBI感染风险比初一年级更高（分别为OR=1.24, 95%CI: 1.13～1.35, P<0.05；OR=2.07, 95%CI: 1.89～2.26, P<0.05；OR=2.33, 95%CI: 2.01～2.71, P<0.05）；与三都水族自治县相比，其余11县（市）的LTBI感染风险均更高（均P值<0.05）；3个月内有病原学阳性肺结核患者密切接触史学生的LTBI感染风险显著高于无接触史学生（OR=15.86, 95%CI: 11.00～22.88, P<0.05）。
    结论 2024年黔南州12县（市）中学生的结核潜伏感染率较低，感染率受年级、地区和密接史等因素影响，未来应重点关注高年级、高疫情地区，以及病原学阳性肺结核患者密切接触者等高风险人群。

     

    Abstract:
    Objective To analyze tuberculosis (TB) screening data among middle and high school students in Qiannan Buyi and Miao Autonomous Prefecture (Qiannan prefecture), Guizhou province, in 2024 and determine the prevalence and influencing factors of latent tuberculosis infection (LTBI), the findings aim to provide scientific evidence for the formulation and optimization of school-based TB preventive treatment strategies in Qiannan prefecture.
    Methods A cross-sectional study was conducted in 2024 to screen students from junior high school and above across 12 counties and cities in Qiannan prefecture for TB infection. A multivariate logistic regression model was applied to identify influencing factors.
    Results Among 142 574 students screened for TB infection, the weighted prevalence of LTBI was approximately 2.46% (95%CI: 2.38–2.54). Multivariate weighted analysis revealed that higher risk of LTBI among students in second-year junior high, second-year senior high, and second-year vocational school compared to those with first-year junior high school students (OR=1.24, 95%CI: 1.13−1.35, P<0.05; OR=2.07, 95%CI: 1.89−2.26, P<0.05; OR=2.33, 95%CI: 2.01−2.71, P<0.05). Compared with Sandu Shui Autonomous County, students in the other 11 counties showed a significantly higher risk of LTBI (all P<0.05). Additionally, students with a history of close contact with bacteriologically confirmed TB cases within the past three months had a markedly higher risk of LTBI compared to those without such contact (OR=15.86, 95%CI: 11.00−22.88, P<0.05).
    Conclusion The 2024 survey revealed a relatively low prevalence of latent tuberculosis infection among secondary school students across 12 counties (cities) in Qiannan prefecture. The infection rate was influenced by factors including grade level, geographical location, and history of close contact with TB patients. Future prevention efforts should prioritize high-risk populations, particularly senior-grade students, residents in high-prevalence areas, and close contacts of bacteriologically confirmed pulmonary tuberculosis patients.

     

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