重庆市病原学阳性肺结核患者密切接触者结核分枝杆菌潜伏感染现状及影响因素
作者:
作者单位:

1.重庆市结核病防治所区县科, 重庆 400050;2.涪陵区结核病防治所预防保健科, 重庆 涪陵 408000;3.忠县疾病预防控制中心疾控科, 重庆 忠县 404300;4.合川区疾病预防控制中心结核病防治科, 重庆 合川 401520;5.巴南区疾病预防控制中心传染病与计划免疫科, 重庆 巴南 401320

作者简介:

通讯作者:

吴成果  E-mail: wcguo94@163.com
钟吉元  E-mail: 515590755@qq.com

中图分类号:

R521

基金项目:

“十三五”国家科技重大专项(2017ZX10201302);重庆市首批公共卫生重点学科(专科)


Latent tuberculosis infection among close contacts of positive etiology pulmonary tuberculosis in Chongqing
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Affiliation:

1.District and County Department, Chongqing Institute of Tuberculosis Control and Prevention, Chongqing 400050, China;2.Department of Preventive Health Care, Fuling Institute of Tuberculosis Control and Prevention, Fuling 408000, China;3.Department of Disease Control, Zhongxian Center for Disease Control and Prevention, Zhongxian 404300, China;4.Department of Tuberculosis Control, Hechuan Center for Disease Control and Prevention, Hechuan 401520, China;5.Department of Infectious Diseases and Immunization, Banan Center for Disease Control and Prevention, Banan 401320, China

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    摘要:

    目的 了解病原学阳性肺结核患者密切接触者结核分枝杆菌潜伏感染(LTBI)现状及影响因素,为制定LTBI干预措施提供基础依据。 方法 采用多阶段分层整群随机抽样方法选取重庆市39个区县病原学阳性肺结核患者密切接触者为研究对象,通过问卷调查收集人口学信息等资料,采用γ-干扰素释放试验(IGRA)检测结核分枝杆菌感染状态。采用χ2检验和二元logistic回归模型对LTBI影响因素进行分析。 结果 共纳入密切接触者2 591例,男女性别比为0.69:1,平均年龄(35.72±16.64)岁。检出LTBI 1 058例,结核分枝杆菌潜伏感染率为40.83%。单因素分析结果显示,不同年龄、身体质量指数(BMI)、职业、文化程度、婚姻状态,是否患有慢性病或大手术史,是否与指示病例共同居住,以及与指示病例累计接触时长是否≥ 250 h者,感染率不同,差异均有统计学意义(均P < 0.05);感染率随年龄和BMI升高均呈上升趋势(均P < 0.001),随文化程度升高呈下降趋势(P < 0.05)。Logistic回归分析显示,年龄45~54岁(OR=1.951,95%CI:1.031~3.693)、55~64岁(OR=2.473,95%CI:1.279~4.781)、其他职业(OR=0.530,95%CI:0.292~0.964)、教师(OR=0.439,95%CI:0.242~0.794)、学生(OR=0.445,95%CI:0.233~0.851)、初中及以下文化程度(OR=1.412,95%CI:1.025~1.944)、BMI < 18.5 kg/m2OR=0.762,95%CI:0.586~0.991)、与指示病例共同居住(OR=1.621,95%CI:1.316~1.997)、与指示病例累计接触时长≥ 250 h(OR=1.292,95%CI:1.083~1.540)是LTBI的影响因素(均P < 0.05)。 结论 病原学阳性肺结核患者密切接触者结核分枝杆菌潜伏感染率高,需重点关注高龄、农民、与患者接触程度高的密切接触者,及时采取针对性干预措施以降低发病风险。

    Abstract:

    Objective To investigate the current situation and influencing factors of latent tuberculosis infection (LTBI) among close contacts of positive etiology pulmonary tuberculosis (PTB) patients, provide basis for formulating intervention measures for LTBI. Methods A multi-stage stratified cluster random sampling method was used to select close contacts of positive etiology PTB patients from 39 districts and counties in Chongqing City as the study objects. Demographic information was collected by questionnaire survey and the infection of Mycobacterium tuberculosis was detected by interferon gamma release assay (IGRA). The influencing factors of LTBI were analyzed by χ2 test and binary logistic regression model. Results A total of 2 591 close contacts were included, the male to female ratio was 0.69:1, with the mean age of (35.72±16.64) years. 1 058 cases of LTBI were detected, Mycobacterium tuberculosis latent infection rate was 40.83%. Univariate analysis showed that the infection rate was different among peoples of different age, body mass index (BMI), occupation, education level, marital status, whether they had chronic disease or major surgery history, whether they lived together with the indicator case, and whether the cumulative contact time with the indicator case ≥ 250 hours, difference were all statistically significant (all P < 0.05); infection rate presented increased trend with the increase of age and BMI (both P < 0.001), and decreased trend with the increase of education (P < 0.05). Logistic regression analysis showed that age 45-54 years old (OR=1.951, 95%CI: 1.031-3.693), age 55-64 years old (OR=2.473, 95%CI: 1.279-4.781), other occupations (OR=0.530, 95%CI: 0.292-0.964), teachers (OR=0.439, 95%CI: 0.242-0.794), students (OR=0.445, 95%CI: 0.233-0.851), junior high school education or below (OR=1.412, 95%CI: 1.025-1.944), BMI < 18.5 kg/m2 (OR=0.762, 95%CI: 0.586-0.991), co-living with indicator cases (OR=1.621, 95%CI: 1.316-1.997) and cumulative contact time with indicator cases ≥ 250 hours (OR=1.292, 95%CI: 1.083-1.540) were the influential factors for LTBI (all P < 0.05). Conclusion The close contacts with positive etiology PTB have a high latent infection rate of Mycobacterium tuberculosis, and it is necessary to pay attention to close contacts of high age, farmers, and frequent contact with patients, and take timely targeted interventions to reduce the risk of occurrence of disease.

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引用本文

雷蓉蓉,隆红霞,罗翠红,等.重庆市病原学阳性肺结核患者密切接触者结核分枝杆菌潜伏感染现状及影响因素[J]. 中国感染控制杂志,2024,23(3):265-270. DOI:10.12138/j. issn.1671-9638.20244977.
Rong-rong LEI, Hong-xia LONG, Cui-hong LUO, et al. Latent tuberculosis infection among close contacts of positive etiology pulmonary tuberculosis in Chongqing[J]. Chin J Infect Control, 2024,23(3):265-270. DOI:10.12138/j. issn.1671-9638.20244977.

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  • 收稿日期:2023-09-12
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  • 在线发布日期: 2024-04-28
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