Bozkanat Erkan, Ciftçi Faruk, Apaydin Murat, Kartaloğlu Zafer, Tozkoparan Ergun, Deniz Omer, Sezer Ogün, Ilvan Ahmet, Bilgiç Hayati
Department of Chest Diseases, GATA Haydarpaşa Training Hospital, Istanbul, Turkey.
Tuberk Toraks. 2005;53(1):40-50.
To investigate the reason of high incidence of annual patients with tuberculosis (TB) in a military school previously known by screening tuberculin skin test (TST) and finding out the proportion of annual infection risk (PAIR), the prevalance of TB infection and the distribution for each grades. Our study is a cross-sectional epidemiologic study made about TB infection. TST were screened for all students in the school. 5 TU PPD was injected to every student and after 72 hours, the results were evaluated by measuring the diameter of enduration. Test was repeated after 10 days for negative reactions. Age, sex, the number of BCG wound, smoking and dwelling for last 5 years were asked from the students and their answers were recorded. More than 10 mm enduration for cases who had no BCG and 15 mm enduration for cases who had BCG were accepted positive. Chest roentgenogram was taken for each student enrolled into the study. Infection prevalance and PAIR were calculated after tests and measurements. The total number of students was 948. Of 917 (96.7%) were male and 31 (3.3%) were female. The mean age was 19.72 +/- 1.25. The mean of TST was 12.79 +/- 5.96 mm for all students. According to the number of BCG scar, the numbers of students, percentage and the mean of TST were like that 70 (7.3%) cases no BCG scar 8.41 +/- 7.87 mm, 393 (41.4%) students one BCG scar, 11.94 +/- 6.26 mm, 343 (36.1%) cases two BCG scars, 13.74 +/- 5.12 mm, 142 (14.9%) students three or more then three scars, 14.97 +/- 4.11 mm. In the students who had no BCG, TST positivity was 50%. TB infection prevalance of entire school and PAIR were 46% and 3.44% (respectively). In this study, we found that increased number of BCG wound associated with the increased diameter of TST enduration. The proportion of unvaccinated students was similar to the same age population in our country but it showed differences in the distribution of regions. The students who started first grade had serious TB infection risk in their first school year. We think that PAIR values derived from TST conversions done in high risky community by screening annual TST could show all aspects of TB infection risk in those community.
为调查某军校以往通过结核菌素皮肤试验(TST)筛查发现的结核病(TB)年度患者高发病率的原因,同时了解年度感染风险比例(PAIR)、TB感染患病率及各年级分布情况。本研究是一项关于TB感染的横断面流行病学研究。对该校所有学生进行TST筛查。给每位学生注射5 TU的PPD,72小时后通过测量硬结直径评估结果。对阴性反应者10天后重复检测。询问学生年龄、性别、卡介苗接种瘢痕数量、吸烟情况及过去5年居住情况并记录。无卡介苗接种史者硬结直径超过10 mm以及有卡介苗接种史者硬结直径超过15 mm判定为阳性。对纳入研究的每位学生进行胸部X线检查。检测和测量后计算感染患病率及PAIR。学生总数为948人。其中男生917人(96.7%),女生31人(3.3%)。平均年龄为19.72±1.25岁。所有学生TST平均直径为12.79±5.96 mm。根据卡介苗瘢痕数量,学生人数、百分比及TST平均值如下:无卡介苗瘢痕者70人(7.3%),8.41±7.87 mm;有1个卡介苗瘢痕者393人(41.4%),11.94±6.26 mm;有2个卡介苗瘢痕者343人(36.1%),13.74±5.12 mm;有3个或更多卡介苗瘢痕者142人(14.9%),14.97±4.11 mm。无卡介苗接种史的学生中,TST阳性率为50%。全校TB感染患病率及PAIR分别为46%和3.44%。本研究发现,卡介苗接种瘢痕数量增加与TST硬结直径增大相关。未接种疫苗学生的比例与我国同年龄人群相似,但地区分布存在差异。一年级学生在其入学第一学年有严重的TB感染风险。我们认为,通过年度TST筛查在高风险社区进行TST转换得出的PAIR值可显示这些社区TB感染风险的各个方面。