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[近期结核病暴发中首例病例职业的影响]

[Influence of occupation of the index cases in recent outbreaks of tuberculosis].

作者信息

Hoshino Hitoshi, Uchimura Kazuhiro, Kato Seiya

机构信息

Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan.

出版信息

Kekkaku. 2009 Oct;84(10):661-6.

Abstract

UNLABELLED

PURPOSE, MATERIALS AND METHODS: In order to elucidate risk factors of TB outbreaks, 223 outbreaks reported between 2000 and 2006 in Japan were analyzed according to sex, occupation and outbreaking place of the index case.

RESULTS

In male, the most frequent occupation was permanent workers who infected contacts mainly at workplaces, followed by unemployed people at general hospital or nursing home for the aged. The third was students who infected contacts mostly at school, followed by customer relations workers at companies or amusement places. In female, the most frequent occupation was students who infected contacts at school. Second most frequent was unemployed who infected contacts at general hospitals and nursing homes for the aged, followed by nurses at general hospitals or mental hospitals. Frequent outbreak places were workplaces, schools, general hospitals, amusement places and mental hospitals in male, and general hospitals and schools in female. The risk of becoming the source of TB outbreak was high in teachers/doctors, students, unemployed as well as customer relations workers in male, and teachers/doctors, students as well as nurses in female.

DISCUSSION

The most important point to prevent outbreaks of TB is to find out TB suspects with relevant symptoms for tuberculosis as early as possible to minimize patient's delay, especially from people with high risk of TB infection to others such as teachers/doctors, students and medical nurses. As most frequent job and place were general permanent workers at workplaces, TB control activities to minimize patient's delay at general workplace is also important.

摘要

未标注

目的、材料与方法:为阐明结核病暴发的风险因素,对2000年至2006年日本报告的223起结核病暴发事件,按首例病例的性别、职业及暴发地点进行了分析。

结果

男性方面,最常见职业是长期工人,他们主要在工作场所感染接触者,其次是综合医院或老年护理院的失业人员。第三是学生,他们大多在学校感染接触者,其次是公司或娱乐场所的客户关系工作人员。女性方面,最常见职业是在学校感染接触者的学生。其次是在综合医院和老年护理院感染接触者的失业人员,然后是综合医院或精神病院的护士。男性常见的暴发地点是工作场所、学校、综合医院、娱乐场所和精神病院,女性则是综合医院和学校。男性中教师/医生、学生、失业人员以及客户关系工作人员,女性中教师/医生、学生以及护士成为结核病暴发源头的风险较高。

讨论

预防结核病暴发的最重要一点是尽早发现有结核病相关症状的结核病疑似患者,以尽量减少患者的延误,特别是从结核病感染高风险人群向教师/医生、学生和医护人员等其他人传播。由于最常见的职业和地点是工作场所的一般长期工人,在一般工作场所开展尽量减少患者延误的结核病控制活动也很重要。

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