School of Medicine, Ningbo University, Ningbo 315211, China.
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
Int J Environ Res Public Health. 2018 Sep 17;15(9):2024. doi: 10.3390/ijerph15092024.
: To explore the incidence rate and characteristics of tuberculosis (TB) among full-time teachers from 2005 to 2016 in southeast China and to provide a basis for TB prevention and control measures in schools. : Information about full-time teachers with TB was obtained from the National Tuberculosis Information Management System (NTIMS). Population data were collected from the Zhejiang Statistical Yearbook and the Zhejiang Education Yearbook. The TB incidence rates and epidemiological characteristics of full-time teachers were analyzed and the Chi-square test was used to analyze influencing factors of epidemiological characteristics and clinical characteristics, case-finding delay, and treatment outcomes. : A total of 1795 teachers with TB were reported from 2005 to 2016, and the annual incidence rate was 28.87 per 100,000. The average annual PTB (pulmonary TB) incidence rate among full-time teachers was 25.43/100,000 from 2005 to 2016 and the average annual PTB incidence rate among students was 15.40/100,000 from 2005 to 2016. The highest average incidence rates were observed in the QZ (Quzhou) and HZ (Hangzhou) districts. The male-to-female ratio of the patients was 0.95:1. Approximately half of the patients were 15⁻40 years old. The mean case-finding interval was 45.3 days. Multivariable logistic regression analysis of TB case-finding delay among full-time teachers revealed that the older (OR = 1.44, 95% CI = 1.18⁻1.76, < 0.01), not local (OR = 1.81, 95% CI = 1.20⁻2.73, < 0.01), retreatment (OR = 2.06, 95% CI = 1.39⁻3.08, < 0.01) and extra-pulmonary tuberculosis (OR = 1.71, 95% CI = 1.13⁻2.61, = 0.01) cases were at high risk of case-finding delay. Compared to physical examination, patients detected by referrals and tracking (OR = 2.26, 95% CI = 1.16⁻4.38, = 0.02) and patients who directly visited the designated TB hospital (OR = 2.00, 95% CI = 1.03⁻3.88, = 0.04) were more prone to case-finding delay. The cure rate of full-time teachers with TB was 77.10%. The cure rates differed significantly between groups classified based on age, case-finding patterns, diagnostic results, treatment classifications, and strategies of patient management. : The TB incidence rate among full-time teachers decreased from 2005 to 2016, but teachers suffered a higher risk of TB than students. Western Zhejiang was a hotspot for TB incidence among full-time teachers. Female teacher and young and middle-aged teacher cases account for the majority of the reported patients. There was a case-finding delay among full-time teachers with TB. We should conduct regular physical examinations and strengthen full-course supervision to reduce the risk of TB patients with case-finding delay and increase the TB cure rate.
探讨中国东南部地区 2005 年至 2016 年期间全职教师的结核病（TB）发病率和特征，为学校结核病防控措施提供依据。
从全国结核病信息管理系统（NTIMS）获取有 TB 的全职教师的信息。人口数据来自《浙江统计年鉴》和《浙江教育年鉴》。分析全职教师的 TB 发病率和流行病学特征，并使用卡方检验分析影响流行病学特征和临床特征、发现延迟、治疗结局的因素。
2005 年至 2016 年共报告 1795 例 TB 教师，发病率为 28.87/10 万。2005 年至 2016 年，全职教师中肺结核（PTB）的年均发病率为 25.43/10 万，同期学生中 PTB 的年均发病率为 15.40/10 万。衢州市（QZ）和杭州市（HZ）的发病率最高。患者中男女比例为 0.95:1。约一半的患者年龄在 15⁻40 岁之间。平均发现间隔为 45.3 天。对全职教师的 TB 发现延迟进行多变量逻辑回归分析显示，年龄较大（OR = 1.44，95%CI = 1.18⁻1.76， < 0.01）、非本地（OR = 1.81，95%CI = 1.20⁻2.73， < 0.01）、复治（OR = 2.06，95%CI = 1.39⁻3.08， < 0.01）和肺外结核（OR = 1.71，95%CI = 1.13⁻2.61， = 0.01）的病例发生发现延迟的风险较高。与体检相比，通过转诊和追踪发现的患者（OR = 2.26，95%CI = 1.16⁻4.38， = 0.02）和直接到指定结核病医院就诊的患者（OR = 2.00，95%CI = 1.03⁻3.88， = 0.04）更易发生发现延迟。全职教师的 TB 治愈率为 77.10%。根据年龄、发现模式、诊断结果、治疗分类和患者管理策略进行分组，治愈率存在显著差异。
全职教师的 TB 发病率从 2005 年至 2016 年呈下降趋势，但教师患 TB 的风险高于学生。浙西是全职教师 TB 发病率的热点地区。女性教师和中青年教师病例占报告患者的大多数。全职教师的 TB 存在发现延迟。我们应定期进行体检，并加强全程监督，以降低 TB 发现延迟患者的风险，提高 TB 治愈率。
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