低估的风险:学校的病原体阴性患者传播结核病
Yaqian Su1, Bijuan Zhong1, Ruiming Chen2
1School of Public Health, Shantou University, 243 Daxue Road, Shantou, 515063, China.
Public health
|December 20, 2025
概括
结核病 (TB) 患者的密切接触者,即使是没有可检测的病原体的人,也有很大的感染风险. 这凸显了针对所有接触类型的更广泛的基于学校的结核病预防策略的需要.
科学领域:
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
- 结核病研究 结核病研究
背景情况:
- 结核病 (TB) 预防策略通常优先考虑病原体阳性结核病患者的接触.
- 关于结核病感染风险在病原体阴性结核病患者的密切接触者中存在有限的数据,特别是在学校环境中.
- 有效的结核病控制需要了解所有患者类型的传播动态.
研究的目的:
- 评估学校中病原体阳性和病原体阴性结核病患者的密切接触者之间的结核感染风险.
- 在这些密切接触者中确定与结核病感染相关的关键因素.
- 在教育环境中为更广泛,更具包容性的结核病预防策略提供信息.
主要方法:
- 在中国山东地区 (2019-2023) 的学校中,对10586名结核病患者的密切接触者进行了一项横截式研究.
- 结核病感染是通过阳性净化蛋白衍生物 (PPD) 试验来确定的.
- 使用后勤回归分析来确定结核病感染的风险因素.
主要成果:
- 结核病感染的总体患病率为17.8%,病原体阴性接触者比病原体阳性接触者 (17.1%) 的比例更高 (18.1%).
- 在病原体阴性患者的接触者中感染的调整后几率比 (OR) 为1.25 (95% CI 1.11-1.40).
- 重要风险因素包括性别,年龄 (15+),与指数病例的关系,学校类型和病原体类型;女性更容易受到感染.
结论:
- 目前的结核病预防策略仅关注病原体阳性病例,可能会错过从病原体阴性病例传染的关键机会.
- 加强学校内所有潜在的结核病源的识别和管理至关重要.
- 需要对病原体阴性结核病患者的接触者进行更严格的监测和预防措施,以减少整体传播风险.
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