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中国防痨杂志 ›› 2022, Vol. 44 ›› Issue (6): 617-624.doi: 10.19982/j.issn.1000-6621.20220039

• 论著 • 上一篇    下一篇

上海市部分养老机构结核病防控相关措施实施情况调查

陈静, 饶立歆, 肖筱, 吴哲渊, 沈鑫()   

  1. 上海市疾病预防控制中心结核病与艾滋病防治所,上海 200336
  • 收稿日期:2022-02-21 出版日期:2022-06-10 发布日期:2022-06-01
  • 通信作者: 沈鑫 E-mail:shenxin@scdc.sh.cn
  • 基金资助:
    上海市加强公共卫生体系建设三年行动计划(2020—2022年)学科人才建设项目(GWV-10.2-XD23)

Investigation on the implementation of tuberculosis prevention and control measures in some pension institutions in Shanghai

CHEN Jing, RAO Li-xin, XIAO Xiao, WU Zhe-yuan, SHEN Xin()   

  1. Division of Tuberculosis and HIV/AIDS Control and Prevention, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China
  • Received:2022-02-21 Online:2022-06-10 Published:2022-06-01
  • Contact: SHEN Xin E-mail:shenxin@scdc.sh.cn
  • Supported by:
    Three-Year Initiative Plan for Strengthening Public Health System Construction in Shanghai(GWV-10.2-XD23)

摘要:

目的: 了解上海市养老机构对结核病防控措施实施情况和工作人员对结核病核心信息知晓情况,为完善养老机构结核病防控措施提供依据。 方法: 2019年1—4月,上海市疾病预防控制中心组织上海市7个区的84家养老机构(城区30家、郊区54家)和其中的21家机构内的858名工作人员(城区234名,郊区624名)开展问卷调查。对养老机构中工作人员和入住老年人在入职/入住前后的胸片检查、结核病等传染病防控措施落实,以及工作人员接受传染病相关培训和对结核病防治核心信息知晓情况进行分析。 结果: 养老机构要求工作人员和老年人在入职/住前后定期进行胸片检查的比例分别为76.2%(64/84)和79.8%(67/84)、98.8%(83/84)和73.8%(62/84);落实每日查房制度、传染病报告制度、消毒隔离制度和传染病(包括结核病)相关知识培训的机构分别占97.6%(82/84)、89.3%(75/84)、91.7%(77/84)和81.0%(68/84)。其中,城区养老机构对工作人员入职前后和老年人入住后胸片检查的比例[分别为93.3%(28/30)、86.7%(26/30)、93.3%(28/30)],以及在传染病报告制度、消毒隔离制度和传染病(包括结核病)相关知识培训制度的落实情况[分别为100.0%(30/30)、100.0%(30/30)、96.7%(29/30)]均明显优于郊区机构[分别为66.7%(36/54)、75.9%(41/54)、63.0%(34/54)、83.3%(45/54)、87.0%(47/54)、72.2%(39/54)],差异均有统计学意义(χ2值分别为9.179、6.579、11.580、5.600、4.242、7.474,P值分别为0.010、0.037、0.003、0.018、0.039、0.006)。858名工作人员中,城区工作人员在入职前和入职后接受传染病相关培训率[分别为76.5%(179/234)和79.9%(187/234)]均高于郊区工作人员[分别为63.0%(393/624)和69.2%(432/624)](χ2值分别为13.988、9.666,P值分别为<0.001、0.002);对咳嗽超过2周、有咳痰和发热疑似症状,以及结核病是呼吸道传染病的知晓率[分别为88.5%(201/227)、74.9%(170/227)、49.3%(112/227)、95.2%(216/227)]均高于郊区工作人员[分别为71.3%(427/599)、64.3%(385/599)、41.1%(246/599)、84.8%(508/599)],差异均有统计学意义(χ2值分别为26.911、8.416、4.586、16.280,P值分别为<0.001、0.004、0.032、<0.001)。 结论: 养老机构应加强工作人员入职前后的胸片检查和传染病(包括结核病)相关知识培训,以及老年人入住后的胸片检查,尤其是郊区养老机构。

关键词: 老人疗养院, 结核, 传染病控制, 问卷调查

Abstract:

Objective: To investigate the implementation of tuberculosis (TB) prevention and control measures and the staff's knowledge of core information of TB in pension institutions in Shanghai, so as to provide basis for improving TB prevention and control measures. Methods: A questionnaire survey was conducted in 84 pension institutions (30 located in urban arears and 54 located in suburban areas) and 858 staff from 21 pension institutions of them in seven districts in Shanghai (234 from urban areas and 624 from suburban areas) from January to April, 2019. The implementation of chest X-ray for the staff and the elderly before and after entering the pension institutions,TB and other infectious diseases prevention and control measures, as well as the training for staff on infectious diseases and their knowledge of the core information of TB prevention and control were analyzed. Results: The proportions of regular chest X-ray test before and after entering pension institutions were 76.2% (64/84) and 79.8% (67/84) of the staff, and 98.8% (83/84) and 73.8% (62/84) of the elderly. The proportions of implementing daily round of checking, infectious diseases report, disinfection and isolation of epidemic and training of infectious diseases (including TB) were 97.6% (82/84), 89.3%(75/84), 91.7% (77/84) and 81.0% (68/84), respectively. The proportions of chest X-ray test for the staff before and after entering pension institutions, and for the elderly after entering pension institutions were 93.3% (28/30), 86.7% (26/30), and 93.3% (28/30) in urban areas, which were significantly higher than those in suburban areas (66.7% (36/54), χ2=9.179, P=0.010; 75.9% (41/54), χ2=6.579, P=0.037; 63.0% (34/54), χ2=11.580, P=0.003, respectively), and so were the infectious diseases report (100.0% (30/30) vs. 83.3% (45/54), χ2=5.600, P=0.018), disinfection and isolation of epidemic (100.0% (30/30) vs. 87.0% (47/54), χ2=4.242, P=0.039) and training of infectious diseases (including TB)(96.7% (29/30) vs. 72.2% (39/54), χ2=7.474, P=0.006). Among the 858 staff, those who in urban areas had significantly higher proportion of receiving training on infectious diseases both before and after entering nursing home than those in suburban areas (76.5% (179/234) vs. 63.0% (393/624), χ2=13.988, P<0.001; (79.9% (187/234) vs. 69.2% (432/624), χ 2=9.666, P=0.002, respectively).In staff from urban areas, the proportions of awareness rate of cough over 2 weeks (88.5% (201/227) vs. 71.3% (427/599), χ2=26.911, P<0.001), expectoration (74.9% (170/227) vs. 64.3% (385/599), χ 2=8.416,P=0.004), suspected symptoms of fever (49.3% (112/227) vs. 41.1% (246/599), χ2=4.586,P=0.032), and TB is a respiratory infectious disease (95.2% (216/227) vs. 84.8% (508/599), χ2=16.280, P<0.001) were significantly higher than those in suburban areas. Conclusion: Chest X-ray for the staff before and after entering pension institution, and for the elderly after entering pension institution, as well as trainings on infectious diseases (including TB) to the staff should be further strengthened, especially in suburban areas.

Key words: Homes for the aged, Tuberculosis, Communicable disease control, Questionnaires

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