关键词: 结核,肺, 接触者追踪, 人群监测, 传染病控制

Abstract: Objective: To analyze the tuberculosis screening of close contacts of pathogenic positive pulmonary tuberculosis patients in Sichuan Province from 2018 to 2022, and to provide a theoretical basis for the screening and management of close contacts. Methods: The pathogenic positive pulmonary tuberculosis patients and the close contacts (those who have direct contact with the pathogenic positive pulmonary tuberculosis patients from within 3 months after the diagnosis to 14 days after the start of anti-tuberculosis treatment) registered in the “Tuberculosis Information Management System” between January 1, 2018 and December 30, 2022 were selected as the survey objects. Of them, the close contacts were all screened, and the close contacts registered in 2022 were the follow-up subjects. The screening of tuberculosis and the detection of active tuberculosis in close contacts at different times and of different types were analyzed. Results: From 2018 to 2022, a total of 99273 pathogenic positive pulmonary tuberculosis patients were reported in Sichuan Province, and 260661 close contacts were registered, of which 260291 (99.86%) were screened for suspected symptoms of tuberculosis, and 2623 active pulmonary tuberculosis patients were detected, with an average detection rate of 1.01%. The tuberculosis inspection rate (98.50%, 6425/6523) and detection rate (4.54%, 292/6425) of close contacts with suspected tuberculosis symptoms were significantly higher than those of close contacts without suspected tuberculosis symptoms (86.40%, 219247/253768) and detection rate (1.06%, 2331/219247), with a statistically significant difference (χ² values were 807.587 and 658.621, respectively, both P<0.001). The examination rate of tuberculosis in close contacts outside the family (96.53%, 82173/85129) was significantly higher than that in close contacts inside the family (81.92%, 143499/175162), with a statistically significant difference (χ²=10595.710, P<0.001). The detection rate of active pulmonary tuberculosis in close contacts within the family (1.58%, 2264/143499) was significantly higher than that of close contacts outside the family (0.44%, 359/82173), and the difference was statistically significant (χ²=591.968, P<0.001). The 42078 close contacts of newly registered pathogenic positive pulmonary tuberculosis patients in 2022 were screened for symptoms at the time of diagnosis, 39056 (92.82%) were examined for tuberculosis, and 719 (1.84%) active pulmonary tuberculosis patients were detected; 35.39% (9705/27423) completed the second follow-up (6 months after the first screening); 55.31% (5368/9705) received tuberculosis examination, and 2 (0.04%) active tuberculosis patients were detected; only 7.08% (4072/57474) completed the third follow-up (one year after the first screening), 38.33% (1561/4072) received tuberculosis examination, and one (0.06%) active tuberculosis patient was detected. Conclusion: From 2018 to 2022, the screening proportion of close contacts of pathogenic positive pulmonary tuberculosis patients in Sichuan Province was relatively high, but the screening effect was unsatisfactory. We should pay attention to the screening of tuberculosis of close contacts outside the home, and pay attention to the follow-up work of close contacts 6 months and 1 year after the first screening.

Key words: Tuberculosis, pulmonary, Contact tracing, Public health surveillance, Communicable disease control