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