Analysis Of Tuberculosis Epidemic Characteristics And Awareness In Students Yunnan Province From 2005 To 2014

Objectives To provide countermeasures for tuberculosis prevention and control in students Yunnan province through analyzing epidemic characteristics and trends of tuberculosis in students Yunnan province. To investigate the main problems and countermeasures of the tuberculosis prevention and control in schools through analyzing tuberculosis aggregation and one epidemic of tuberculosis aggregation in schools. To provide evidence of tuberculosis health education in schools through understanding the awareness of tuberculosis prevention and control knowledge in students.Methods1. Past data analysis. The datas of 6-30 teens tuberculosis patients on "Infectious disease reporting information management system" and "Tuberculosis information management system" were collected retrospectively, according to occupational classification, divided into student and non-student groups, to compare epidemic characteristics and trends of student and non-student tuberculosis in Yunnan province from 2005 to 2014, to analysis tuberculosis aggregation in schools and epidemic of tuberculosis aggregation in schools by using epidemic methods, to calculate PPD strong positive rate of close contacts of student tuberculosis patients, then to analysis influencing factors.2. Awareness survey. After one year of tuberculosis education in a school, to design《Students tuberculosis knowledge questionnaire》 and survey the students agreed, to understand the awareness of tuberculosis knowledge in students and the effect of tuberculosis health education in school. Descriptive statistics,X2 test, correlation analysis, binary Logistic regression analysis, ROC curve were used in the whole research, significant difference was P<0.05.Results1. The reported incidence rate of student tuberculosis patients in Yunnan province from 2005 to 2014 declined and it was lower than non-student tuberculosis patients (P<0.05), it had greater decline. Sex distribution was becoming more and more male:female was 1:1, but more male than female every years (P<0.05). The ages mainly concentrated in 16 to 18 and>18. The proportion of smear-negative and tuberculous pleurisy increased year by year, the proportion of smear-positive reduced (P<0.05). The proportion of new patients was increasing every year and it was greater than non-student patients (P<0.05). The largest number of cases in April. There was a positive correlation of the regional incidence between student and non-student patients (P<0.05). Influencing factors of patient delay were female, non-local household registration, smear-negative (P<0.05). Influencing factors of treatment success rate were non-local household registration, smear-positive, retreatment (P<0.05).2. Schools present scattered punctate distribution of student patients reported, but tuberculosis aggregation in schools in recent years was increasing, the largest distribution was in Zhaotong and Qujing.3. According to analysis of epidemiological three distributions, the first patients of smear-positive had patient delay, the major spread period concentrated June to August, spread place was mainly in the classrooms, the vast majority of students were 16-18 years old,40.0% student patients had no symptoms of tuberculosis. PPD strong positive rate of close contacts of student tuberculosis patients had positive correlation with incidence of student tuberculosis patients (P<0.05), but ROC curve showed it had no diagnostic value (P>0.05).4. Awareness of students (74.5%) was obviously higher than average level of tuberculosis information surveyed in 2010 at rural areas Yunnan province (43.5%).Conclusions DOTS strategy was quite powerfull, the effort of student tuberculosis prevention and control was big. The reported incidence rate of student tuberculosis patients in Yunnan province from 2005 to 2014 declined, but tuberculosis aggregation in schools was increasing, the school had become a new priority area of tuberculosis prevention and control in our province. One of the best screening methods for close contacts of student tuberculosis patients, molecular epidemiology was suggested to explore the discipline of tuberculosis outbreak and spread in schools, and to build a long-term network for tuberculosis in schools. Tuberculosis health education efforts should be strengthened to increase knowledge level of tuberculosis prevention and control and prevent occurs of tuberculosis.