2~14岁赴美移民申请人结核病筛查结果分析

    张建明1 何洪涛1 黄立萍1 王舜钦2 雷兆良1 黄永欣1 王向阳1 冯心文1 张敏1

    （1.广东国际旅行卫生保健中心，广州 510635；2.厦门市卫生局，厦门361003）

    摘要 〔目的〕对2~14岁赴美移民申请人结核病筛查的结果进行分析,为早期发现潜伏结核感染、肺结核患者及结核病防控提供参考依据。〔方法〕对2009年7月—2010年3月期间在广东国际旅行卫生保健中心体检的2747名2~14岁赴美移民申请人进行结核病筛查，所有申请人均进行结核菌素皮试（TST）；若TST≥10mm或申请人有疑似结核的体征或症状,应进行X线胸片检查；若胸片所见疑似结核或有疑似结核的体征或症状的，进行结核分枝杆菌实验室检测。〔结果〕TST皮试结果显示阳性率为47.40%，阴性率52.60%，其中中度阳性者624名，占总人数的22.72%，强阳性者25名，占总人数的0.91%。阴性率随年龄增长逐渐下降，阳性与中度阳性率随年龄增长逐渐上升（P< 0.001）。649名TST≥10mm者胸片检查结果发现，疑似结核病患者8人，其中非领养儿童1例,领养儿童7例。结核分枝杆菌实验室检测结果发现，8例疑似肺结核患者中，1例为耐多药结核患者。〔结论〕加强儿童，特别是生活条件和营养条件差的儿童结核病的筛查，提高卡介苗覆盖率及接种质量对于儿童肺结核的防控具有重要意义。

    关键词 结核菌素试验；潜伏结核；结核；儿童；领养儿童；移民；筛查

    〔中图分类号〕　R446.61　〔文献标识码〕　B

    Analysis on the Results of TuberculosisScreening among the USA Immigrating Applicants of 2~14 YearsOld  Zhang Jianming1, He Hongtao1, Huang Liping1, WangShunqin2, Lei Zhaoliang1, Huang Yongxin1, Wang Xiangyang1, FengXinwen1, Zhang Min1. (1.Guangdong International Travel Health CareCenter, Guangzhou 510635，China;2.Xiamen Health Department, Xiamen361003，China.）

    [Abstract]   Objective  To provide references for early latent tuberculosis infection(LTBI) , tuberculosis detection and TB control and prevention byanalysing the results of tuberculosis screening conducted on 2~14years old immigrating applicants to USA.  Methods  TST was conducted among 2 747 immigrating applicants of 2~14 yearsold to USA in Guangdong International Tranel Health Care Centerfrom July 2009 to March 2010. If the result of TST was ≥ 10 mm, orif it suggests the applicant symptoms or signs of TB, chestradiography(CXR) should be performed. And applicants with symptoms,signs or CXR suggestive of  TB, sputum specimens should becollected to undergo microscopy for acid-fast bacilli(AFB), as wellas culture for mycobacteria and confirmation of the Mycobacteriumspecies.   Results    The positive rateand the negative rate of TST results were 47.40% and 52.60%,respectively. A total of 624  cases were moderatelypositive(++), accounting for 22.72%; 25 cases were strongpositive(+++), accounting for 0.91%. Negative rate of TST decreasedgradually with age. Positive and moderately positive rate of TSTincreased gradually with age(P＜ 0.001). The chest examination found8 suspected TB patients, including 1 case of non-adopted child and7 cases of adopted children. Among 8 suspecpted TB patients, therewas one case of MDR-TB patient in laboratory test of Mycobacteriumtuberculosis. Conclusion  It is important to conduct thescreening of TB upon children, especially those live in poorconditions and malnutrition, and increase BCG vaccination coveragefor the prevention and control of TB within children.

    [Key words]   Tuberculin skin test;Latent tuberculosis infection; Tuberculosis; Children ; Adoptedchildren; Immigration; Screen