中国东部监狱羁押人群结核潜伏感染的流行病学特征及影响因素分析

Epidemiological characteristics and influencing factors of latent tuberculosis infection among detainees in eastern China

  • 摘要: 目的 分析中国东部地区新进羁押人群结核潜伏感染(LTBI)的流行病学特征,识别高危人群,为制定监狱系统结核病防控策略提供科学依据。方法 采用横断面研究设计,以2022年中国东部两所监狱新进羁押人群为研究对象。通过结构化问卷收集研究对象的人口学特征、行为危险因素、既往疾病史等信息,采用γ-干扰素释放试验(QFT-GIT)检测羁押人群LTBI感染状况。分类变量采用χ2检验,连续变量采用t检验或Wilcoxon秩和检验。运用Lasso回归筛选变量,采用多因素logistic回归分析LTBI的独立影响因素。结果 研究共纳入305名研究对象,其中女性100人,男性205人,年龄集中于31~40岁,结核潜伏感染率为14.75%。对比LTBI与Non-LTBI人群的人口学特征后发现,吸烟史(χ2=7.40,P=0.025)、吸毒史(χ2=5.49,P=0.019)及人类免疫缺陷病毒(HIV)感染(χ2=8.12,P=0.004)与LTBI感染存在显著关联。多因素logistic回归分析结果显示,曾吸烟调整比值比(aOR)=4.08,95%置信区间(95%CI):1.60~10.42,P=0.003、HIV感染阳性(aOR=11.57,95%CI:2.50~53.51,P=0.002)、吸毒(aOR=3.04,95%CI:1.02~9.09,P=0.046)是结核潜伏感染的危险因素。结论 中国东部地区新进羁押人群的LTBI感染率略低于长期羁押人群,工作中应对新进人员开展早期筛查与干预措施。吸烟史与HIV感染是LTBI的主要危险因素,建议在监狱系统实施LTBI筛查时,应重点关注有吸烟史、吸毒史、HIV感染的高危人群,并加强对男性羁押人群的监测管理,降低传播风险。

     

    Abstract: Objective: To analyze the epidemiological characteristics of latent tuberculosis infection (LTBI) among newly detained populations in eastern China, to identify high-risk groups, and to provide a scientific basis for formulating tuberculosis prevention and control strategies in the prison system. Methods: A cross-sectional study was performed to the newly admitted detainees in two prisons in eastern China in 2022. Data of demographic characteristics, behavioral risk factors and previous disease history of the research subjects were collected through a structured questionnaire survey. The LTBI status of the detainees was detected by QuantiFERON-TB Gold In-Tube (QFT-GIT) method. Categorical variables were tested using the χ2 test, and continuous variables were tested using the t-test or the Wilcoxon rank sum test. Variables were selected by Lasso regression, and the independent risk factors for LTBI were identified by multivariate logistic regression analyses. Results: A total of 305 research subjects were included in the study, including 100 females and 205 males. Their ages were concentrated between 31 and 40 years old, and the LTBI rate was 14.75%. After comparing the demographic characteristics of LTBI and Non-LTBI groups, it was found that smoking history (χ2=7.40, P=0.025), drug use history (χ2=5.49, P=0.019), and human immunodeficiency virus(HIV)infection (χ2=8.12, P=0.004) were statistically correlated with LTBI infection. The results of multivariate logistic regression analyses showed that smoking adjusted odds ratio (aOR)=4.08, 95% confidence interval (95%CI) : 1.60-10.42, P=0.003 and positive HIV infection (aOR =11.57, 95%CI:) 2.50-53.51, P=0.002) and drug use (aOR=3.04, 95%CI: 1.02-9.09, P=0.046) were risk factors for LTBI. Conclusion: The infection rate of LTBI among newly admitted detainees in eastern China is slightly lower than those detained in the custody for a long time. Therefore, early screening and intervention measures should be implemented for newly detained individuals. Smoking history and HIV infection are the main risk factors for LTBI. It is recommended that when LTBI screening is implemented in the prison system, special attention should be paid to high-risk groups with a history of smoking, drug use and HIV infection. In addition, surveillance on male detainees should be intensified to reduce the risk of transmission.

     

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