Analysis on aggregation outbreaks of pulmonary tuberculosis in a private middle school in Minhang District of Shanghai / 复旦学报（医学版）

Objective To analyze the epidemiological characteristics of aggregation outbreaks of pulmonary tuberculosis (TB) in a private middle school in Minhang District of Shanghai.Methods Symptom and radiographic screening were performed on the students of Grade 3 in this senior high school.Epidemiological survey,sputum smear,culture and molecular epidemiological examination were conducted on suspected patients.Whole genome sequencing was completed on positive strains.Results In the screening of 49 close contacts with one TB patient (index case) in the school,a total of 10 patients with pulmonary TB were diagnosed,of which 3 cases were positive for culture.Another case was diagnosed and positive for culture after expanding the scope of screening.The genotype of the isolated strains from index case and the 4 patients positive for culture was identical to that of the first case of the classoneyear before,suggesting the transmission within the grade of Senior Three.Conclusions This is an aggregation outbreak that may be attributable to the first patient with positive bacteria.Therefore,timely diagnosis and effective treatment of pulmonary TB patients,as well as timely screening of close contacts with pulmonary TB patients are significant to control potential outbreaks in schools.

Analysis on direct medical expenses and relief items service package of pulmonary tuberculosis patients in Minhang District of Shanghai / 复旦学报（医学版）

Objective To investigte the direct medical expense for diagnosis and treatment of pulmonary tuberculosis (TB) patients and its financial burden on family in Minhang District,Shanghai,and to provide evidence for improving TB derating policy and reducing the economic burden.Methods A total of 347 pulmonary TB patients who had completed treatment were investigated by questionnaire.Their receipts on diagnosis and treatment of TB were collected.Ranksum test,linear regression and x2 test were used to analyze medical expenses,influencing factors and social economic burden.Results The median of TB patients' direct medical expenses was 5 657 yuan/person.Linear regression showed that direct medical expenses were related with census,main medical institutions and complications.The main medical institutions have a greater impact on direct medical expenses (β'=-0.217).In the patients,7.5 ％ had high medical expenditures after the deduction of medical reimbursement and derating.And they were mainly distributed among low-income people.Conclusions The diagnosis and treatment expenses of TB patients were relatively high,which resulted in a heavier financial burden to the patient's family.The elderly tuberculosis patients,patients with complications and poor groups should become the focus of medical reimbursement and derating policy.

Analysis on aggregation outbreaks of pulmonary tuberculosis in a private middle school in Minhang District of Shanghai / 复旦学报（医学版）

Objective To analyze the epidemiological characteristics of aggregation outbreaks of pulmonary tuberculosis (TB) in a private middle school in Minhang District of Shanghai.Methods Symptom and radiographic screening were performed on the students of Grade 3 in this senior high school.Epidemiological survey,sputum smear,culture and molecular epidemiological examination were conducted on suspected patients.Whole genome sequencing was completed on positive strains.Results In the screening of 49 close contacts with one TB patient (index case) in the school,a total of 10 patients with pulmonary TB were diagnosed,of which 3 cases were positive for culture.Another case was diagnosed and positive for culture after expanding the scope of screening.The genotype of the isolated strains from index case and the 4 patients positive for culture was identical to that of the first case of the classoneyear before,suggesting the transmission within the grade of Senior Three.Conclusions This is an aggregation outbreak that may be attributable to the first patient with positive bacteria.Therefore,timely diagnosis and effective treatment of pulmonary TB patients,as well as timely screening of close contacts with pulmonary TB patients are significant to control potential outbreaks in schools.

Analysis on direct medical expenses and relief items service package of pulmonary tuberculosis patients in Minhang District of Shanghai / 复旦学报（医学版）

Objective To investigte the direct medical expense for diagnosis and treatment of pulmonary tuberculosis (TB) patients and its financial burden on family in Minhang District,Shanghai,and to provide evidence for improving TB derating policy and reducing the economic burden.Methods A total of 347 pulmonary TB patients who had completed treatment were investigated by questionnaire.Their receipts on diagnosis and treatment of TB were collected.Ranksum test,linear regression and x2 test were used to analyze medical expenses,influencing factors and social economic burden.Results The median of TB patients' direct medical expenses was 5 657 yuan/person.Linear regression showed that direct medical expenses were related with census,main medical institutions and complications.The main medical institutions have a greater impact on direct medical expenses (β'=-0.217).In the patients,7.5 ％ had high medical expenditures after the deduction of medical reimbursement and derating.And they were mainly distributed among low-income people.Conclusions The diagnosis and treatment expenses of TB patients were relatively high,which resulted in a heavier financial burden to the patient's family.The elderly tuberculosis patients,patients with complications and poor groups should become the focus of medical reimbursement and derating policy.