Revealed: Why schools are a key battlefield in the fight against tuberculosis?

my country is a country with a high burden of tuberculosis in the world. Although the epidemic has been declining year by year in recent years, due to the large population base and high infection rate, the number of new tuberculosis patients is still large each year. Students are prone to tuberculosis after being infected with tuberculosis bacteria due to factors such as heavy study burden, the immune system is still in the process of development, and the limited protective efficacy of BCG. The campus is densely populated, and once there is an infectious source, it is easy to cause transmission. So why is school a key battlefield in the fight against tuberculosis?

1. What is tuberculosis?

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis complex. The disease can cause pulmonary tuberculosis and invade other organs such as liver, kidney, brain, lymph nodes, and form extrapulmonary tuberculosis. Because it was called "consumption" in ancient times, it still poses a threat to human health and is a major public health issue. Medium- and high-risk groups include people with low immunity (such as AIDS patients, users of immunosuppressants, etc.), diabetic patients, etc.

The main route of tuberculosis transmission is through the air, or through coughing, sneezing, laughing, talking loudly, etc., which can spread to others by expelling droplets containing Mycobacterium tuberculosis into the air. The clinical symptoms of pulmonary tuberculosis mainly include coughing and expectoration, which may be accompanied by systemic symptoms such as low-grade fever, night sweats, weight loss, and weakness; while the symptoms of extrapulmonary tuberculosis depend on the location of the organ.

2. What are the reasons why tuberculosis can easily spread in schools?

The dense social environment, the incomplete immune function of students, the hidden nature of tuberculosis, and the insufficient knowledge of tuberculosis by students' parents and school teachers have resulted in the failure to achieve "early detection and early treatment."

3. How should schools prevent and control tuberculosis?

The school is the first person responsible for the prevention and control of tuberculosis on campus. It is necessary to establish a responsibility system for prevention and control work, with the top leader taking overall responsibility and the leaders in charge taking specific responsibility, and to clearly designate specific people to be responsible, focusing on the following points:

1. Conduct health examinations for students

Early and proactive detection of tuberculosis patients is an effective way for schools to keep cases out of campus. Schools should make tuberculosis screening a mandatory item in the physical examinations for new students and the annual routine physical examinations for students and faculty, and students, their parents, and faculty should actively cooperate.

1) New students entering kindergarten should be questioned about their history of close contact with tuberculosis patients and suspected symptoms of tuberculosis. Those with a history of close contact with tuberculosis patients or suspected symptoms of tuberculosis should be tested for Mycobacterium tuberculosis infection.

2) New students entering primary schools, junior high schools and high schools should be interviewed for suspected symptoms of pulmonary tuberculosis and tested for Mycobacterium tuberculosis infection.

3) New university students will be interviewed for suspected tuberculosis symptoms and given chest X-rays.

4) Physical examinations for new students enrolled in secondary vocational schools, work-study schools and special education schools shall be conducted with reference to people in the same age group.

5) Students who transfer from primary school to junior high school, students who transfer directly from vocational high school to junior college, and students who transfer from other schools are all considered new students and are screened according to the corresponding procedures.

6) Tuberculosis screening for new students is generally completed before entering school, and no later than one month after the start of school.

2. Screening for suspected symptoms of tuberculosis

Students were asked whether they had any suspected symptoms of tuberculosis, such as cough and sputum for ≥ 2 weeks, blood in sputum or hemoptysis, chest tightness, chest pain, low-grade fever, night sweats, fatigue, and weight loss.

3. Screening for close contact history of tuberculosis

Ask students whether they have had close contact with someone with active pulmonary tuberculosis (living, studying together, etc.)

4. Mycobacterium tuberculosis infection detection and chest imaging examination

When the tuberculosis screening results are abnormal, you need to go to a designated tuberculosis hospital for a clear diagnosis in time.

If diagnosed with tuberculosis, students must report to the school in a timely manner, actively cooperate with doctors, complete standardized treatment, and go to the local chronic disease prevention and control agency to obtain a certificate of resumption of classes before returning to school.

Do a good job in tracking absenteeism due to illness, registering morning and afternoon health checks, and providing information report feedback.

The school should keep records of suspected tuberculosis patients or suspected tuberculosis patients found during daily diagnosis and treatment/morning check-ups/sickness absences, promptly guide parents to regular medical institutions for diagnosis, and track their diagnosis results. Once a tuberculosis case is found, the school should cooperate with the community health center to screen close contacts and conduct medical observation and follow-up of high-risk groups to prevent the spread of the epidemic.

6. Open windows for ventilation on a daily basis.

Students spend most of their time indoors at school, so schools should establish a regular ventilation system. In warm seasons, classrooms should be ventilated by opening windows all day long. In cold seasons, doors and windows should be opened for ventilation before classes, during breaks, and when students leave the classroom. Classrooms should be ventilated after each class, and at noon and during long breaks, classrooms should be ventilated for more than 30 minutes. Dormitories, libraries, computer rooms and other teaching and living rooms should be ventilated at least twice a day, for more than 60 minutes each time.

Do a good job in tuberculosis prevention and control publicity and education for parents and faculty.

Schools should incorporate tuberculosis prevention and control knowledge into the important content of school health education, and use health education classes, theme class meetings, special lectures, and traditional media or new media on campus to regularly publicize the core knowledge of tuberculosis prevention and control to students and faculty and staff, and improve the level of awareness of tuberculosis among parents, teachers and students.

In summary, schools play a vital frontline role in the fight against tuberculosis. By implementing effective screening, education and prevention measures, schools can not only protect the health of students and staff, but also reduce the spread of tuberculosis in the wider community. The prevention and control of tuberculosis requires the joint efforts of the whole society, and the active participation of schools is undoubtedly a key factor in this battle.

Written by: Li Xuexian, Daliang Community Health Service Center, Shunde District, Foshan City