Abstract:

Objective: To analyze the operation of Automated-alert System for tuberculosis in schools in Guangzhou, and to provide suggestions for further application and improvement of the system. Methods: The signals and response of school tuberculosis in Guangzhou from July 2018 to December 2021 was derived from the Automated-alert System for Tuberculosis, and was analyzed and evaluated according to the spatial, temporal and population distribution, the effect of the System was evaluated by comparing epidemiological survey report of pulmonary tuberculosis in schools in the same period. Results: A total of 12034 early-warning signals were issued by Automated-alert System for Tuberculosis in schools from July 2018 to December 2021 with a response rate of 100.00%, and 98.76% (11885/12034) of signals were responded in 24 hours. The responding time (M(Q₁,Q₃)) was 2.02 (0.61, 6.58) h, 23.01% (2769/12034) of early-warning signals were finally identified as suspected events. From 2018 to 2021, the overall signal response time decreased from 2.51 (0.63, 11.71) h to 2.01 (0.67, 7.01) h, and the suspected event rate increased from 19.94% (429/2151) to 33.70% (548/1626). Baiyun District had the most warning signals (n=2735), and Yuexiu District had the highest suspected event rate (38.52%, 156/405). The 22-24-year-old group had the most warning signals (n=5318), and the 12-14-year-old group had the highest suspected event rate (64.56%, 133/206). Male accounted for 60.10% (232/12034) of the total signals, the proportion was higher than that of female (39.90%, 4802/12034). The housework and unemployed population group had the most warning signals (n=3708), and the nursery governess and housekeeper population group had the highest suspected event rate (8/9). With the increase of the diagnostic basis of pulmonary tuberculosis, the number of early warning signals decreased from 7969 to 56, the etiological negative pulmonary tuberculosis had the highest suspected event rate (31.03%, 818/2636). The Automated-alert System had the sensitivity of 41.18% (7/17) of aggregation tuberculosis outbreaks in Guangzhou schools. Conclusion: The signal sending function of the Automated-alert System for Tuberculosis in Guangzhou schools play a positive role, however, there are still some parts need to be improved. If the signal sending of cross-regional cases could be improved, the sensitivity of alert signals to the clustering epidemic situation could be further improved.

Key words: Tuberculosis, pulmonary, Students, Disease notification, Evaluation studies