Table of Content

30 December 2021, Volume 2 Issue 4

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Original Articles

Characteristics of report, registration and epidemiolog from children pulmonary tuberculosis in Beijing during 2011-2020

SUN Shan-hua, LI Yan-yuan, TAO Li-ying, GAO Zhi-dong, ZHANG Hong-wei, XU Yan, CHEN Xi

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  305-310.  doi:10.3969/j.issn.2096-8493.20210137

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Objective The report, registration and epidemiological characteristics of tuberculosis (TB) among children in Beijing during 2011-2020 were analyzed to provide evidence for the formulation of tuberculosis control strategies in Beijing. Methods The data of TB patients and population in 0-14 years old children reported in Beijing from 2011 to 2020 were collected from TB Management Information System and the Basic Information System, which belonged to the subsystems of China Information System for Disease Control and Prevention. The Information of the patients’ report hospitals, regional distribution, registration, diagnosis type, incidence rate, etc were analyze. Results From 2011 to 2020, a total of 76 medical institutions in Beijing reported 1671 cases of pulmonary tuberculosis in children aged 0-14 years. The patients came from 30 provinces (autonomous regions and municipalities directly under the central government) except Shanghai, Hong Kong, Macao and Taiwan. The proportion of patients with negative etiology was the highest, accounting for 40.99% (685/1671), followed by 35.79% (598/1671) without etiological results, 22.44% (375/1671) etiologically positive and 0.78% (13/1671) of rifampicin resistance. Among the reported cases, 24.48% (409/1671) were registered and managed. There was no significant difference in the admission proportion between cases with current address in Beijing (27.59%, 133/482) and non Beijing cases (23.21%, 276/1189) (χ²=3.560, P=0.059). The registration rate of 10-14 years old group was 36.93% (277/750), which was significantly higher than that of 0-4 years group (11.36%,61/537) and 5-9 years group (18.49%,71/384)(χ ²=12.386, P<0.05). There were 482 Beijing children among the cases, with an average incidence rate of 2.41/100000 in 10 years, and the incidence rate decreased (Cochran-Armitage test, Z=-4.766, P<0.05). The peak incidence rate was 10-14 years old group, and the incidence rate was 5.42/100000. Conclusion The incidence rate of tuberculosis in Beijing children is relatively low and has a downward trend. Etiologically negative cases are the most in all diagnosis types. The reported cases mainly come from other provinces in China except Beijing,and the registration management rate is low.

A study of detection methods of latent Mycobacterium tuberculosis infection in close contacts of active tuberculosis patients among college students

XIAO Xiao, CHEN Jing, RAO Li-xin, JIANG Yue, LI Jin, ZHAO Ya-meng, SHEN Xin

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  311-316.  doi:10.3969/j.issn.2096-8493.20210120

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Objective This study aims to explore detection methods of latent Mycobacterium tuberculosis infection (LTBI) in close contacts of active tuberculosis patients among college students in Shanghai, to provide evidence for screening of close contacts of active tuberculosis patients in schools in areas with low prevalence of tuberculosis in China. Methods According to the different levels of reported incidence of tuberculosis in 2019 in Shanghai, we choose Pudong New Area, Songjiang District and Minhang District as study sites, close contacts of college active tuberculosis patients among the freshman/sophomore in three districts were continuously recruited as study subjects. In addition to routine screening methods, a questionnaire and interferon gamma release assay (IGRA, by QFT-GIT) were conducted in the subjects. Of the 767 close contacts who finished the baseline questionnaire, 747 had both TST (by BCG-PPD) and QFT results. The positive rate, cost effectiveness and screening efficiency of TST, QFT and TST-QFT combined tests, as well as the influencing factors of the inconsistent of TST and QFT test results were analyzed. Results The positive rates were 5.0% (37/747) by QFT, 17.1% (128/747) by TST and 4.0% (30/747) by TST-QFT combined test. The cost per case of LTBI detected by QFT alone was the highest (RMB 6218.9 yuan), while that by the combined use of TST-QFT reduced to 51.4% (RMB 3023.0 yuan). One LTBI could be found among 24.9 subjects by TST-QFT (numbers needed to screen (NNS) was 24.9), screening was more effective in those with no BCG scar (NNS=7.3), BMI<18.5 (NNS=5.5) and smokers (NNS=14.8). Multivariate logistic regression analysis showed that inconsistent of TST and QFT detection (TST(-)/QFT(+) vs. TST(-)/QFT(-): aOR (95%CI)=10.99 (1.76-68.54); TST(+)/QFT(-) vs. TST(-)/QFT(-): aOR (95%CI)=1.98 (1.13-3.49)) were more likely to be found in smokers. Conclusion When IGRA could not be widely used for LTBI detection, the TST-IGRA two-step method was recommended, especially in those without BCG scar and BMI<18.5. It could reduce the screening cost and improve the efficiency to a certain extent, while smokers are recommended to use IGRA test directly.

Investigation on knowledge,attitude,practice of tuberculosis among students in secondary vocational school in Zhuhai City

OU Qing-ye, ZHANG Wei-hua, ZHAO Wen-jun, KUANG Jun-rong

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  317-321.  doi:10.3969/j.issn.2096-8493.20210088

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Objective To understand the knowledge, attitude and practice (KAP) level of tuberculosis prevention and control among students in secondary vocational school in Zhuhai City, and to provide scientific basis for health education and intervention of tuberculosis. Methods The cluster sampling method was used to select ten classes of students from the first grade and ten classes from the second grade in a secondary vocational school in Zhuhai City as the research subjects.Tuberculosis-related KAP survey was conducted using a unified questionnaire from January 2021 to March 2021.A total of 843 students were investigated and 843 valid questionnaires were collected. Results The total awareness rate of tuberculosis prevention and control key messages was 48.99% (2891/5901), of which the awareness rate of tuberculosis contagion was the highest (81.73%,689/843), and the awareness rate of the tuberculosis school suspension policy was the lowest (23.01%,194/843). The median scores of K,A and P of female students were 8 (6,10), 13 (12,13) and 11 (8,14) respectively, which were higher than that of male students (6 (4,8), 12 (11,13) and 10 (8,12))(Z=-6.97, P<0.01; Z=-4.37, P<0.01; Z=-4.20, P<0.01). The median scores of K and A in the first grade were 8 (4,10) and 13 (11,13), which were higher than the students in the second grade (6 (4,8), 12 (10,13))(Z=-4.02, P<0.01; Z=-3.05, P<0.01). Conclusion The awareness rate of tuberculosis was low among students in secondary vocational college in Zhuhai City, and attitudes and practices still need to be improved. Schools and health education departments should strengthen health education to promote the formation of a virtuous circle of KAP among students and improve their overall health literacy.

Investigation and analysis of the implementation status of tuberculosis prevention and control in schools in Gansu Province during 2015 to 2020

GUO Qiang, MA Ling, LI Jiang-hong, ZHANG Lei-lei, SHAO Fu-rong, ZHANG Lan, YANG Shu-min

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  322-325.  doi:10.3969/j.issn.2096-8493.20210086

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Objective To assess the implementation status of routine tuberculosis prevention and control measures and tuberculosis screening for newly enrolled students in schools of Gansu province. Methods Using a combination of stratified random sampling and typical sampling, according to the reported incidence of tuberculosis in the whole population of each city (state) in Gansu Province in 2019, the 14 cities (states) were divided into three groups (high, medium, and low tuberculosis incidence group) using tertiles; In each group, one city (state) was randomly selected within which 8 junior high schools, 4 high schools, and 2 universities were selected by the typical sampling method. A total of 42 schools were selected in the whole province to fill in the school tuberculosis prevention and control work questionnaire. Descriptive analysis was done for illustrating basic information of the school, status of students being absent from school due to illness, implementation of morning check-ups, students being suspended from school for tuberculosis and returning to school afterwards, etc. Linear trend test was used to analyze the trend of tuberculosis screening for newly enrolled students in school and tuberculosis physical examination methods. For all statistical tests, α=0.05. Results In 2020, 90.5% (38/42) schools included the prevention and control of tuberculosis in their school’s annual work plan, 95.2% (40/42) schools deployed focal point for reporting tuberculosis cases, and 88.1% (37/42) schools deployed health technicians/health teachers. In 2020, both senior and junior high schools had carried out morning check-ups, and 97.6% (41/42) of schools registered students’ absences due to illness and traced causes of disease. In 2020, the tuberculosis detection rate of the physical examination for newly enrolled students was 10.6 per 100000, and 28.6% (12/42) of the schools had students who had been suspended from/returned to school due to tuberculosis. Conclusion The prevention and control measures of tuberculosis in schools in Gansu Province have been implemented well, and the prevention and control work has achieved ideal results.

Analysis of epidemiological characteristics of pulmonary tuberculosis among students in Ordos, Inner Mongolia Autonomous Region from 2010 to 2019

HAO Rui-xia, LI Bing, LIU Min, BAI Jun, QI Dan

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  326-329.  doi:10.3969/j.issn.2096-8493.20210092

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Objective To explore the epidemiological characteristics of tuberculosis among students in Ordos, Inner Mongolia Autonomous Region, to provide feasible suggestions for tuberculosis prevention and control in schools. Methods Data of 314 student tuberculosis cases reported in Ordos, Inner Mongolia Autonomous Region from January 1, 2010 to December 31, 2019 were collected from the Tuberculosis Management Information System. The incidence, distribution characteristics, source of cases, and delay in diagnosis of tuberculosis were analyzed. Results From 2010 to 2019, the average annual incidence of tuberculosis among students in Ordos, Inner Mongolia Autonomous Region was 14.18/100000 (314/2215000), and the reported incidence decreased from 36.43/100000 (78/214100) in 2010 to 6.98/100000 (18/257800) in 2019, decreased by 80.84%, showing a downward trend year by year, the difference was statistically significant (χ ²=130.100, P=0.000). There were 128 pathogen-positive pulmonary tuberculosis patients, with an average reported incidence rate of 5.78/100000. The reported incidence rate decreased from 17.75/100000 (38/214100) in 2010 to 2.33/100000 (6/257800) in 2019, decreased by 86.87%, showing a downward trend year by year, the difference was statistically significant (χ ²=106.659, P=0.000). March to April and November each year were the peak periods of reported cases of tuberculosis among students, accounting for 38.54% (121/314) of the whole year. The top 4 areas with the number of cases were Dongsheng District (95 cases, 30.25%), Dalate Banner (52 cases, 16.56%), Wushen Banner (50 cases, 15.92%) and Zhungeer Banner (46 cases, 14.65%). The ratio of male to female cases was 1:1.08 (151/163), the incidence was concentrated in 16-20 years old (57.96%, 182/314), and the diagnosis was mainly based on referral (53.50%, 168/314), the delay rate of treatment was 52.23% (164/314), the diagnosis delay rate was 19.75% (62/314). Conclusion The incidence of tuberculosis in students in Ordos, Inner Mongolia Autonomous Region decreased year by year. The epidemic mainly occurred in Dongsheng District, Dalate Banner, Wushen Banner and Zhungeer Banner, and the incidence was high in those who aged 16-20 years. The prevention and control of tuberculosis in students should be enhanced in Spring and Winter.

Clinical characteristics and treatment outcome of 151 hospitalized students with tuberculosis

WEI Jian-hua, GUO Tao, GAO Xiao-na, WU Wei, GUO Lei

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  330-335.  doi:10.3696/j.issn.2096-8493.20210064

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Objective To analyze the clinical characteristics and treatment outcome of 151 hospitalized students with tuberculosis. Methods Clinical data of 151 tuberculosis students admitted to the Fourth People’s Hospital of Ningxia Hui Autonomous Region from January 2019 to December 2020 were collected. Gender, age, student types, past history of anti-tuberculosis treatment, complicated disease, visit and treatment, first symptom, chest imaging examination, tuberculin skin test, pathogenic examination, drug resistance and tuberculosis type were retrospectively analyzed. Results Most of the 151 cases, there were 91 cases (60.3%), 146 cases (96.7%), 145 cases (96.0%) and 85 cases (56.3%) of college students, newly diagnosed tuberculosis, secondary pulmonary tuberculosis and symptomatic patients. Clinical symptoms were found in 108 cases (71.5%). Cough and expectoration accounted for 63.0% (68/108) and 50.9% (55/108), respectively. The delayed visit and treatment, and delayed diagnosis were 32.4% (35/108) and 28.7% (31/108), respectively. The tuberculin skin test was strongly positive in 86.1% (124/144), and the lesions with bilateral multi-lobar distribution and patches, exudation and consolidation were 75.5% (114/151) and 94.4% (142/151), respectively; tuberculous pleurisy was found in 30.5% (46/151) of the cases. The positive rate of etiology was 52.3% (79/151), and the drug resistance rate was 12.6% (19/151). There were 134 cases (88.7%) who completed the treatment, and the clinical cure rate was 94.8% (127/134). Conclusion The prognosis of hospitalized student tuberculosis patients was good in general. As the initial symptoms and chest lesions were not specific, delayed visits, missed diagnosis, misdiagnosis and the illness becoming worse were prone to happen. Tuberculosis should be identified as a common pulmonary disease, and tuberculosis screening and surveillance in schools should be done well, achieving early detection and early treatment, in order to avoid delay the condition advancement, drug-resistance transmission and aggregated epidemic.

Analysis of risk factors of anti-tuberculosis drug-induced liver injury in 7043 tuberculosis patients in Guiyang

CHEN Jing, ZHAO Peng

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  335-339.  doi:10.3969/j.issn.2096-8493.20210094

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Objective To analyze the risk factors of anti-tuberculosis drug-induced liver injury (ATB-DILI). Methods The clinical data of 7043 tuberculosis (TB) patients admitted to Guiyang Public Health Treatment Center from January 2014 to December 2016 were retrospectively collected,all the patients were followed up. Logistic regression method was used to analyze the risk factors related to age, gender, drinking history, nutritional status and complicated underlying liver disease. Results Among the 7043 tuberculosis patients, ATB-DILI were found in 319 cases (4.53%) (male: 179 (56.11%), female: 140 (43.89%)).Logistic regression analysis showed that aged ≥60 years (OR (95%CI)=0.629 (0.458-0.862), P=0.004) was protective factor for ATB-DILI; female (OR (95%CI)=1.394 (1.092-1.780), P=0.008), current alcohol consumption (OR (95%CI)=2.222 (1.569-3.148), P<0.001), malnutrition (OR (95%CI)=2.051 (1.589-2.648), P<0.001) and complicated with underlying liver disease (OR (95%CI)=1.892 (1.158-3.092), P=0.011) were risk factors for ATB-DILI. Conclusion For tuberculosis patients, female, <60 years old, current alcohol consumption, malnutrition and complicated with underlying liver disease were high-risk groups for ATB-DILI during treatment, and individualized anti-tuberculosis programs should be implemented for these patients.

Investigation of tuberculosis screening and core knowledge among elderly people in elderly care institutions

FANG Lan-jun, WU Hui-zhong, ZHOU Fang-jing, SU Jing, WEN Wen-pei, ZHOU Lin, CHEN Liang

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  340-346.  doi:10.3969/j.issn.2096-8493.20210096

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Objective To investigate the status of tuberculosis screening and core knowledge awareness among the elderly in elderly care institutions. Methods By cluster random sampling, four elderly care institutions were selected from Guangzhou, Shenzhen and Qingyuan in Guangdong Province from October 2019 to December 2020, including two public and two private institutions. A total of 178 subjects admitted to elderly care institutions without blurred consciousness or related major diseases were enrolled in this study, all of them aged ≥60 years, could communicate normally, and received tuberculosis screening and questionnaire survey. Questionnaires were used to collect sociodemographic information, suspicious symptoms of tuberculosis, history, physical examination, and awareness of tuberculosis prevention and control knowledge. Symptom screening and chest X-ray were used for tuberculosis screening, and tuberculosis was confirmed or excluded by sputum smear and culture, GeneXpert MTB/RIF and chest CT for those with suspicious symptoms of tuberculosis or abnormal shadow on chest X-ray. The health status, physical examination status, tuberculosis screening status and knowledge of core knowledge of tuberculosis prevention and treatment were analyzed. Results Among the 178 subjects, one case was diagnosed as active pulmonary tuberculosis (positive in etiology), and the prevalence of active pulmonary tuberculosis was 561.80/100000; 85.39% (152/178) had chronic diseases. Among the 142 people who underwent physical examination in the past year, the proportion of chest X-ray examination was 33.80% (48/142). The proportion of chest X-ray examination of private elderly care institutions (60.61%, 20/33) was significantly higher than that of public elderly care institutions (25.69%, 28/109) (χ²=13.803, P<0.001). The total awareness rate of core knowledge of tuberculosis prevention and treatment was 43.35% (463/1068). The total awareness rate of private elderly care institutions (53.88%, 139/258) was significantly higher than that of public elderly care institutions (40.00%, 324/810) (χ²=15.341, P<0.001). Conclusion The prevalence of active tuberculosis among the elderly in elderly care institutions was high, and the tuberculosis screening rate and core knowledge of prevention and control were low. Therefore, the elderly in elderly care institutions should be regarded as the key population of tuberculosis prevention and control, health education should be carried out continuously and effectively, and active tuberculosis screening should be carried out regularly, to detect pulmonary tuberculosis patients early.

Analysis of drug resistance characteristics and influencing factors in 159 patients with re-treated pulmonary tuberculosis

LI Yuan-yuan, SU Dong-dong, Aertai

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  347-351.  doi:10.19983/j.issn.2096-8493.20210063

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Objective To analyze independent factors associated with drug resistance in re-treated pulmonary tuberculosis (PTB) patients and evaluate their predictive values. Methods Between January 2019 and December 2020, a total of 159 re-treated PTB patients were divided into drug resistant group (71 cases) and sensitive group (88 cases) according to drug susceptibility test. Demographic data, clinical characteristics, chest computed tomography (CT) characteristics and laboratory test results were collected. Multivariate analysis was performed using binomial logistic regression model to identify independent risk factors associated with drug resistance of re-treated PTB, and their predictive values were evaluated with receiver operating characteristics (ROC) curves. Results The total drug resistance rate was 44.7% (71/159). According to univariate analysis results, average duration of disease in the drug resistant group was longer than that in the sensitive group (0.82±0.27 vs 0.29±0.13, t=15.181, P<0.001), proportion of cavitary PTB in the drug-resistant group was greater than that in the sensitive group (71.8% (51/71) vs 54.5% (48/88), χ²=4.997, P=0.025), average cavity count of the drug resistant group was greater than that of the sensitive group (4 (2, 4) vs 2 (1, 4), Z=2.703, P=0.007), average chest CT score for tuberculosis of the drug resistant group was greater than that of the sensitive group (12.61±2.84 vs 11.22±2.79, t=3.098, P=0.002), average C-reactive protein (CRP) level of the drug-resistant group was higher than that of the sensitive group (52.60 (24.67, 80.30) mg/L vs 34.04 (17.43, 58.37) mg/L, Z=2.604, P=0.009), and average white blood cell count of the drug resistant group was higher than that of the sensitive group (8.90 (7.42, 11.18)×10 ⁹/L vs 7.76 (5.71, 10.75)×10 ⁹/L, Z=-2.165, P=0.030). Binary logistic regression analysis showed that CRP was independently associated with drug resistance in re-treated PTB patients after adjusting for duration of disease, proportion of cavitary PTB, cavity count, chest CT score for PTB, white blood cells, age, previous medication irregularity and counts of blood platelets, and its odds ratio (OR) was 1.019 (95% confidence interval (CI): 1.006-1.032, P=0.011). The area under curve (AUC) of CRP in predicting drug-resistance was 0.631 (standard error: 0.048, P=0.009), and the best cutoff was 49.01mg/L with the sensitivity of 57.6% and specificity of 69.3%. Conclusion CRP was independently associated with drug-resistance in re-treated PTB patients, which had the potential for predicting drug-resistance of re-treated PTB.

Clinical analysis of 17 cases with non-tuberculous mycobacterium disease

HUANG Lin-huan, ZHOU Hou-shi, LIN Wan, LIN Qi

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  352-354.  doi:10.19983/j.issn.2096-8493.20210117

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Objective To analyze the clinical features, treatment and prognosis of patients with non-tuberculous mycobacteria (NTM) disease, and to improve the cognition of NTM disease. Methods A retrospective study was conducted in 17 patients with NTM disease diagnosed in Shantou Central Hospital, Guangdong Province from 2016 to 2020. The clinical data, including demographic characteristics, disease history, clinical symptoms and signs, lesions, bacteria species distribution, imaging examination results, treatment plan and prognosis, etc., were collected and analyzed. Results Among the 17 patients with NTM disease, 11 aged ≥60 years 11 were diagnosed as NTM lung disease, 7 were identified as Mycobacterium intracellular, and 15 complicated with underlying diseases. Chest CT examination of 11 patients with NTM lung disease showed that the lesions involved both lungs, of which 9 cases had multiple patchy shadows. Of the 17 patients, 15 were treated with anti-NTM combination therapy in our hospital. In terms of outcome, of the 17 patients, 2 were lost to follow-up, 2 were still under treatment, 3 died, as to the other 10 cases, the clinical symptoms were relieved and therefore the treatment had been stopped. Conclusion NTM mainly occured in the elderly, and always combined with underlying diseases. NTM lung disease was more common. There were various types of bacteria, and it was necessary to identify the bacteria and conduct drug sensitivity test to guide drug selection. The treatment should be combined with medication and sufficient course of treatment.

Diagnostic value of combined detection of coagulation screening indicators and D-dimer in clinical classification of COVID-19

WU Di, FAN Xin-xin, SHEN Jian-shan, LIN You-fei, CHEN Xiao-hong, HUANG Ming-xiang, CHEN Li-zhou

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  355-360.  doi:10.19983/j.issn.2096-8493.20210133

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Objective To explore the diagnostic value of coagulation screening indicators and D-dimer test results in clinical classification of COVID-19. Methods Clinical data of 72 COVID-19 patients diagnosed in Fuzhou Pulmonary Hospital, Fujian from January 23, 2020 to February 26, 2020 were collected and retrospectively studied. The blood coagulation screening index and D-dimer level of patients were tested on and during hospitalization, and progression. The blood coagulation screening index and D-dimer samples were excluded if not simultaneously tested or the test items not incomplete. Finally, a total of 147 results were obtained. According to different clinical classification on the day of blood collection, the patients were divided into mild group (mild and common types, n=72) and severe group (severe and imminent types, n=75). The coagulation screening indicators include activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT) and plasma fibrinogen (Fib). Receiver operating curve (ROC) was used to analysis the relationship between coagulation screening indicators and D-dimer levels, and the severity of the disease, as well as the diagnostic value of clinical classification. Results The levels of TT, PT, and Fib in the D-dimer and coagulation screening indexes in the severe group were significantly higher than those in the mild group (0.99 (0.67,1.63) mg/L vs 0.04 (0.02,0.16) mg/L, Z=-8.780, P<0.001; 13.05 (12.41,13.70) s vs 12.58 (11.93,13.59) s, Z=-2.450, P=0.014; 12.40 (11.70,13.20) s vs 11.65 (11.20,12.20) s, Z=-4.500, P<0.001; 3.99 (3.23,4.75) g/L vs 3.36 (2.76,3.91) g/L, Z=-3.600, P<0.001), while the difference of APTT was not statistically significant (27.20 (24.80,34.00) s vs 28.25 (25.50,30.55) s, Z=0.060, P=0.951). ROC curve showed that the area under the curve of D-dimer was 0.917 (95%CI: 0.869-0.964), higher than those under TT, PT and Fib (0.617 (95%CI: 0.526-0.709), 0.715 (95%CI: 0.623-0.799) and 0.672 (95%CI: 0.585-0.759), respectively). When the Youden index was the maximum (0.756), the critical value of D-dimer was 0.364 mg/L, the sensitivity and specificity of diagnosis in severe group were 86.7% and 88.9%. Conclusion D-dimer index in peripheral blood had high diagnostic value for classification of COVID-19, and could be used as an indicator of clinical diagnosis and treatment.

Review Articles

Advances about screening and preventive treatment of Mycobacterium tuberculosis latent infection in students

YANG Kui, CHEN Wei

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  361-365.  doi:10.19983/j.issn.2096-8493.20210141

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About a quarter of the whole population were infected with Mycobacterium tuberculosis worldwide, of which about 5%-10% will develop into tuberculosis patients. Students with pulmonary tuberculosis in the schools, were prone to cause cluster diseases. Implementing active screening, preventive treatment and other intervention measures in advance were significantly to reduce the secondary cases and the spread of tuberculosis in schools. This article summarized the epidemic status of latent tuberculosis infection of the students in schools, analyzed the testing results of different screening methods, and summarized the objective, treatment scheme, treatment outcome, side effect and feasibility of preventive treatment for students with latent tuberculosis infection, aiming to provide policy suggestion for the prevention and control of the latent infection of students in schools.

Short Articles

Investigation and analysis of tuberculosis epidemic situation in a school in Wugang, Hu’nan

ZOU Xia-li, YANG Hai-mei, ZENG Ran-yuan, WU Zi-jian, TANG Qiong, LI Jue, CHEN Qian-you

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  366-369.  doi:10.3969/j.issn.2096-8493.20210106

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On December 7, 2020, the Wugang City Center for Disease Control and prevention (subordinate to Shaoyang City) received the early warning information of a high school student Deng diagnosed as active tuberculosis. On the same day, Wugang Center for Disease Control and prevention organized professionals to go to hospitals and schools to carry out investigation. A total of 14 cases of student pulmonary tuberculosis were detected, with 2 males and 12 females, and an average age of (16.07±0.48) years. A total of 1194 contacts were screened, of which 144 were strongly positive by tuberculin skin test (TST), with a strong positive rate of 12.06%. Among them, 13 patients were found, with an incidence rate of 1.09%; 130 patients with strong positive TST received TB preventive treatment, and there was no incident case; 14 strong positive patients did not receive preventive treatment, and 5 cases developed disease.When the outbreak happened, the contacts should be screened in time, and those with strong PPD should take preventive treatment, which is conducive to the control of school tuberculosis.

Investigation report on a cluster epidemic of pulmonary tuberculosis in junior middle school in Wuhe, Anhui

NI Jian-jun, JIANG Qiang, GE Rui-rui, DING Ya-qian, CHEN Jing

Journal of Tuberculosis and Lung Disease. 2021, 2(4):  370-372.  doi:10.3969/j.issn.2096-8493.20210099

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In January 23, 2020, one active pulmonary tuberculosis from school (indicated case) was reported by the tuberculosis designated hospital of Wuhe, Anhui. Due to COVID-19 epidemic control, on the day of school resumption (April 13th), according to the epidemiological screening process of tuberculosis, epidemiological survey and tuberculosis screening (purified protein derivative of tuberculin test (PPD test) and chest X-ray examination) were hierarchically conducted among 443 contacts (centered on the student: classmates, teachers, students on the same floor and extracurricular classmates) by the Center for Disease Control and Prevention of Wuhe County. It was found that the case was delayed for 34 days, and had no close contact history of tuberculosis. The strongly positive rate of PPD test for teachers and students was 2.7% (12/443), and the abnormal rate of chest X-ray was 2.1% (9/436). The strongly positive rate of PPD test (7.7% (5/65)) and the abnormal rate of chest X-ray of close contacts in the same class (12.3% (8/65)) were significantly higher than that of general contacts in other classes on the same floor and weekend extracurricular classes (1.9% (7/378) and 0.3% (1/371))(χ²=5.134, P=0.023; χ ²=33.917, P<0.001). Seven tuberculosis cases were found in two classes, the incidence rates were 10.3% (6/58) and 1.8% (1/56), respectively. It was considered that the epidemic was found late and the screen wasn’t conducted in time because of COVID-19, furthermore, the tuberculosis was disseminated and the risk of infection among the close contacts was significantly higher than that of the general contacts. The awareness of tuberculosis prevention and control in schools should be enhanced, and closer cooperation with the health department should be strengthened to ensure the implementation of the prevention and control measures.