Abstract:

Objective: To evaluate the implementation effect of online pulmonary tuberculosis (PTB) symptom questionnaire screening system, provide a novel pathway for PTB screening among students, and expand practical experience in active screening experience. Methods: Freshmen from all types of schools in Huizhou from 2021 to 2022 were enrolled. An independently developed WeChat-based “Tuberculosis Prevention and Control Integrated Management System” (referred to as the “Micro-Supervision System”) was used to conduct online PTB symptom screening. The Markov state transition model was employed to analyze the cost-effectiveness of screening strategy. Results: From 2021 to 2022, a total of 917991 freshmen participated in the screening with 4908 cases (0.53%) identified as having suspected PTB symptoms. Ten active PTB cases were confirmed, yielding a detection rate of 1.09 per 100000. The Markov state transition model estimated that symptoms screening could prevent 3100 PTB cases. The incremental cost-effectiveness ratio for gaining one quality-adjusted life year was RMB 3060 yuan, significantly lower than China’s 2023 per capita GDP (RMB 89358 yuan). Conclusion: The “Micro-Supervision System” is a cost-effective strategy for PTB screening among freshmen, effectively reducing PTB incidence in children and adolescents.

Key words: Tuberculosis, pulmonary, Mycobacterium infections, Students, public health, Population surveillance, Models, statistical, Markov