Acceptance of preventive treatment for latent tuberculosis infection and its influencing factors:a Meta-analysis

doi:10.19983/j.issn.2096-8493.20250091

Abstract

Abstract:

Objective: To systematically evaluate the acceptance rate of preventive treatment and its influencing factors among individuals with latent tuberculosis infection (LTBI) in China, and to provide evidence for public health departments to implement targeted LTBI interventions. Methods: Chinese and English databases (including CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Embase, and The Cochrane Library) were searched for studies published up to February 19, 2025, related to preventive treatment for LTBI in China. Two researchers independently screened literature, extracted data, and assessed study quality. Stata 14.0 was used for Meta-analysis to calculate the pooled acceptance rate and analyze influencing factors. Results: A total of 16 studies were included, involving 8806 participants. The pooled acceptance rate of preventive treatment among LTBI individuals in China was 66.2% (95%CI: 56.9%-74.9%). Subgroup analysis showed higher acceptance rates in western regions (70.0%) and in studies published before 2020 (68.7%). Demographic analysis revealed higher acceptance among females (68.4%), individuals aged 18-45 years (80.1%), and those with education levels of junior high school or below (77.7%). Acceptance was highest among close contacts of pulmonary tuberculosis patients (79.5%), followed by other high-risk populations (71.9%), and lowest among students identified with LTBI through school screening (51.4%). Multivariable analysis identified the following protective factors: females (OR=1.05, 95%CI: 1.01-1.16), being a student (OR=1.23, 95%CI: 1.04-1.52) or manual laborers (OR=1.65, 95%CI: 1.39-1.93), having good knowledge of the disease (OR=1.18, 95%CI: 1.07-1.29), and a history of BCG vaccination (OR=1.42, 95%CI: 1.01-2.08). Risk factors included being boarding students (OR=0.61, 95%CI: 0.35-0.88) and longer treatment regimens (OR=0.38, 95%CI: 0.04-0.71). Conclusion: The acceptance rate of preventive treatment among individuals with LTBI in China remains suboptimal. Strengthening health education, addressing stigma, improving disease awareness, and promoting shorter treatment regimens may help enhance treatment uptake in key populations.

Key words: Tuberculosis, Mycobacterium infections, Preventive medicine, Patient acceptance of health care, Systems analysis

CLC Number:

R183.3

Yang Yulan, Wan Bin, Zhao Xia, Shen Jing, Yao Rong, Yu Qiaolin, He Ting. Acceptance of preventive treatment for latent tuberculosis infection and its influencing factors:a Meta-analysis[J]. Journal of Tuberculosis and Lung Disease , 2026, 7(1): 21-29. doi: 10.19983/j.issn.2096-8493.20250091

Figures/Tables 9

步骤	检索式
#1	(″latent tuberculosis″[MeSH])
#2	(″latent tuberculosis″[Title/Abstract] OR ((″Tuberculosis″[MeSH Terms] OR ″tuberculosis″[All Fields] OR ″tuberculosis″[All Fields] OR ″tuberculosis s″[All Fields]) AND ″latent″[Title/Abstract]) OR ″tuberculosis latent″[Title/Abstract] OR ″latent tuberculosis infection″[Title/Abstract] OR ″infection latent tuberculosis″[Title/Abstract] OR ″infections latent tuberculosis″[Title/Abstract] OR ″latent tuberculosis infections″[Title/Abstract] OR ″tuberculosis infection latent″[Title/Abstract] OR ((″tuberculosis″[All Fields] OR ″tuberculosis″[MeSH Terms] OR ″tuberculosis″[All Fields] OR ″tuberculosis″[All Fields] OR ″tuberculosis″[All Fields]) AND ″infections latent″[Title/Abstract]) OR ″LTBI″[Title/Abstract]))
#3	#1 OR #2
#4	(″prevention and control″[MeSH Subheading]
#5	(″preventive treatment″[Title/Abstract] OR ″preventive therapy″[Title/Abstract] OR ″prophylaxis″[Title/Abstract] OR ″TPT″[Title/Abstract] OR ″ Rifapentine″[Title/Abstract] OR ″3HP″[Title/Abstract] OR ″3HR″[Title/Abstract] OR ″Isoniazid″[Title/Abstract])
#6	#4 OR #5
#7	(″intention″[Title/Abstract] OR ″intentional″[Title/Abstract] OR ″intent″[Title/Abstract] OR ″intend″[Title/Abstract] OR ″willingness″[Title/Abstract] OR ″will″[Title/Abstract] OR ″utilization″[Title/Abstract] OR ″utilisation″[Title/Abstract] OR ″acceptance″[Title/Abstract] OR ″acceptability″[Title/Abstract] OR ″adoption″[Title/Abstract] OR ″uptake″[Title/Abstract] OR ″usage″[Title/Abstract] OR ″use″[Title/Abstract] OR ″awareness″[Title/Abstract] OR ″adherence″[Title/Abstract] OR ″knowledge″[Title/Abstract] OR ″attitude″[Title/Abstract] OR ″perception″[Title/Abstract] OR ″feasibility″[Title/Abstract])
#8	#3 AND #6 AND #7

References 41

[1]	Getahun H, Matteelli A, Abubakar I, et al. Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries. Eur Respir J, 2015, 46(6): 1563-1576. doi:10.1183/13993003.01245-2015.
[2]	World Health Organization. WHO consolidated guidelines on tuberculosis: module 1: prevention: tuberculosis preventive treatment. Geneva: World Health Organization, 2020.
[3]	Zenner D, Beer N, Harris RJ, et al. Treatment of Latent Tuberculosis Infection: An Updated Network Meta-analysis. Ann Intern Med, 2017, 167(4): 248-255. doi:10.7326/m17-0609. pmid: 28761946
[4]	Cho H, Seok J, Park Y, et al. Cost-Effectiveness of Age-Expanding Strategy of Latent Tuberculosis Infection Treatment in Household Contacts in South Korea. Yonsei Med J, 2023, 64(6): 366-374. doi:10.3349/ymj.2022.0624. pmid: 37226563
[5]	卢鹏, 成君, 路希维, 等. 科学开展预防性治疗加速遏制结核病进程. 中国防痨杂志, 2020, 42(4):316-321. doi:10.3969/j.issn.1000-6621.2020.04.004.
[6]	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四:观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4):297-299. doi:10.3969/j.1674-4055.2012.04.004.
[7]	Andreas S. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605. doi:10.1007/s10654-010-9491-z. pmid: 20652370
[8]	Li Y, Zheng YH, Lu LP, et al. Acceptance of Chemo-prophylaxis for Latent Tuberculosis Infection among High School/College Student Contacts of Tuberculosis Patients in Shanghai, China. Biomed Environ Sci, 2018, 31(4): 317-321. doi:10.3967/bes2018.041. pmid: 29773096
[9]	Huang H, Yuan G, Du Y, et al. Effects of preventive therapy for latent tuberculosis infection and factors associated with treatment abandonment: a cross-sectional study. J Thorac Dis, 2018, 10(7): 4377-4386. doi:10.21037/jtd.2018.06.138. pmid: 30174886
[10]	祖筱雯, 要玉霞, 龚德华, 等. 肺结核患者密切接触者对6个月单用异烟肼预防性治疗方案的接受度. 中国公共卫生, 2020, 36(3):369-374. doi:10.11847/zgggws1127769.
[11]	任哲雯, 张国龙, 龚德华, 等. 结核潜伏感染者对12周预防性治疗方案的接受意愿研究. 中国防痨杂志, 2020, 42(5):503-509. doi:10.3969/j.issn.1000-6621.2020.05.016.
[12]	张霞, 汤泓. 上海市长宁区老年糖尿病患者结核潜伏感染现况和预防性治疗态度. 中国热带医学, 2021, 21(5):408-412. doi:10.13604/j.cnki.46-1064/r.2021.05.03.
[13]	Chiu TF, Yen MY, Shie YH, et al. Determinants of latent tuberculosis infection and treatment interruption in long-term care facilities: A retrospective cohort study in Chinese Taiwan. J Microbiol Immunol Infect, 2022, 55(6 Pt 2): 1310-1317. doi:10.1016/j.jmii.2021.09.013.
[14]	玛依沙·达肯, 陈阳贵, 李德洋, 等. 2021—2022年乌鲁木齐市肺结核家庭密切接触者预防性治疗意愿的影响因素分析. 预防医学情报杂志, 2023, 39(8):918-925.
[15]	Yuan Y, Jin J, Bi X, et al. Factors associated with refusal of preventive therapy after initial willingness to accept treatment among college students with latent tuberculosis infection in Shandong, China. BMC Infect Dis, 2023, 23(1): 38. doi:10.1186/s12879-023-08005-5. pmid: 36670356
[16]	Yuan Y, Jin J, Bi X, et al. Gender-Specific Association Between Perceived Stigma Toward Tuberculosis and Acceptance of Preventive Treatment Among College Students With Latent Tuberculosis Infection: Cross-Sectional Analysis. JMIR Public Health Surveill, 2023, 9: e43972. doi:10.2196/43972.
[17]	王展, 李忠奇, 丁晓艳, 等. 江苏省学生结核潜伏感染者预防性治疗意愿现状及其影响因素. 中国热带医学, 2024, 24(3):244-251. doi:10.13604/j.cnki.46-1064/r.2024.03.03.
[18]	张静, 付若楠, 王森路, 等. 高负担地区肺结核密切接触者中结核分枝杆菌潜伏感染者预防性治疗接受意愿及影响因素研究. 中国防痨杂志, 2024, 46(2):165-172. doi:10.19982/j.issn.1000-6621.20230395.
[19]	Xie L, Chen Y, Zhang L, et al. Knowledge and Attitudes About Screening and Preventive Treatment of Latent Tuberculosis Infection Among Patients with Rheumatic Diseases in Beijing, China. Infect Drug Resist, 2024, 17: 3403-3414. doi:10.2147/IDR.S471448. pmid: 39131513
[20]	冯彬, 周婷钰, 王舟, 等. 常州市结核潜伏感染大一新生预防性治疗意愿及相关因素. 中国学校卫生, 2024, 45(12):1802-1806. doi:10.16835/j.cnki.1000-9817.2024360.
[21]	黄涛, 菅辉勇, 冯建宇, 等. 2023年新疆维吾尔自治区肺结核密切接触者结核潜伏感染者预防性治疗接受意愿及影响因素分析. 疾病监测, 2024, 39(12):1604-1609. doi:10.3784/jbjc.202405140283.
[22]	马作丽, 刘芳. 马鞍山市学生结核潜伏感染者的预防性治疗情况及影响因素分析. 中国科技期刊数据库(医药), 2024(12):13-16.
[23]	彭晓唯, 张江萍, 罗鹏, 等. 贵阳市云岩区中学新生结核潜伏感染现状与预防性治疗意愿. 中国学校卫生, 2025, 46(1):129-133. doi:10.16835/j.cnki.1000-9817.2025007.
[24]	中华人民共和国国家统计局. 2024中国统计年鉴. 北京: 中国统计出版, 2024.
[25]	Alsdurf H, Hill PC, Matteelli A, et al. The cascade of care in diagnosis and treatment of latent tuberculosis infection: a systematic review and meta-analysis. Lancet Infect Dis, 2016, 16(11): 1269-1278. doi:10.1016/s1473-3099(16)30216-x. pmid: 27522233
[26]	陈伟, 李雪, 刘小秋, 等. 《全国结核病防治规划(2024—2030年)》解读. 中国防痨杂志, 2025, 47(2):130-136. doi:10.19982/j.issn.1000-6621.20240585.
[27]	Maskit B, Gali P, Ayal R, et al. Identifying factors affecting latent tuberculosis treatment acceptance among healthcare workers: a retrospective analysis in a tertiary care centre. BMJ Open, 2021, 11(9): e047444. doi:10.1136/bmjopen-2020-047444.
[28]	Spruijt I, Haile DT, Erkens C, et al. Strategies to reach and motivate migrant communities at high risk for TB to participate in a latent tuberculosis infection screening program: a community-engaged, mixed methods study among Eritreans. BMC Public Health, 2020, 20(1): 315. doi:10.1186/s12889-020-8390-9. pmid: 32164637
[29]	何楚, 吴兆军, 彭红, 等. 江苏省结核病示范区结核病患者健康素养调查及影响因素分析. 中国防痨杂志, 2024, 46(2):190-198. doi:10.19982/j.issn.1000-6621.20230335.
[30]	Dong X. Need of Practical Strategy for Improving Awareness of Acceptance of Tuberculosis Preventive Treatment among the Public and the Healthcare Workers. Biomed Environ Sci, 2024, 37(11): 1233-1234. doi:10.3967/bes2024.174. pmid: 39667960
[31]	王健, 国杰, 次松. 西藏地区肺结核病流行特征. 中国公共卫生, 2019, 35(10):1353-1356.
[32]	Swift MD, Molella RG, Vaughn AIS, et al. Determinants of Latent Tuberculosis Treatment Acceptance and Completion in Healthcare Personnel. Clin Infect Dis, 2020, 71(2): 284-290. doi:10.1093/cid/ciz817. pmid: 31552416
[33]	王丽莎, 李娜, 闫晓婷, 等. 潜伏性结核感染预防性治疗中的医学困境及解决策略. 医学与哲学, 2024, 45(18):68-72.
[34]	陈钢, 屈燕, 李玉红, 等. 中国老年人结核病防治核心信息知晓率及影响因素分析. 中华流行病学杂志, 2024, 45(2):237-241. doi:10.3760/cma.j.cn112338-20230606-00351.
[35]	Spruijt I, Erkens C, Suurmond J, et al. Implementation of latent tuberculosis infection screening and treatment among newly arriving immigrants in the Netherlands: A mixed methods pilot evaluation. PLoS One, 2019, 14(7): e0219252. doi:10.1371/journal.pone.0219252.
[36]	Colson PW, Hirsch-Moverman Y, Bethel J, et al. Acceptance of treatment for latent tuberculosis infection: prospective cohort study in the United States and Canada. Int J Tuberc Lung Dis, 2013, 17(4): 473-479. doi:10.5588/ijtld.12.0697. pmid: 23485381
[37]	Goswami ND, Gadkowski LB, Piedrahita C, et al. Predictors of latent tuberculosis treatment initiation and completion at a U.S. public health clinic: a prospective cohort study. BMC Public Health, 2012, 12: 468. doi:10.1186/1471-2458-12-468. pmid: 22720842
[38]	肖文静, 沈鑫. 进一步推进结核分枝杆菌潜伏感染管理加快实现终结结核病目标. 结核与肺部疾病杂志, 2024, 5(5):385-387. doi:10.19983/j.issn.2096-8493.2024138.
[39]	尤媛媛, 张国龙, 陈裕. 120例初治耐多药肺结核患者治疗依从性的影响因素分析. 中国防痨杂志, 2020, 42(3):249-254. doi:10.3969/j.issn.1000-6621.2020.03.013.
[40]	Huang W, Fang Z, Luo S, et al. The effect of BCG vaccination and risk factors for latent tuberculosis infection among college freshmen in China. Int J Infect Dis, 2022, 122: 321-326. doi:10.1016/j.ijid.2022.06.010. pmid: 35700876
[41]	Asare-Baah M, Salmon-Trejo LaT, Venkatappa T, et al. Factors Associated With the Discontinuation of Two Short-Course Tuberculosis Preventive Therapies in Programmatic Settings in the United States. Open Forum Infect Dis, 2024, 11(6): ofae313. doi:10.1093/ofid/ofae313.

第一作者	发表年份	研究类型	研究地区	研究对象	符合治疗者(名)	接受治疗者(名)	接受度 (%)	质量评价(分)	影响因素
Li^[8]	2018	A	上海	a	560	487	86.96	5	⑦12
Huang^[9]	2018	B	广州	b	362	156	43.09	6	-
祖筱雯^[10]	2020	A	河南、湖南、重庆	a	991	633	63.87	5	①②③④⑤⑥⑦⑨
任哲雯^[11]	2020	A	河南、湖南、重庆	a	1033	788	76.28	6	①②③④⑤⑥⑦⑨
张霞^[12]	2021	A	上海	c	74	45	60.81	5	①③⑦
Chiu^[13]	2022	B	台湾	c	371	274	73.85	6	-
玛依沙·达肯^[14]	2023	B	乌鲁木齐	a	435	306	70.34	6	①②③④⑦
Yuan^[15]	2023	B	山东	b	723	287	39.70	6	①②⑧⑩
Yuan^[16]	2023	A	山东	b	1547	723	46.73	8	①
王展^[17]	2024	B	江苏	b	347	164	47.30	6	①②⑧⑨12
张静^[18]	2024	A	新疆	a	516	497	96.32	7	①②③④⑤⑥⑨⑩11
Xie^[19]	2024	A	北京	c	200	153	76.50	6	-
冯彬^[20]	2024	A	江苏	b	368	253	68.75	7	①④⑦⑩11
黄涛^[21]	2024	A	新疆	a	663	497	74.96	6	①②③④⑤⑥⑦⑨⑩12
马作丽^[22]	2024	A	安徽	b	158	77	48.73	6	①②③④⑨
彭晓唯^[23]	2025	A	贵州	b	458	299	83.99	7	①②③⑧11

亚组分析	纳入文献数 (篇)	异质性检验结果		效应模型	预防性治疗接受度 (95%CI)
亚组分析	纳入文献数 (篇)	P值	I²值	效应模型	预防性治疗接受度 (95%CI)
性别
男性	12^{[10-12,14-18,20-23]}	<0.01	97.9	随机	64.4(52.6~75.5)
女性	12^{[10-12,14-18,20-23]}	<0.01	97.8	随机	68.4(57.6~78.2)
年龄组(岁)
≤18	6^{[10-11,14,18,21,23]}	<0.01	91.6	随机	77.8(67.5~86.7)
18~45	5^{[10-11,14,18,21]}	<0.01	97.2	随机	80.1(65.0~91.7)
≥45	5^{[10-11,14,18,21]}	<0.01	94.9	随机	77.1(67.3~85.6)
文化程度
初中及以下	8^{[10-12,14,18,21-23]}	<0.01	97.1	随机	77.7(67.2~86.6)
初中以上	8^{[10-12,14,18,21-23]}	<0.01	94.3	随机	65.5(57.8~80.0)
研究人群
a	6^{[8,10-11,14,18,21]}	<0.01	98.5	随机	79.5(68.7~88.5)
b	7^{[9,15-17,20,22-23]}	<0.01	95.8	随机	51.4(43.4~59.5)
c	3^[12-13,19]	<0.01	96.5	随机	71.9(64.7~78.6)
地区^[24]
东部	9^{[8-9,12-13,19-20]}	<0.01	98.6	随机	61.1(48.4~73.1)
西部	5^{[8,10-11,14,18,21]}	<0.01	98.7	随机	70.0(51.9~85.4)
中部	3^[10-11,22]	<0.01	98.1	随机	63.8(50.7~76.0)
发表年份
2020年以前	4^[8-11]	<0.01	98.8	随机	68.7(52.4~82.9)
2020年以后	12^[12-23]	<0.01	98.8	随机	65.4(53.6~76.3)
研究类型
横断面研究	11^{[8,10-12,16,18-23]}	<0.01	98.8	随机	71.0(60.2~80.8)
队列研究	5^[9,13-15,17]	<0.01	97.9	随机	55.1(40.4~69.4)

影响因素	纳入文献 (篇)	异质性检验结果		效应模型	Meta分析结果
影响因素	纳入文献 (篇)	P值	I²(%)	效应模型	OR(95%CI)	P值
一般因素
性别(女)	12^{[10-12,14 -18,20 -23]}	<0.05	43.4	固定	1.05(1.01~1.16)	0.048
年龄	6^{[10-11,14,18,21,23]}	<0.05	11.4	固定	0.84(0.65~1.04)	0.336
文化程度	8^{[10-12,14,18,21 -23]}	<0.05	52.4	随机	0.76(0.54~0.98)	0.032
家庭经济收入	7^{[10-11,14,18,20 -22]}	<0.05	78.8	随机	0.89(0.57~1.22)	0.964
职业因素
学生	4^{[10-11,18,21]}	0.07	52.1	随机	1.23(1.04~1.52)	<0.05
体力劳动者	4^{[10-11,18,21]}	<0.05	80.1	随机	1.65(1.39~1.93)	<0.05
寄宿学生	3^[15,17,23]	<0.05	92.1	随机	0.61(0.35~0.88)	<0.05
疾病相关因素
疾病知识具备者	7^{[8,10 -12,14,20 -21]}	<0.05	82.4	随机	1.18(1.07~1.29)	<0.05
吸烟者	4^{[15,18,20 -21]}	0.057	60.0	随机	1.17(0.66~2.08)	0.588
卡介苗接种者	3^[18,20,23]	0.110	54.8	随机	1.42(1.01~2.08)	0.042
治疗周期长	3^[8,17,21]	<0.05	89.5	随机	0.38(0.04~0.71)	0.090
结核病患者接触者	6^{[10-11,17 -18,21 -22]}	<0.05	67.7	随机	0.77(0.44~1.09)	0.320