NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
The Sixth People's Hospital of Zhengzhou, Zhengzhou, China.
Clin Microbiol Infect. 2019 Sep;25(9):1120-1126. doi: 10.1016/j.cmi.2019.01.021. Epub 2019 Feb 7.
Elderly individuals in rural China have been known to be at increased risk of contracting tuberculosis (TB) and developing active disease. This study aims to estimate the burden of mycobacterium tuberculosis (MTB) infection and to identify potential targeted subgroups for infection control.
As part of the investigation of an interventional study, 50- to 70-year-old rural residents in Zhongmu County were targeted for MTB infection testing using QuantiFERON-TB Gold In-Tube (QFT). Questionnaires and physical examinations were conducted to acquire their demographic information and health status.
A total of 20 486 individuals were included in the analysis. The prevalence of QFT positivity was 20.79% (4259/20 486) and 50 participants (0.24%) had indeterminate results. A positive dose-response relation was found for QFT positivity with smoking intensity. Compared with non-drinkers, the risk of MTB infection was lower among participants with moderate alcohol consumption (<10 g/day) with adjusted odds ratio (OR) of 0.82 (95% CI 0.71-0.94). In addition, gender of male, with a history of previous TB or silicosis, and hepatitis B/C virus infection were associated with increased risk of MTB infection. An indeterminate QFT result was related to being underweight (adjusted OR 3.18; 95% CI 1.09-9.26).
Our results indicate a high burden of MTB infection among the elderly in this rural area. Smokers, individuals with a history of previous TB or silicosis, and those with hepatitis B/C virus infection should be prioritized for MTB infection control to reduce the risk of disease development from a new infection.
中国农村的老年人感染结核分枝杆菌（TB）并发展为活动性疾病的风险增加。本研究旨在评估结核分枝杆菌（MTB）感染负担，并确定潜在的感染控制目标亚组。
作为一项干预性研究的一部分，对中牟县 50-70 岁的农村居民进行 MTB 感染检测，采用 QuantiFERON-TB Gold In-Tube（QFT）。通过问卷调查和体格检查获取其人口统计学信息和健康状况。
共纳入 20486 人进行分析。QFT 阳性率为 20.79%（4259/20486），50 名参与者（0.24%）结果不确定。QFT 阳性与吸烟强度呈正相关剂量反应关系。与不饮酒者相比，中强度饮酒（<10g/天）者 MTB 感染风险较低，调整后的优势比（OR）为 0.82（95%CI 0.71-0.94）。此外，男性、既往结核或矽肺史以及乙型/丙型肝炎病毒感染与 MTB 感染风险增加相关。QFT 结果不确定与体重不足有关（调整后的 OR 3.18；95%CI 1.09-9.26）。
我们的研究结果表明，该农村地区老年人 MTB 感染负担较重。吸烟者、既往结核或矽肺史以及乙型/丙型肝炎病毒感染者应优先进行 MTB 感染控制，以降低新发感染导致疾病发展的风险。
