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解决中国学童和青少年潜伏性结核感染的负担和检测差距:一项横断面研究。

Addressing the burden and detection gap of latent tuberculosis infection in schoolchildren and adolescents in China: a cross-sectional study.

机构信息

Chongqing Municipal Institute of Tuberculosis, Chongqing, 400045, China.

出版信息

BMC Infect Dis. 2024 Sep 16;24(1):984. doi: 10.1186/s12879-024-09812-0.

Abstract

BACKGROUND

The latent tuberculosis infection (LTBI) burden is still unclear in schoolchildren and adolescents in China. Previous study and daily surveillance data indicate a LTBI detection gap. The research objective was to evaluate the LTBI burden and detection gap among schoolchildren and adolescents in China.

METHODS

A cross-sectional study was conducted among 69,667 schoolchildren and adolescents in Chongqing, China between September 2022 and December 2023 implemented by Chongqing Municipal Institute of Tuberculosis using tuberculin skin test (TST) and creation tuberculin skin test (C-TST). To evaluate the LTBI detection gap, the pulmonary tuberculosis (PTB) screening data implemented by Chongqing Municipal Institute of Tuberculosis have been compared with the data in 2021 implemented by community-level medical and health care institutions.

RESULTS

The LTBI prevalence rate using TST and C-TST implemented by Chongqing Municipal Institute of Tuberculosis was 12.8% (95%CI, 12.5-13%) and 6.4% (95%CI, 6-6.8%) respectively. The LTBI prevalence rate by Chongqing Municipal Institute of Tuberculosis was 9.6% higher than that by community-level medical and health care institutions (χ = 2931.9, P < 0.001).

CONCLUSIONS

The LTBI detection gap existed among schoolchildren and adolescents in Chongqing, and it also may exist in other similar countries and regions. National screening strategy needs improvement. Regular training and quality assurance could improve the performance of TST and C-TST and close the detection gap of LTBI.

摘要

背景

中国儿童和青少年中的潜伏性结核感染(LTBI)负担仍不清楚。以往的研究和日常监测数据表明存在 LTBI 检测差距。本研究旨在评估中国儿童和青少年中的 LTBI 负担和检测差距。

方法

2022 年 9 月至 2023 年 12 月,重庆市结核病防治所采用结核菌素皮肤试验(TST)和改良结核菌素皮肤试验(C-TST)对重庆市 69667 名儿童和青少年进行了横断面研究。为了评估 LTBI 检测差距,将重庆市结核病防治所实施的肺结核(PTB)筛查数据与 2021 年社区级医疗卫生机构实施的数据进行了比较。

结果

重庆市结核病防治所采用 TST 和 C-TST 检测 LTBI 的流行率分别为 12.8%(95%CI,12.5-13%)和 6.4%(95%CI,6-6.8%)。重庆市结核病防治所的 LTBI 流行率比社区级医疗卫生机构高 9.6%(χ²=2931.9,P<0.001)。

结论

重庆市儿童和青少年中存在 LTBI 检测差距,其他类似国家和地区也可能存在这种情况。国家筛查策略需要改进。定期培训和质量保证可以提高 TST 和 C-TST 的性能,缩小 LTBI 的检测差距。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da29/11403834/70ab9c6944c7/12879_2024_9812_Fig1_HTML.jpg

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