State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, People's Republic of China.
Xiamen Tongan District Center for Disease Control and Prevention, Xiamen City, People's Republic of China.
BMC Infect Dis. 2024 Nov 27;24(1):1354. doi: 10.1186/s12879-024-10221-6.
The elevated incidence of tuberculosis (TB) outbreaks in schools poses a significant challenge to prevention and control efforts in China. The commonality among most outbreaks is the failure to isolate patients at an early stage. Early isolation of TB cases is crucial for reducing the spread of TB within schools. This study aims to quantify the impact of different isolation proportions and durations on the attack rate of TB in schools. It explored the intervention effects of isolation measures in preventing and controlling TB in school settings. The goal is to provide insights that can serve as a reference for reducing the occurrence of TB outbreaks in schools.
We collected data from 4 school TB outbreaks. Susceptible-Exposed-Infected-Recovered (SEIR) model was used to fit the collected data and calculate transmissibility. Susceptible-Exposed-Infected-Quarantined-Recovered (SEIQR) model was employed to evaluate the effect of isolation. Effective reproduction numbers and cumulative incidence were used to quantify the transmissibility of TB.
In the 4 outbreaks, the majority of student cases were distributed in high grades of high school and universities, with a widespread occurrence of significant intervention delays. The median ascending reproduction value for the 4 outbreaks was 18.44 [interquartile range: 15.40-20.11]. Isolating 100% of the patients at the first month could reduce the number of cases by 99.47%, 87.99%, 96.48%, and 99.16%, respectively.
This study suggests that high schools and universities may represent significant high-risk environments for TB outbreaks. Early detection and isolation of cases are important strategies that can help reduce the risk of TB outbreaks, with observed case reductions of up to 99.47% when implemented promptly.
学校结核病（TB）爆发的发生率升高，对中国的预防和控制工作构成了重大挑战。大多数爆发的共同点是未能在早期隔离患者。早期隔离结核病病例对于减少学校内结核病的传播至关重要。本研究旨在量化不同隔离比例和持续时间对学校结核病发病率的影响。探讨了隔离措施在学校环境中预防和控制结核病的干预效果。目的是提供见解，为减少学校结核病爆发提供参考。
我们从 4 起学校结核病爆发中收集数据。使用易感-暴露-感染-恢复（SEIR）模型拟合收集的数据并计算传染性。使用易感-暴露-感染-隔离-恢复（SEIQR）模型评估隔离的效果。有效繁殖数和累积发病率用于量化结核病的传染性。
在这 4 起爆发中，大多数学生病例分布在高中和大学的高年级，干预延迟普遍存在。4 起爆发的中位数上升繁殖值为 18.44 [四分位距：15.40-20.11]。在第一个月隔离 100%的患者，可分别减少 99.47%、87.99%、96.48%和 99.16%的病例数。
本研究表明，高中和大学可能是结核病爆发的高风险环境。早期发现和隔离病例是减少结核病爆发风险的重要策略，及时实施可将病例减少高达 99.47%。
