Xiao Xiao, Li Zhipeng, Zhang Haoyue, Xin Xin, Chen Lili, Chen Jing, Shen Xin, Chen Xin
Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
Shanghai Academy of Preventive Medicine, Shanghai, China.
BMJ Open Respir Res. 2025 May 11;12(1):e002799. doi: 10.1136/bmjresp-2024-002799.
Tuberculosis preventive treatment (TPT) has been initiated systematically in Shanghai supported by a public health project. This study aimed to evaluate the acceptance of TPT, identify the factors related to its refusal, and find an optimal way to promote TPT among student tuberculosis (TB) contacts.
We screened contacts of the TB index case from a TB outbreak on campus. A two-step approach of first conducting a lecture of TB health literacy, followed by one-on-one TPT consultations was used to mobilise TPT among students with latent TB infection (LTBI). A semistructured questionnaire was designed between the lecture and the one-on-one TPT consultations, covering general demographic information, awareness of core TB knowledge and willingness to accept TPT, along with the reasons for refusal. Logistic regression analysis was used to identify the risk factors for refusing TPT.
A total of 52 contacts were identified with LTBI. After the lecture on TB health literacy, their scores on the core TB knowledge was 14.0±2.3. Students had a poor awareness rate of TB knowledge in the part of TB treatment and policy (70.2%) and infection preventive measures and LTBI (67.3%) compared with the average rate (84.3%). The acceptance rate of TPT reached 42.3% at the end of the two-step promotion. The main reasons for refusing TPT included: (1) the duration for TPT was too long and follow-up management was too cumbersome; (2) the confidence in their own immunity and belief in their low risk of TB and (3) the fear of side effects of TPT.
The two-step approach of first conducting a lecture of TB health literacy, followed by one-on-one TPT consultations, is effective for mobilising TPT. To further implement TPT, we recommend making the scientific popularisation for LTBI in a more easy-to-understand way and optimising the management of TPT.
在一项公共卫生项目的支持下，上海市已系统开展了结核病预防性治疗（TPT）。本研究旨在评估TPT的接受情况，确定拒绝TPT的相关因素，并找到在学生结核病（TB）接触者中推广TPT的最佳方法。
我们从校园结核病疫情中筛查了结核病索引病例的接触者。采用先进行结核病健康素养讲座，然后进行一对一TPT咨询的两步法，在潜伏性结核感染（LTBI）学生中推动TPT。在讲座和一对一TPT咨询之间设计了一份半结构化问卷，涵盖一般人口统计学信息、结核病核心知识知晓情况和接受TPT的意愿，以及拒绝的原因。采用逻辑回归分析确定拒绝TPT的风险因素。
共确定52名接触者患有LTBI。在结核病健康素养讲座后，他们的结核病核心知识得分为14.0±2.3。与平均知晓率（84.3%）相比，学生在结核病治疗与政策部分（70.2%）以及感染预防措施和LTBI方面（67.3%）的结核病知识知晓率较低。在两步推广结束时，TPT的接受率达到42.3%。拒绝TPT的主要原因包括：（1）TPT疗程太长且随访管理过于繁琐；（2）对自身免疫力有信心且认为自己患结核病的风险低；（3）担心TPT的副作用。
先进行结核病健康素养讲座，然后进行一对一TPT咨询的两步法，对推动TPT有效。为进一步实施TPT，我们建议以更通俗易懂的方式对LTBI进行科普宣传，并优化TPT管理。
