Adolescent tuberculosis associated with tuberculosis exposure in classrooms and dorm rooms in Guangxi, China

Abstract

Objective: Quantify tuberculosis (TB) risk attributable to dorm room exposure in addition to classroom exposure. Methods: Adolescent school contact investigations were conducted for every reported index TB case, and similar contact investigations were conducted in selected community-control classes from November 2016 to October 2017 in Guangxi, China. Results: A total of 6263 contacts of 112 index TB cases and 6130 classmates of 112 controls were investigated. There were 14, 12, and 2 new active TB cases detected among classmates/non-roommates of index cases, classmates/roommates of index cases, and control classmates, respectively. Compared with control contacts, the adjusted relative risk (95% confidence interval (CI)) and population attributable fraction (PAF) for being a classmate/non-roommate of the index case increased the risk of active TB diagnosis to 8.44 (95% CI: 1.31–54.48) and 44.1%. The adjusted RR and PAF for being a classmate/ roommate of the index case was 29.37 (95% CI: 3.80, 227.11) and 41.4%. Being classmates/roommates significantly increased the risk of TB compared to a classmate/non-roommate of the index case (RR = 3.48, 95% CI: 1.64, 7.40). Conclusion: The additional risk of TB due to exposure in the dorm room should be taken into account in planning of TB prevention and control in boarding schools.

Pulmonary Tuberculosis Outbreak in a High School, China

“…According to Chinese guidelines for TB prevention and control in school, student with TB need to leave school for isolation and treatment, some students worry about interruption of studies rather than their disease [17]. Meanwhile, because of TB related social discrimination, some TB cases deliberately conceal their illness to avoid isolation, they may try to live with it for as long as possible, being the source of infection to others [18].The school with enclosed, air-conditioned, overcrowded classroom put students at high risk for TB infection if one student among them is infectious [3].…”

“…Current measures to prevent and control of TB are often focused on adults, while adolescents are often neglected in China. In recent years, some school based TB outbreaks have been reported in China [2][3][4][5][6][7], which attracts considerable attention. Data from released annual report on surveillance of infectious disease in China in 2017, 835193 TB cases were notified in China, among which, 40656 (4.87%) were students, incidence of pulmonary TB was 15.47/100000 students, and incidence of smear positive of pulmonary TB was 2.64/100000 students, the proportion of laboratory confirmed TB ranged from 8.3% to 20.8% [8].…”

Tuberculosis infection and epidemiological characteristics in Haidian District, Beijing, 2005–2018

“…TB was easy to spread among crowed population, leading to the prevalence in campus areas. Schools are considered common places for the community-based of outbreak of TB in China, so the exposure risk in the dorm room and tuberculin test results should be taken into consideration in prevention and control [10,11]. Moreover, although students were screened, no surveillance, follow-up or control activities were carried out, which may result in delays in the diagnosis of TB and thus caused its wide spread [12].…”

Infectivity ofMycobacterium tuberculosisGenotypes and Outcome of Contact Investigation in Classroom in Guangxi, China

“…Investigation of contacts included tuberculin skin test (TST) and questionnaire. Detail of contact investigation has been described in previous study [16]. Briefly, the investigated procedures included the following:…”