Spatial–temporal analysis of pulmonary tuberculosis among students in the Zhejiang Province of China from 2007–2020

Zhang, Mengdie; Chen, Songhua; Luo, Dan; Chen, Bin; Wang, Wei; Wu, Qian; Liu, Kui; Wang, Hongmei; Jiang, Jianmin

doi:10.3389/fpubh.2023.1114248

Cited by 7 publications

(3 citation statements)

References 40 publications

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“…We also found that the symptoms of pulmonary tuberculosis among students in suburb district were mild; the positive rate of pathogens was low, and it was difficult to detect and diagnose compared to the general population, with strong concealment. It is necessary to strengthen students' active physical examination screening and molecular biological detection technology, which is consistent with the fact that students' tuberculosis patients are easily found in Wuhan every year during graduation, admission, and annual physical examination and similar to many research results (19)(20)(21)(22)(23).…”

Section: Discussionsupporting

confidence: 55%

Epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan, China during 2017–2022

Zhang,

Wu,

et al. 2024

Front. Public Health

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BackgroundWuhan is located in the hinterland of China, in the east of Hubei Province, at the intersection of the Yangtze River and Hanshui River. It is a national historical and cultural city, an important industrial, scientific, and educational base, and a key transportation hub. There are many schools in Wuhan, with nearly a thousand of all kinds. The number of students is ~2.2 million, accounting for nearly one-fifth of the resident population; college or university students account for ~60% of the total student population. The geographical location of these colleges is relatively concentrated, and the population density is relatively high, making it prone to tuberculosis cluster epidemic.ObjectiveThis study analyzed the epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan, China, during 2017–2022 to provide the basis for the scientific development of tuberculosis prevention and control strategies and measures in schools.MethodsThis study adopted the methods of descriptive epidemiology to analyze the epidemic characteristics of tuberculosis aggregation in schools in Wuhan from January 2017 to December 2022, collecting the relevant data on tuberculosis prevention and control in all kinds of schools in the city using Questionnaire Star, an application of the China network questionnaire survey, and analyze the influencing factors of tuberculosis aggregation by using multifactor logistic regression analysis.ResultsFrom 2017 to 2022, 54 outbreaks of pulmonary tuberculosis aggregation in schools were reported in Wuhan, which involved 37 different schools, including 32 colleges or universities and five senior high schools; 176 cases were reported, among which 73 were positive for pathogens and 18 were rifampicin or izoniazid resistant. The median duration of a single cluster epidemic was 46 (26,368) days. Universities were more prone to cluster outbreaks than middle schools (χ2 = 105.160, P = 0.001), and the incidence rate among male students was higher than that of female students in cluster epidemics (χ2 = 12.970, P = 0.001). The multivariate logistic regression analysis results showed that boarding in school (OR = 7.60) is the risk factor for a tuberculosis cluster epidemic in schools. The small number of students (OR = 0.50), the location of the school in the city (OR = 0.60), carry out physical examinations for freshmen (OR = 0.44), carry out illness absence and cause tracking (OR = 0.05), dormitories and classrooms are regularly ventilated with open windows (OR = 0.16), strict implement the management of sick student's suspension from school (OR = 0.36), and seeking timely medical consultation (OR = 0.32) were the protective factors for a tuberculosis cluster epidemic in schools.ConclusionWe successfully identified the epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan. The results revealed the influence and status of various factors and indicated ways for schools to improve their TB prevention and control measures in their daily activities. These measures can effectively help curb the cluster epidemic of tuberculosis in schools.

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Section: Discussionsupporting

confidence: 55%

Epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan, China during 2017–2022

Zhang,

Wu,

et al. 2024

Front. Public Health

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“…Conversely, other occupational segments depict a downward trajectory, indicative of enhanced health protection and preventive measures within those sectors.Notably, students rank third among all occupations, comprising 4.33% of cases, potentially re ecting RR-PTB transmission within campus settings. Strengthening health education and preventive measures within the student populace is warranted [51][52][53].…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics and diagnosis and treatment effect of rifampicin-resistant pulmonary tuberculosis (RR-PTB) in Guizhou province

Zhou,

Li,

et al. 2024

Preprint

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Background Rifampicin-resistant pulmonary tuberculosis (RR-PTB) presents a significant threat to global public health security. China bears a substantial burden of RR-PTB cases globally, with Guizhou Province experiencing particularly alarming trends, marked by a continual increase in patient numbers. Understanding the population characteristics and treatment modalities for RR-PTB is crucial for mitigating morbidity and mortality associated with this disease. Methods We gathered epidemiological, diagnostic, and treatment data of all RR-PTB cases recorded in Guizhou Province from 2017 to 2023. Utilizing composition ratios as the analytical metric, we employed Chi-square tests to examine the spatiotemporal distribution patterns of RR-PTB patients and the evolving trends among different patient classifications over the study period. Results In our study, 3396 cases of RR-PTB were analyzed, with an average age of 45 years. The number of RR-PTB patients rose significantly from 176 in 2017 to 960 in 2023, peaking notably among individuals aged 23–28 and 44–54, with a rising proportion in the 51–80 age group (P < 0.001). Since 2021, there has been a notable increase in the proportion of female patients. While individuals of Han nationality comprised the largest group, their proportion decreased over time (P < 0.001). Conversely, the Miao ethnicity showed an increasing trend (P < 0.05). The majority of patients were farmers, with their proportion showing an upward trajectory (P < 0.001), while students represented 4.33% of the cases. Geographically, most patients were registered in Guiyang and Zunyi, with a declining trend (P < 0.001), yet household addresses primarily clustered in Bijie, Tongren, and Zunyi. The proportion of floating population patients gradually decreased, alongside an increase in newly treated patients and those without prior anti-tuberculosis therapy. Additionally, there was a notable rise in molecular biological diagnostic drug sensitivity (P < 0.001). However, the cure rate declined, coupled with an increasing proportion of RR-PTB patients lost to follow-up and untreated (P < 0.05). Conclusions Enhanced surveillance is crucial for detecting tuberculosis patients aged 23–28 and 44–54 years. The distribution of cases varies among nationalities and occupations, potentially influenced by cultural and environmental factors. Regional patterns in RR-PTB incidence suggest tailored prevention and control strategies are necessary. Despite molecular biology advances, challenges persist with low cure rates and high loss to follow-up. Strengthening long-term management, resource allocation, and social support systems for RR-PTB patients is essential.

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“…The overall trend is a gradual decrease from coastal cities to inland cities. High-quality medical and health resources are highly concentrated in the northern Zhejiang plain [40], especially in Hangzhou. There is a relative gap in the management level of hospitals in the southwestern region, so there is also a gap in the efficiency and thoroughness of process simplification linked to it.…”

Section: Regional Heterogeneity Of Wise Medical Constructionmentioning

confidence: 99%

Low-Carbon Action in Full Swing: A Study on Satisfaction with Wise Medical Development

Fan

Sun

et al. 2022

IJERPH

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The development of “wise medical” is crucial to global carbon reduction. The medical sector not only has the moral obligation to reduce carbon emissions, but also has the responsibility to provide high-quality services to patients. Existing research mostly focuses on the relationship between low-carbon and wise medical, while ignoring the transformation of wise medical and patients’ opinions in the context of low-carbon transition. The paper crawls the text data of comments on the Zhihu platform (a Chinese platform similar to Quora), explores the focus of patients on wise medical through the co-occurrence analysis of high-frequency words, with a focus directly related to the role of wise medical treatment in carbon reduction, and designed a questionnaire accordingly. Using 837 valid questionnaires collected in Zhejiang Province, an XGBoost model was constructed to discuss the main factors affecting patient satisfaction, and the regional heterogeneity among the coastal area of eastern Zhejiang, the plain area of northern Zhejiang and the mountainous area of southwestern Zhejiang is discussed. The results show that patients’ focus on wise medical lies mainly in the convenience brought by digitalization and the actual medical effect, and the main factors affecting satisfaction with medical treatment are the flow of people in hospitals, optimization of the medical treatment process, the application of digital platforms, the quality of telemedicine services and the appropriate quality of treatment. In terms of regional differences in Zhejiang Province, wise medical is more developed in the plain area of northern Zhejiang, with better simplified medical treatment processes and the construction of a digital platform, while the mountainous areas of southwestern Zhejiang have better quality in telemedicine services despite the geographical environment. Eastern Zhejiang is somewhere in between.

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Spatial–temporal analysis of pulmonary tuberculosis among students in the Zhejiang Province of China from 2007–2020

Cited by 7 publications

References 40 publications

Epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan, China during 2017–2022

Epidemiological characteristics and influencing factors of tuberculosis aggregation in schools in Wuhan, China during 2017–2022

Epidemiological characteristics and diagnosis and treatment effect of rifampicin-resistant pulmonary tuberculosis (RR-PTB) in Guizhou province

Low-Carbon Action in Full Swing: A Study on Satisfaction with Wise Medical Development

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