Association between the risk of tuberculosis outbreak in schools and the visit interval of index cases

ZHANG Xiaolong; CUI Caiyan; FU Ying; WANG Feixian; LI Yun; JIANG Jun

doi:10.16835/j.cnki.1000-9817.2024038

Volume 45 Issue 1

Jan. 2024

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ZHANG Xiaolong, CUI Caiyan, FU Ying, WANG Feixian, LI Yun, JIANG Jun. Association between the risk of tuberculosis outbreak in schools and the visit interval of index cases[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2024, 45(1): 138-141. doi: 10.16835/j.cnki.1000-9817.2024038

Citation:

ZHANG Xiaolong, CUI Caiyan, FU Ying, WANG Feixian, LI Yun, JIANG Jun. Association between the risk of tuberculosis outbreak in schools and the visit interval of index cases[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2024, 45(1): 138-141. doi: 10.16835/j.cnki.1000-9817.2024038

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Association between the risk of tuberculosis outbreak in schools and the visit interval of index cases

doi: 10.16835/j.cnki.1000-9817.2024038

Suzhou Center for Disease Control and Prevention, Suzhou (215004), Jiangsu Province, China

Received Date: 2023-10-16
Rev Recd Date: 2023-11-15

Available Online: 2024-02-01

Publish Date: 2024-01-25

Abstract

Abstract

Objective To analyze the relationship between the risk of tuberculosis outbreaks in schools and the visit interval of index cases, so as to provide a scientific reference for predicting the risks of tuberculosis outbreak and making preventive measures. Methods A total of 630 index cases from school tuberculosis outbreaks were studied during January, 2015 to December, 2022. Data on demographics, consultation history, etiological diagnosis, and methods of detection were collected. Restricted Cubic Splines (RCS), unconditional Logistic regression, and the receiver operating characteristic curve (ROC curve) were used for analysis. Results The RCS fitted curve showed that the risk of a tuberculosis outbreak linearly increased when the consultation interval for etiologically negative patients exceeded 5.79 days, or for etiologically positive patients exceeded 8.37 days. After multi-factor adjustment, for every additional day in the visit interval of the index case, the odds ratio (OR) value for a high-risk outbreak was 1.10 (95%CI=1.07-1.13)(P < 0.05). When analyzed by tertiles of visit intervals, compared to an interval of < 14 days, the OR values (95%CI) for high-risk outbreaks in schools with intervals of 14- < 28 days and ≥28 days were 10.32(3.04-35.10) and 82.58(28.42-239.95), respectively(P < 0.01), indicating a trend of increasing outbreak risk with longer visit intervals. Based on the ROC curve analysis, the optimal threshold for predicting a high-risk school tuberculosis outbreak was 23.5 days, with an area under the curve (AUC) of 0.93 (95%CI=0.89-0.98). Conclusion An extended visit interval of index cases is a good early warning indicator for high-risk tuberculosis outbreaks in schools and could be considered a key factor in early intervention and risk control strategies.
- Tuberculosis, pulmonary,
- Disease outbreaks,
- Case reports,
- Ambulatory care,
- Students

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References(17)

References

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