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Outline
To understand the incidence risk and risk factors of tuberculosis (TB) among middle school students in Chongqing, so as to provide a basis for formulating TB prevention and control strategies.
From September to December 2022, 32 181 middle school students were selected as the study cohort from 15 administrative districts in Chongqing by using the stratified cluster random sampling method. All cohort members were screened with the tuberculin skin test (TST), and relevant information was collected from January 1, 2023 to December 31, 2024. On the basis of active screening, the follow-up data of the participants were compared with the National Tuberculosis Management Information System to obtain the incidence status of the study subjects. The Log-rank test was used to compare the TB incidence rates among students with different characteristics, and a Cox proportional hazards model was established to analyze the incidence risk and risk factors of TB.
The TST screening rate of the cohort members was 93.0%. During the 2-year follow-up period, a total of 36 TB cases occurred, with a cumulative incidence rate of 111.87/100 000 and an incidence density of 55.95/100 000. Among them, the cumulative incidence rate of students from public schools (170.44/100 000) was higher than that of students from private schools (41.16/100 000), the cumulative incidence rate of students in schools located in high-epidemic areas (153.95/100 000) was higher than that in medium-epidemic areas (69.00/100 000), and the difference was statistically significant (χ2=11.49, 4.73, both P < 0.05). The Log-rank test for different TST results showed that the difference in TB comulative incidence rate between students with strongly positive TST results (216.55/100 000) and those with negative TST results (81.40/100 000) was statistically significant (χ2=5.85, P < 0.05). Univariate analysis using the Cox proportional hazards model revealed that the risk of TB was lower in students from private schools (HR=0.25, 95%CI=0.10-0.59) and students in medium-epidemic areas (HR=0.46, 95%CI=0.23-0.94); whereas the risk of TB was increased in students with strongly positive TST results (HR=1.39, 95%CI=1.05-1.84) (all P < 0.05). Multivariate Cox regression analysis showed that the risk of TB in students from private schools was lower than that of students from public schools (HR=0.23, 95%CI=0.08-0.62, P < 0.05).
The annual average incidence rate of TB among middle school students in Chongqing is at a relatively high level. It is necessary to strengthen the management and intervention for student groups, including those in public schools, those in schools located in high-epidemic areas, and those with strongly positive TST results, so as to reduce the incidence rate of TB.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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