Epidemiological Characteristics of Rifampicin-Resistant Tuberculosis in Students - China, 2015-2019

Prevalence and risk factors of latent tuberculosis infection among college students: a systematic review and meta-analysis

OBJECTIVES

College students are at increased risk of tuberculosis (TB), which increases their likelihood of developing latent tuberculosis infections (LTBI). This study aimed to estimate the pooled prevalence of LTBI and identify its risk factors.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

We searched PubMed, Embase, Scopus, Web of Science, CNKI, Wanfang and CBM databases (10 March 2022) for studies published in any language. The pooled prevalence of LTBI was estimated using random effects methods. Factors associated with LTBI were evaluated by determining standardised mean difference (SMD) with 95% confidence interval (CI). All analyses were performed using the Stata 15.1.

RESULTS

A total of 50 studies from 18 countries were included, with 44 tuberculin skin test (n = 623,732) and 19 interferon gamma release assay (n = 38,266) estimates. The prevalence of a positive tuberculin skin test was 20% (95% CI: 17-23%), and the prevalence of a positive interferon gamma release assay was 9% (95% CI: 7%-11%) among college students. Older age (SMD: 1.67, 95% CI: 1.31-2.13), no Bacillus Calmette-Guérin vaccination/scar (SMD: 1.51, 95% CI: 1.06-2.16), contact with TB cases (SMD: 1.34, 95% CI: 1.11-1.62), clinical training (SMD: 1.93, 95% CI: 1.65-2.26) and overweight/obesity (SMD: 1.17, 95% CI: 1.06-1.30) were associated with a higher prevalence of LTBI. Sex was not associated with LTBI prevalence.

CONCLUSION

College students have an increased risk of LTBI, although it varies by geographical area. This meta-analysis provides evidence of risk factors for LTBI in college students. Infection control measures should be conducted for college students with LTBI.

Multi-modal deep learning based on multi-dimensional and multi-level temporal data can enhance the prognostic prediction for multi-drug resistant pulmonary tuberculosis patients

Despite the advent of new diagnostics, drugs and regimens, multi-drug resistant pulmonary tuberculosis (MDR-PTB) remains a global health threat. It has a long treatment cycle, low cure rate and heavy disease burden. Factors such as demographics, disease characteristics, lung imaging, biomarkers, therapeutic schedule and adherence to medications are associated with MDR-PTB prognosis. However, thus far, the majority of existing studies have focused on predicting treatment outcomes through static single-scale or low dimensional information. Hence, multi-modal deep learning based on dynamic data for multiple dimensions can provide a deeper understanding of personalized treatment plans to aid in the clinical management of patients.

A university-clustered tuberculosis outbreak during the COVID-19 pandemic in eastern China

During the COVID-19 pandemic in 2020, a tuberculosis outbreak occurred in a university in eastern China, with 4,488 students and 421 staff on the campus. A 19-year-old student was diagnosed in August 2019. Later, the first round of screening was initiated among close contacts, but no active cases were found. Till September 2020, four rounds of screening were performed. Four rounds of screening were conducted on September 9, November 8, November 22-25 in 2019 and September 2020, with 0, 5, 0 and 43 cases identified, respectively. A total of 66 active tuberculosis were found in the same university, including 4 sputum culture-positive and 7 sputum smear-positive. The total attack rate of active tuberculosis was 1.34% (66/4909). The whole-genome sequencing showed that the isolates belonged to the same L2 sub-specie and were sensitive to all tested antituberculosis drugs. Delay detection, diagnosis and report of cases were the major cause of this university tuberculosis epidemic. More attention should be paid to the asymptomatic students in the index class. After the occurrence of tuberculosis cases in schools, multiple rounds of screening should be carried out, and preventive therapy should be applied in a timely manner.