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Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China

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  • Dongxiang Pan

    (Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530021, Guangxi, China
    Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hatyai 90110, Songkhla, Thailand)

  • Mei Lin

    (Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530021, Guangxi, China
    Contributed equally to this work.)

  • Rushu Lan

    (Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530021, Guangxi, China)

  • Edward A Graviss

    (Department of Pathology and Genomic Medicine, The Center for Molecular and Translational Human Infectious Diseases Research, Houston Methodist Research Institute, Houston, TX 77030, USA)

  • Dingwen Lin

    (Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530021, Guangxi, China)

  • Dabin Liang

    (Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530021, Guangxi, China)

  • Xi Long

    (School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China)

  • Huifang Qin

    (Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530021, Guangxi, China)

  • Liwen Huang

    (Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530021, Guangxi, China)

  • Minying Huang

    (Department of Tuberculosis Prevention and Control, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530021, Guangxi, China)

  • Virasakdi Chongsuvivatwong

    (Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hatyai 90110, Songkhla, Thailand
    Contributed equally to this work.)

Abstract

The aim of this paper is to evaluate the link between the history of exposure to tuberculosis (TB) in the household and diagnosed TB cases at school, and to compare the detection rate of active TB among household contacts and classroom contacts of adolescent TB cases with the rates among contacts of healthy controls. From November 2016 to December 2017, a prospective matched case-control study was conducted using passively identified index adolescent student cases from the TB surveillance system and healthy controls (matched by county, school type, sex, age and ethnicity). Contacts in households and classrooms of index cases and of controls were investigated. Matched tabulation of 117 case-control pairs revealed exposure to TB in the household as a strong risk factor (odds ratio (OR) = 21.0, 95% confidence interval (CI): 3.4, 868.6). Forty-five (case detection rate 0.69%) and two (case detection rate 0.03%) new active TB cases were detected among 6512 and 6480 classroom contacts of the index cases and controls, respectively. Having an index case in the classroom significantly increased the risk of classmates contracting active TB (OR = 22.5, 95% CI: 5.9, 191.4). Our findings suggested that previous exposure to TB in the household could lead a child to catch TB at school, then spread TB to classmates.

Suggested Citation

  • Dongxiang Pan & Mei Lin & Rushu Lan & Edward A Graviss & Dingwen Lin & Dabin Liang & Xi Long & Huifang Qin & Liwen Huang & Minying Huang & Virasakdi Chongsuvivatwong, 2018. "Tuberculosis Transmission in Households and Classrooms of Adolescent Cases Compared to the Community in China," IJERPH, MDPI, vol. 15(12), pages 1-10, December.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:12:p:2803-:d:189314
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    References listed on IDEAS

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    1. Joël Mossong & Niel Hens & Mark Jit & Philippe Beutels & Kari Auranen & Rafael Mikolajczyk & Marco Massari & Stefania Salmaso & Gianpaolo Scalia Tomba & Jacco Wallinga & Janneke Heijne & Malgorzata Sa, 2008. "Social Contacts and Mixing Patterns Relevant to the Spread of Infectious Diseases," PLOS Medicine, Public Library of Science, vol. 5(3), pages 1-1, March.
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    Cited by:

    1. Zhezhe Cui & Dingwen Lin & Virasakdi Chongsuvivatwong & Edward A. Graviss & Angkana Chaiprasert & Prasit Palittapongarnpim & Mei Lin & Jing Ou & Jinming Zhao, 2019. "Hot and Cold Spot Areas of Household Tuberculosis Transmission in Southern China: Effects of Socio-Economic Status and Mycobacterium tuberculosis Genotypes," IJERPH, MDPI, vol. 16(10), pages 1-18, May.

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