Latent tuberculosis infection among the elderly in Nanchuan District
ZHANG Wen1, WU Chengguo1, ZHENG Denghu1, LUO Jiankui2, LUO Jie1, SUN Jian2, ZHANG Liyi1, LEI Rongrong1, LIAO Wenping1
1. Chongqing Institute of Tuberculosis Control and Prevention, Chongqing 400050, China; 2. Nanchuan Institute of Tuberculosis Control and Prevention, Chongqing 408400, China
Abstract：Objective To analyze the current status and influencing factors for latent tuberculosis infection (LTBI) among the elderly in Nanchuan District, Chongqing Municipality, so as to provide a reference for developing targeted prevention and control measures and reducing the risk of tuberculosis incidence. Methods From June to December 2024, a multi-stage random cluster sampling method combined with probability proportional to population size sampling was used to select residents aged ≥65 years from four townships (streets) in Nanchuan District as study participants. Demographic information, disease history, and history of close contact with tuberculosis were collected through a questionnaire survey. Tuberculin skin test (TST) was used to detect Mycobacterium tuberculosis infection. LTBI was defined as a mean induration diameter of ≥10 mm on the TST, with active pulmonary tuberculosis excluded. Factors affecting LTBI among the elderly were identified using a multivariable logistic regression model. Results A total of 3 699 participants were surveyed, including 1 707 males (46.15%) and 1 992 females (53.85%). The median age was 71.00 (interquartile range, 8.00) years. There were 285 participants (7.70%) with pulmonary disease, 18 (0.49%) with immune system disease, 47 (1.27%) with a history of tuberculosis, and 17 (0.46%) with a history of close contact with tuberculosis. LTBI was detected in 628 participants, with a detection rate of 16.98%. Multivariable logistic regression analysis showed that elderly participants with senior high school education or above (OR=2.292, 95%CI: 1.508-3.484), those with immune system disease (OR=3.226, 95%CI: 1.240-8.393), and those with a history of tuberculosis (OR=4.797, 95%CI: 2.436-9.447) were significantly associated with a higher risk of LTBI. Conclusions The detection rate of LTBI among the elderly in Nanchuan District was relatively low. Educational level, immune system disease, and history of tuberculosis were influencing factors for LTBI risk in this population. It is necessary to strengthen health education, screening, and preventive interventions.
[1] 中华人民共和国国家卫生和计划生育委员会.结核病分类:WS 196—2017[S].北京:中国标准出版社,2017. [2] 高磊,张慧,胡茂桂.全国结核分枝杆菌潜伏感染率估算专家共识[J].中国防痨杂志,2022,44(1):4-8. [3] KIM S,THAL R,SZKWARKO D.Management of latent tuberculosis infection[J].JAMA,2023,329(5):421-422. [4] STERLING T R,NJIE G,ZENNER D,et al.Guidelines for the treatment of latent tuberculosis infection:recommendations from the national tuberculosis controllers association and CDC,2020[J].MMWR Recomm Rep,2020,69(1):1-11. [5] GAO L,LU W,BAI L Q,et al.Latent tuberculosis infection in rural China:baseline results of a population-based,multicentre,prospective cohort study[J].Lancet Infect Dis,2015,15(3):310-319. [6] 先时莉. 2013—2023年重庆市65岁及以上老年人肺结核流行特征及发病预测研究[D].重庆:重庆医科大学,2025. [7] 中华人民共和国国家卫生和计划生育委员会.肺结核诊断:WS 288—2017[S].北京:中国标准出版社,2017. [8] 蒋骏,李云,姜伟,等.肺结核密切接触者结核分枝杆菌潜伏感染情况及影响因素分析[J].结核与肺部疾病杂志,2023,4(4):318-322. [9] 中华人民共和国国家卫生和计划生育委员会.成人体重判定:WS/T 428—2013[S].北京:中国标准出版社,2013. [10] 王倩倩,章涛,李傅冬,等.老年人群白内障的影响因素分析[J].预防医学,2023,35(4):311-315. [11] 中国防痨协会结核病控制专业分会,中国防痨协会老年结核病防治专业分会,《中国防痨杂志》编辑委员会.中国社区肺结核主动筛查循证指南[J].中国防痨杂志,2022,44(10):987-997. [12] 腾子豪,蒋远东,王玥,等.新疆某职业院校新生结核潜伏感染的影响因素分析[J].预防医学,2022,34(11):1156-1160. [13] 雷蓉蓉,张婷,吴成果,等.南川区居民结核潜伏感染调查[J].预防医学,2022,34(4):371-374. [14] 高磊,张慧,胡茂桂,等.基于多中心调查数据和空间统计模型的全国结核分枝杆菌潜伏感染率估算[J].中国防痨杂志,2022,44(1):54-59. [15] WANG W,CHEN X Y,CHEN S H,et al.The burden and predictors of latent tuberculosis infection among elder adults in high epidemic rural area of tuberculosis in Zhejiang,China[J/OL].Front Cell Infect Microbiol,2022,12[2026-04-07].https://doi.org/10.3389/fcimb.2022.990197. [16] 张慧,范明宽.结核分枝杆菌感染检测技术应用专家共识[J].中国防痨杂志,2025,47(7):813-829. [17] 祖筱雯,法立峰,徐彩红,等.结核分枝杆菌潜伏感染影响因素研究进展[J].江苏预防医学,2021,32(5):561-563,567. [18] World Health Organization.WHO consolidated guidelines on tuberculosis:Module 3:diagnosis-tests for tuberculosis infection[Z].Geneva:WHO,2022. [19] 国家传染病医学中心,复旦大学附属华山医院.免疫抑制剂与结核潜伏感染激活的临床专家共识(2025版)[J].中华传染病杂志,2024,42(12):715-735. [20] 张健,宋玉芳,任飞林,等.浙江省长兴县农村老年人结核分枝杆菌潜伏感染调查[J].上海预防医学,2025,37(6):503-506.
