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Latent tuberculosis infection in rural China: baseline results of a population-based, multicentre, prospective cohort study

Summary Background Prophylactic treatment of individuals with latent Mycobacterium tuberculosis infection is an essential component of tuberculosis control in some settings. In China, the prevalence of latent tuberculosis infection, and preventive interventions against this disease, have not been sy... Full description

Journal Title: The Lancet infectious diseases 2015, Vol.15 (3), p.310-319
Main Author: Gao, Lei, PhD
Other Authors: Lu, Wei, PhD , Bai, Liqiong, PhD , Wang, Xinhua, PhD , Xu, Jinsheng, MD , Catanzaro, Antonino, PhD , Cárdenas, Vicky, PhD , Li, Xiangwei, MD , Yang, Yu, PhD , Du, Jiang, MD , Sui, Hongtao, MPH , Xia, Yinyin, PhD , Li, Mufei, BS , Feng, Boxuan, BS , Li, Zhen, BS , Xin, Henan, BS , Zhao, Rong, PhD , Liu, Jianmin, MD , Pan, Shouguo, MD , Shen, Fei, MPH , He, Jian, PhD , Yang, Shumin, MPH , Si, Hongyan, MPH , Wang, Yi, MPH , Xu, Zuhui, MPH , Tan, Yunhong, MPH , Chen, Tianzhu, MD , Xu, Weiguo, MD , Peng, Hong, MD , Wang, Zhijian, MPH , Zhu, Tao, MPH , Zhou, Feng, PhD , Liu, Haiying, PhD , Zhao, Yanlin, Prof , Cheng, Shiming, Prof , Jin, Qi, Prof
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Ltd
ID: ISSN: 1473-3099
Link: https://www.ncbi.nlm.nih.gov/pubmed/25681063
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title: Latent tuberculosis infection in rural China: baseline results of a population-based, multicentre, prospective cohort study
format: Article
creator:
  • Gao, Lei, PhD
  • Lu, Wei, PhD
  • Bai, Liqiong, PhD
  • Wang, Xinhua, PhD
  • Xu, Jinsheng, MD
  • Catanzaro, Antonino, PhD
  • Cárdenas, Vicky, PhD
  • Li, Xiangwei, MD
  • Yang, Yu, PhD
  • Du, Jiang, MD
  • Sui, Hongtao, MPH
  • Xia, Yinyin, PhD
  • Li, Mufei, BS
  • Feng, Boxuan, BS
  • Li, Zhen, BS
  • Xin, Henan, BS
  • Zhao, Rong, PhD
  • Liu, Jianmin, MD
  • Pan, Shouguo, MD
  • Shen, Fei, MPH
  • He, Jian, PhD
  • Yang, Shumin, MPH
  • Si, Hongyan, MPH
  • Wang, Yi, MPH
  • Xu, Zuhui, MPH
  • Tan, Yunhong, MPH
  • Chen, Tianzhu, MD
  • Xu, Weiguo, MD
  • Peng, Hong, MD
  • Wang, Zhijian, MPH
  • Zhu, Tao, MPH
  • Zhou, Feng, PhD
  • Liu, Haiying, PhD
  • Zhao, Yanlin, Prof
  • Cheng, Shiming, Prof
  • Jin, Qi, Prof
subjects:
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis
  • Child
  • Child, Preschool
  • China - epidemiology
  • Cohort Studies
  • Disease
  • Disease prevention
  • Epidemiology
  • Family income
  • Female
  • Health aspects
  • Households
  • Humans
  • Infections
  • Infectious Disease
  • Interferon-gamma Release Tests
  • Laboratories
  • Latent Tuberculosis - epidemiology
  • Male
  • Middle Aged
  • Multivariate analysis
  • Mycobacterium
  • Mycobacterium tuberculosis
  • Prevalence
  • Prevalence studies (Epidemiology)
  • Prevention
  • Prospective Studies
  • Rural areas
  • Rural Population
  • Skin
  • Studies
  • Tuberculin Test
  • Tuberculosis
  • Young Adult
ispartof: The Lancet infectious diseases, 2015, Vol.15 (3), p.310-319
description: Summary Background Prophylactic treatment of individuals with latent Mycobacterium tuberculosis infection is an essential component of tuberculosis control in some settings. In China, the prevalence of latent tuberculosis infection, and preventive interventions against this disease, have not been systematically studied. We aimed to assess the prevalence of latent tuberculosis and its associated risk factors in rural populations in China. Methods Between July 1, and Sept 30, 2013, we undertook a baseline survey of a population-based, multicentre, prospective cohort study of registered residents (≥5 years old) at four study sites in rural China. Eligible participants were identified by door-to-door survey with a household sampling design. We screened participants for active tuberculosis and history of tuberculosis then used a tuberculin skin test and an interferon-γ release assay (QuantiFERON [QFT]) to test for latent infection. We used odds ratios (ORs) and 95% CIs to assess variables associated with positivity of QFT and tuberculin skin tests. Findings 21 022 (90%) of 23 483 eligible participants completed a baseline survey. Age-standardised and sex-standardised rates of skin-test positivity (≥10 mm) ranged from 15% to 42%, and QFT positivity rates ranged from 13% to 20%. Rates of positivity for the tuberculin skin test and the QFT test were low in study participants younger than 20 years and gradually increased with age (p for trend
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1473-3099
fulltext: fulltext
issn:
  • 1473-3099
  • 1474-4457
url: Link


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titleLatent tuberculosis infection in rural China: baseline results of a population-based, multicentre, prospective cohort study
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creatorGao, Lei, PhD ; Lu, Wei, PhD ; Bai, Liqiong, PhD ; Wang, Xinhua, PhD ; Xu, Jinsheng, MD ; Catanzaro, Antonino, PhD ; Cárdenas, Vicky, PhD ; Li, Xiangwei, MD ; Yang, Yu, PhD ; Du, Jiang, MD ; Sui, Hongtao, MPH ; Xia, Yinyin, PhD ; Li, Mufei, BS ; Feng, Boxuan, BS ; Li, Zhen, BS ; Xin, Henan, BS ; Zhao, Rong, PhD ; Liu, Jianmin, MD ; Pan, Shouguo, MD ; Shen, Fei, MPH ; He, Jian, PhD ; Yang, Shumin, MPH ; Si, Hongyan, MPH ; Wang, Yi, MPH ; Xu, Zuhui, MPH ; Tan, Yunhong, MPH ; Chen, Tianzhu, MD ; Xu, Weiguo, MD ; Peng, Hong, MD ; Wang, Zhijian, MPH ; Zhu, Tao, MPH ; Zhou, Feng, PhD ; Liu, Haiying, PhD ; Zhao, Yanlin, Prof ; Cheng, Shiming, Prof ; Jin, Qi, Prof
creatorcontribGao, Lei, PhD ; Lu, Wei, PhD ; Bai, Liqiong, PhD ; Wang, Xinhua, PhD ; Xu, Jinsheng, MD ; Catanzaro, Antonino, PhD ; Cárdenas, Vicky, PhD ; Li, Xiangwei, MD ; Yang, Yu, PhD ; Du, Jiang, MD ; Sui, Hongtao, MPH ; Xia, Yinyin, PhD ; Li, Mufei, BS ; Feng, Boxuan, BS ; Li, Zhen, BS ; Xin, Henan, BS ; Zhao, Rong, PhD ; Liu, Jianmin, MD ; Pan, Shouguo, MD ; Shen, Fei, MPH ; He, Jian, PhD ; Yang, Shumin, MPH ; Si, Hongyan, MPH ; Wang, Yi, MPH ; Xu, Zuhui, MPH ; Tan, Yunhong, MPH ; Chen, Tianzhu, MD ; Xu, Weiguo, MD ; Peng, Hong, MD ; Wang, Zhijian, MPH ; Zhu, Tao, MPH ; Zhou, Feng, PhD ; Liu, Haiying, PhD ; Zhao, Yanlin, Prof ; Cheng, Shiming, Prof ; Jin, Qi, Prof ; for the LATENTTB-NSTM study team ; LATENTTB-NSTM study team
descriptionSummary Background Prophylactic treatment of individuals with latent Mycobacterium tuberculosis infection is an essential component of tuberculosis control in some settings. In China, the prevalence of latent tuberculosis infection, and preventive interventions against this disease, have not been systematically studied. We aimed to assess the prevalence of latent tuberculosis and its associated risk factors in rural populations in China. Methods Between July 1, and Sept 30, 2013, we undertook a baseline survey of a population-based, multicentre, prospective cohort study of registered residents (≥5 years old) at four study sites in rural China. Eligible participants were identified by door-to-door survey with a household sampling design. We screened participants for active tuberculosis and history of tuberculosis then used a tuberculin skin test and an interferon-γ release assay (QuantiFERON [QFT]) to test for latent infection. We used odds ratios (ORs) and 95% CIs to assess variables associated with positivity of QFT and tuberculin skin tests. Findings 21 022 (90%) of 23 483 eligible participants completed a baseline survey. Age-standardised and sex-standardised rates of skin-test positivity (≥10 mm) ranged from 15% to 42%, and QFT positivity rates ranged from 13% to 20%. Rates of positivity for the tuberculin skin test and the QFT test were low in study participants younger than 20 years and gradually increased with age (p for trend <0·0001). Rates of latent tuberculosis infection were higher for men than women (p<0·0001). Overall agreement between the tuberculin skin test and the QFT test was moderate (81·06%; kappa coefficient 0·485), with skin-test-only positive results associated with the presence of BCG scar, male sex, and ages of 60 years and older, and QFT-only positive results associated with male sex and ages of 60 years and older. Interpretation On the basis of findings showing that the performance of the tuberculin skin test might be affected by various factors including BCG vaccination and age, our results suggest that the prevalence of latent tuberculosis in China might be overestimated by skin tests compared with interferon-γ release assays. Funding The National Science and Technology Major Project of China, the Program for Changjiang Scholars and Innovative Research Team in University of China.
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subjectAdolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis ; Child ; Child, Preschool ; China - epidemiology ; Cohort Studies ; Disease ; Disease prevention ; Epidemiology ; Family income ; Female ; Health aspects ; Households ; Humans ; Infections ; Infectious Disease ; Interferon-gamma Release Tests ; Laboratories ; Latent Tuberculosis - epidemiology ; Male ; Middle Aged ; Multivariate analysis ; Mycobacterium ; Mycobacterium tuberculosis ; Prevalence ; Prevalence studies (Epidemiology) ; Prevention ; Prospective Studies ; Rural areas ; Rural Population ; Skin ; Studies ; Tuberculin Test ; Tuberculosis ; Young Adult
ispartofThe Lancet infectious diseases, 2015, Vol.15 (3), p.310-319
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4Xu, Jinsheng, MD
5Catanzaro, Antonino, PhD
6Cárdenas, Vicky, PhD
7Li, Xiangwei, MD
8Yang, Yu, PhD
9Du, Jiang, MD
10Sui, Hongtao, MPH
11Xia, Yinyin, PhD
12Li, Mufei, BS
13Feng, Boxuan, BS
14Li, Zhen, BS
15Xin, Henan, BS
16Zhao, Rong, PhD
17Liu, Jianmin, MD
18Pan, Shouguo, MD
19Shen, Fei, MPH
20He, Jian, PhD
21Yang, Shumin, MPH
22Si, Hongyan, MPH
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24Xu, Zuhui, MPH
25Tan, Yunhong, MPH
26Chen, Tianzhu, MD
27Xu, Weiguo, MD
28Peng, Hong, MD
29Wang, Zhijian, MPH
30Zhu, Tao, MPH
31Zhou, Feng, PhD
32Liu, Haiying, PhD
33Zhao, Yanlin, Prof
34Cheng, Shiming, Prof
35Jin, Qi, Prof
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descriptionSummary Background Prophylactic treatment of individuals with latent Mycobacterium tuberculosis infection is an essential component of tuberculosis control in some settings. In China, the prevalence of latent tuberculosis infection, and preventive interventions against this disease, have not been systematically studied. We aimed to assess the prevalence of latent tuberculosis and its associated risk factors in rural populations in China. Methods Between July 1, and Sept 30, 2013, we undertook a baseline survey of a population-based, multicentre, prospective cohort study of registered residents (≥5 years old) at four study sites in rural China. Eligible participants were identified by door-to-door survey with a household sampling design. We screened participants for active tuberculosis and history of tuberculosis then used a tuberculin skin test and an interferon-γ release assay (QuantiFERON [QFT]) to test for latent infection. We used odds ratios (ORs) and 95% CIs to assess variables associated with positivity of QFT and tuberculin skin tests. Findings 21 022 (90%) of 23 483 eligible participants completed a baseline survey. Age-standardised and sex-standardised rates of skin-test positivity (≥10 mm) ranged from 15% to 42%, and QFT positivity rates ranged from 13% to 20%. Rates of positivity for the tuberculin skin test and the QFT test were low in study participants younger than 20 years and gradually increased with age (p for trend <0·0001). Rates of latent tuberculosis infection were higher for men than women (p<0·0001). Overall agreement between the tuberculin skin test and the QFT test was moderate (81·06%; kappa coefficient 0·485), with skin-test-only positive results associated with the presence of BCG scar, male sex, and ages of 60 years and older, and QFT-only positive results associated with male sex and ages of 60 years and older. Interpretation On the basis of findings showing that the performance of the tuberculin skin test might be affected by various factors including BCG vaccination and age, our results suggest that the prevalence of latent tuberculosis in China might be overestimated by skin tests compared with interferon-γ release assays. Funding The National Science and Technology Major Project of China, the Program for Changjiang Scholars and Innovative Research Team in University of China.
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3Aged, 80 and over
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12Li, Mufei, BS
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14Li, Zhen, BS
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titleLatent tuberculosis infection in rural China: baseline results of a population-based, multicentre, prospective cohort study
authorGao, Lei, PhD ; Lu, Wei, PhD ; Bai, Liqiong, PhD ; Wang, Xinhua, PhD ; Xu, Jinsheng, MD ; Catanzaro, Antonino, PhD ; Cárdenas, Vicky, PhD ; Li, Xiangwei, MD ; Yang, Yu, PhD ; Du, Jiang, MD ; Sui, Hongtao, MPH ; Xia, Yinyin, PhD ; Li, Mufei, BS ; Feng, Boxuan, BS ; Li, Zhen, BS ; Xin, Henan, BS ; Zhao, Rong, PhD ; Liu, Jianmin, MD ; Pan, Shouguo, MD ; Shen, Fei, MPH ; He, Jian, PhD ; Yang, Shumin, MPH ; Si, Hongyan, MPH ; Wang, Yi, MPH ; Xu, Zuhui, MPH ; Tan, Yunhong, MPH ; Chen, Tianzhu, MD ; Xu, Weiguo, MD ; Peng, Hong, MD ; Wang, Zhijian, MPH ; Zhu, Tao, MPH ; Zhou, Feng, PhD ; Liu, Haiying, PhD ; Zhao, Yanlin, Prof ; Cheng, Shiming, Prof ; Jin, Qi, Prof
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24Multivariate analysis
25Mycobacterium
26Mycobacterium tuberculosis
27Prevalence
28Prevalence studies (Epidemiology)
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30Prospective Studies
31Rural areas
32Rural Population
33Skin
34Studies
35Tuberculin Test
36Tuberculosis
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eissn1474-4457
codenLANCAO
abstractSummary Background Prophylactic treatment of individuals with latent Mycobacterium tuberculosis infection is an essential component of tuberculosis control in some settings. In China, the prevalence of latent tuberculosis infection, and preventive interventions against this disease, have not been systematically studied. We aimed to assess the prevalence of latent tuberculosis and its associated risk factors in rural populations in China. Methods Between July 1, and Sept 30, 2013, we undertook a baseline survey of a population-based, multicentre, prospective cohort study of registered residents (≥5 years old) at four study sites in rural China. Eligible participants were identified by door-to-door survey with a household sampling design. We screened participants for active tuberculosis and history of tuberculosis then used a tuberculin skin test and an interferon-γ release assay (QuantiFERON [QFT]) to test for latent infection. We used odds ratios (ORs) and 95% CIs to assess variables associated with positivity of QFT and tuberculin skin tests. Findings 21 022 (90%) of 23 483 eligible participants completed a baseline survey. Age-standardised and sex-standardised rates of skin-test positivity (≥10 mm) ranged from 15% to 42%, and QFT positivity rates ranged from 13% to 20%. Rates of positivity for the tuberculin skin test and the QFT test were low in study participants younger than 20 years and gradually increased with age (p for trend <0·0001). Rates of latent tuberculosis infection were higher for men than women (p<0·0001). Overall agreement between the tuberculin skin test and the QFT test was moderate (81·06%; kappa coefficient 0·485), with skin-test-only positive results associated with the presence of BCG scar, male sex, and ages of 60 years and older, and QFT-only positive results associated with male sex and ages of 60 years and older. Interpretation On the basis of findings showing that the performance of the tuberculin skin test might be affected by various factors including BCG vaccination and age, our results suggest that the prevalence of latent tuberculosis in China might be overestimated by skin tests compared with interferon-γ release assays. Funding The National Science and Technology Major Project of China, the Program for Changjiang Scholars and Innovative Research Team in University of China.
copUnited States
pubElsevier Ltd
pmid25681063
doi10.1016/S1473-3099(14)71085-0