Analysis of re-screening for latent tuberculosis infection in 2025 and related factors affecting infection status among rural doctors in Zhongmu County, Henan Province, based on 2017 screening

doi:10.19982/j.issn.1000-6621.20260062

Abstract

Abstract:

Objective: To systematically reassess the latent tuberculosis infection (LTBI) status among rural doctors in Zhongmu County, Henan Province via re-screening conducted in 2025 based on the baseline LTBI screening implemented in 2017, and to explore influencing factors associated with changes in infection status. Methods: Using an open-cohort study design, from September 12 to 21, 2025, 599 village doctors registered in Zhongmu County, Henan Province, who had participated in the 2017 baseline screening for Mycobacterium tuberculosis (MTB), were re-screened for LTBI (using the QuantiFERON-TB Gold (abbreviated as “QFT”) test) in accordance with the inclusion criteria, to assess the LTBI screening status of this population across different years. Univariate and multivariate logistic regression models were applied to identify factors correlated with QFT test results. Results: In 2025, a total of 516 participants were included in the study, of whom 20.74% (107/516) tested for LTBI, markedly lower than the LTBI prevalence of 27.71% (166/599) recorded in 2017. After age and gender standardization, the standardized LTBI prevalence declined from 23.14% in 2017 to 15.47% in 2025, with a statistically significant difference (χ²=9.163, P=0.002). Among the 333 participants who completed both rounds of MTB infection screening, the QFT reversion rate in 2025 was 21.84% (19/87) for those who were LTBI in 2017, while the QFT conversion rate in 2025 was 4.88% (12/246) for those who were not infected with MTB in 2017. Multivariate regression analysis indicated that participants who had never smoked were more likely to achieve QFT reversion compared with current smokers (adjusted OR(95%CI)=3.464 (0.803-24.101)), with a marginally significant trend (P=0.068). Participants with a practice duration of ≥26 years exhibited a greater risk of QFT conversion relative to those with a practice duration of <26 years (adjusted OR (95%CI)=7.520 (0.978-27.820)), with a marginally significant trend (P=0.052). Participants with a monthly income of <2500 RMB had significantly higher risks of QFT conversion than those with a monthly income of ≥2500 RMB (adjusted OR (95%CI)=3.706 (1.058-12.987), P=0.042). Conclusion: Consistent with the overall declining tuberculosis epidemic in Henan Province, the LTBI prevalence among rural doctors in Zhongmu County decreased significantly in 2025 relative to 2017, yet remained higher than that of the general population. While sustaining population-wide tuberculosis prevention and control strategies, targeted infection control measures should be further guaranteed and implemented for frontline medical staff such as rural doctors. Special attention should be paid to MTB infection surveillance for rural doctors who smoke, earn less than 2500 RMB monthly, or have worked in the profession for an extended period.

Key words: Mycobacterium tuberculosis, Mycobacterium infections, Hospitals, rural, Caregivers, Immunologic tests, Factor analysis, statistical

CLC Number:

R52
R183

Liu Zisen, Zhao Yaqi, Zhang Bin, Xin Henan, Du Jiang, Feng Boxuan, He Yijun, Li Zihan, Yu Yilin, Wang Dakuan, Yan Jiaoxia, Gao Lei, Jin Qi, Duan Weitao, Cao Xuefang. Analysis of re-screening for latent tuberculosis infection in 2025 and related factors affecting infection status among rural doctors in Zhongmu County, Henan Province, based on 2017 screening[J]. Chinese Journal of Antituberculosis, 2026, 48(8): 1139-1147. doi: 10.19982/j.issn.1000-6621.20260062

Figures/Tables 7

References 14

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特征	人数(名)	构成比(%)	特征	人数(名)	构成比(%)
年龄组(岁)			24.0~27.9	212	41.09
<50	230	44.57	≥28	135	26.16
≥50	286	55.43	村医执业时间(年)^b
性别			<26	247	47.87
男性	312	60.47	≥26	269	52.13
女性	204	39.53	最高教育水平
月收入(元)^a			高中及以下	331	64.15
<2500	164	31.78	大学及以上	185	35.85
≥2500	352	68.22	是否管理过肺结核患者
吸烟			否	236	45.74
否	400	77.52	是	280	54.26
是	116	22.48	是否接触过肺结核患者
饮酒			否	503	97.48
否	386	74.81	是	13	2.52
是	130	25.19	QFT
BMI(kg/m²)			阳性	107	20.74
<18.5	4	0.77	阴性	404	78.29
18.5~23.9	165	31.98	不确定	5	0.97

变量	2017年		2025年		χ²值	P值
变量	筛查人数(名)	感染例数(感染率,%)	筛查人数(名)	感染例数(感染率,%)	χ²值	P值
总计	599	166(27.71)	516	107(20.74)	7.924	0.005
年龄组(岁)
<50	362	79(21.82)	230	29(12.61)	7.400	0.006
≥50	237	87(36.71)	286	78(27.27)	4.916	0.027
性别
男性	410	129(31.46)	312	80(25.64)	2.644	0.104
女性	189	37(19.58)	204	27(13.24)	2.447	0.118

特征	人数(名)	构成比(%)	特征	人数(名)	构成比(%)
年龄组(岁)			18.5~23.9	86	25.83
20~29	0	0.00	24~27.9	147	44.14
30~39	26	7.81	≥28	98	29.43
40~49	74	22.22	村医执业时间^b(年)
50~59	151	45.35	<26	111	33.33
≥60	82	24.62	≥26	222	66.67
性别			最高教育水平
男性	234	70.27	初中及以下	16	4.80
女性	99	29.73	高中	228	68.47
月收入^a(元)			大学及以上	89	26.73
<2500	125	37.54	是否为管理结核病人员
≥2500	208	62.46	否	116	34.83
吸烟			是	217	65.17
否	255	76.58	是否接触结核病患者
是	78	23.42	否	324	97.30
饮酒			是	9	2.70
否	239	71.77	QFT检测
是	94	28.23	阳性	78	23.42
BMI(kg/m²)			阴性	252	75.68
<18.5	2	0.60	不确定	3	0.90

变量	2017年阴性人数(名)	2025年[例/名(构成比,%)]		χ²值	P值^b
变量	2017年阴性人数(名)	阴性	阳性^a	χ²值	P值^b
总计	246	234(95.12)	12(4.88)
年龄组(岁)				10.652	0.001
<50	86	86(100.00)	0(0.00)
≥50	160	148(92.50)	12(7.50)
性别				1.544	0.214
女性	79	77(97.47)	2(2.53)
男性	167	157(94.01)	10(5.99)
月收入^c(元)				4.920	0.027
<2500	90	82(91.11)	8(8.89)
≥2500	156	152(97.44)	4(2.56)
吸烟				0.049	0.824
否	191	182(95.29)	9(4.71)
是	55	52(94.55)	3(5.45)
饮酒				0.136	0.712
否	173	164(94.80)	9(5.20)
是	73	70(95.89)	3(4.11)
BMI(kg/m²)				0.304	0.959
<18.5	1	1(1/1)	0(0/1)
18.5~23.9	62	59(95.16)	3(4.84)
24~27.9	109	103(94.50)	6(5.50)
≥28	74	71(95.95)	3(4.05)
村医执业时间^d(年)				6.124	0.013
<26	96	95(98.96)	1(1.04)
≥26	150	139(92.67)	11(7.33)
最高教育水平				1.137	0.286
高中及以下	173	163(94.22)	10(5.78)
大学及以上	73	71(97.26)	2(2.74)
是否管理过结核病患者				0.002	0.999
否	82	78(95.12)	4(4.88)
是	164	156(95.12)	8(4.88)
是否接触结核病患者				0.608	0.436
否	240	228(95.00)	12(5.00)
是	6	6(6/6)	0(0/6)

变量	β值	s${}_{\overline{\mathit{x}}}$值	Wald χ²值	P值	校正OR(95%CI)值^a
性别
女性					参考
男性	0.900	0.804	1.250	0.264	2.460(0.510~11.870)
月收入(元)
<2500	1.310	0.645	4.120	0.042	3.706(1.058~12.987)
≥2500					参考
村医执业时间(年)^b
<26					参考
≥26	2.017	1.040	3.760	0.052	7.520(0.978~27.820)