Risk factors of latent tuberculosis infection among close contacts of drug-resistant pulmonary tuberculosis patients

doi:10.19982/j.issn.1000-6621.20230402

Abstract

Abstract:

Objective: To explore the situation and risk factors of latent tuberculosis infection (LTBI) in close contacts of drug-resistant pulmonary tuberculosis patients. Methods: Using a prospective research method, 306 close contacts of 154 drug-resistant pulmonary tuberculosis (including rifampicin resistant pulmonary tuberculosis and multidrug-resistant pulmonary tuberculosis) patients admitted to the Wenzhou Central Hospital from July 2020 to January 2022 were selected as the study subjects. Collected information included the sociodemographic characteristics, history of BCG vaccination, disease history, and contact with indicated cases of the research subjects; in addition, HIV antibody screening, chest CT scan, T-SPOT.TB and/or PPD test, etc. were conducted. The LTBI situation of the research subjects was investigated, and logistic regression models were used to analyze the influencing factors of their occurrence of LTBI. Results: The LTBI rate among the study subjects was 18.6% (57/306). The results of multivariate analysis showed that, for the close contacts, aged ≥40 years, female, physical workers, and those with clinical symptoms such as cough and sputum in the indication case were at a higher risk of developing LTBI (OR (95%CI) values of 6.501 (1.371-30.827), 2.961 (1.472-5.956), 2.716 (1.368-5.391), 3.100 (1.278-7.521), and 3.065 (1.336-7.031), respectively); family monthly income ≥RMB 5000 yuan was a protective factor for close contacts to develop LTBI (OR (95%CI)=0.308 (0.156-0.607)). Conclusion: Close contacts of drug-resistant pulmonary tuberculosis patients have a higher LTBI rate. Elderly, female, physically active workers, low-income individuals, as well as close contacts with relapsed drug-resistant pulmonary tuberculosis patients and drug-resistant pulmonary tuberculosis patients with clinical symptoms such as cough and sputum, are high-risk population for latent infection.

Key words: Tuberculosis, pulmonary, Drug resistance, bacterial, Contact tracing, Infection, Factor analysis, statistical

CLC Number:

R521

Ye Xinchun, Liu Saiduo, Cheng Fang, Jiang Xiangao, Ning Hongye, Wu Zhengxing, Zhou Yueying, Qiu Chaochao, Pan Ning, Shi Jichan. Risk factors of latent tuberculosis infection among close contacts of drug-resistant pulmonary tuberculosis patients[J]. Chinese Journal of Antituberculosis, 2024, 46(5): 525-530. doi: 10.19982/j.issn.1000-6621.20230402

Figures/Tables 3

因素	潜伏感染组(57例)	未感染组(249名)	统计检验值	P值
年龄组[名/例(构成比,%)]			χ²=14.500	<0.001
<20岁	2(3.5)	30(12.1)
20~39岁	24(42.1)	147(59.0)
≥40岁	31(54.4)	72(28.9)
体质量指数($\bar{x}±s$)	23.00±2.63	22.62±2.70	t=-1.017	0.309
性别[名/例(构成比,%)]			χ²=7.159	0.007
男性	17(29.8)	123(49.4)
女性	40(70.2)	126(50.6)
文化程度[名/例(构成比,%)]			χ²=2.081	0.149
高中及以下	36(63.2)	131(52.6)
其他	21(36.8)	118(47.4)
居住地[名/例(构成比,%)]			χ²=5.190	0.023
农村	37(64.9)	120(48.2)
城市	20(35.1)	129(51.8)
家庭月收入[名/例(构成比,%)]			χ²=8.407	0.004
<5000 元	38(66.7)	113(45.4)
≥5000 元	19(33.3)	136(54.6)
职业[名/例(构成比,%)]			χ²=8.351	0.004
体力劳动	40(70.2)	122(49.0)
其他	17(29.8)	127(51.0)
卡介苗接种史[名/例(构成比,%)]			χ²=1.329	0.514
无	9(15.8)	30(12.0)
有	38(66.7)	160(64.3)
不清楚	10(17.5)	59(23.7)
结核病病史[名/例(构成比,%)]			χ²=1.254	0.263
无	55(96.5)	246(98.8)
有	2(3.5)	3(1.2)
吸烟史[名/例(构成比,%)]			χ²=0.229	0.632
无	34(59.6)	157(63.1)
有	23(40.4)	92(36.9)
饮酒史[名/例(构成比,%)]			χ²=0.114	0.736
无	39(68.4)	176(70.7)
有	18(31.6)	73(29.3)
其他疾病史[名/例(构成比,%)]			χ²=0.629	0.428
无	49(86.0)	203(81.5)
有	8(14.0)	46(18.5)
家庭同居人数[名,M(Q₁,Q₃)]	3.0(2.0,3.0)	3.0(2.0,3.0)	Z=-1.301	0.193
与指示病例每周接触时间[h, M(Q₁,Q₃)]	56.0(45.5,85.0)	56.0(30.5,82.5)	Z=-1.488	0.137
与指示病例每天接触时间[h, M(Q₁,Q₃)]	8.0(6.5,12.2)	8.0(4.4,11.8)	Z=-1.488	0.137
接触场所通风条件[名/例(构成比,%)]			χ²=1.275	0.529
好	40(70.2)	191(76.7)
中	14(24.5)	45(18.1)
差	3(5.3)	13(5.2)
接触场所面积[名/例(构成比,%)]			χ²=3.135	0.209
<60m²	32(56.1)	162(65.1)
60~120m²	22(38.6)	83(33.3)
>120m²	3(5.3)	4(1.6)
与指示病例共同居住[名/例(构成比,%)]			χ²=19.764	<0.001
否	0(0.0)	44(17.7)
是	57(100.0)	205(82.3)
指示病例治疗情况[名/例(构成比,%)]			χ²=7.676	0.006
初治	45(78.9)	228(91.6)
复治	12(21.1)	21(8.4)
指示病例临床症状^a			χ²=4.106	0.043
无	9(15.8)	72(28.9)
有	48(84.2)	177(71.1)

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变量	赋值	变量	赋值
年龄	0=<20岁;1=20~39岁;2=≥40岁	职业	0=其他;1=体力劳动
性别	0=男性;1=女性	与指示病例共同居住	0=否;1=是
居住地	0=农村;1=城市	指示病例治疗情况	0=初治;1=复治
家庭月收入	0=<5000元;1=≥5000元	指示病例临床症状^a	0=无;1=有

因素	β值	$s_{\bar{x}}$值	Wald χ²值	P值	OR(95%CI)值
年龄(以<20岁为参照)
20~39岁	0.628	0.794	0.624	0.429	1.873(0.395~8.885)
≥40岁	1.872	0.794	5.556	0.018	6.501(1.371~30.827)
女性	1.086	0.357	9.268	0.002	2.961(1.472~5.956)
家庭月收入≥5000元	-1.178	0.347	11.550	0.001	0.308(0.156~0.607)
体力劳动	0.999	0.350	8.154	0.004	2.716(1.368~5.391)
指示病例为复治患者	1.131	0.452	6.262	0.012	3.100(1.278~7.521)
指示病例有相关临床症状^a	1.120	0.424	6.992	0.008	3.065(1.336~7.031)

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