Prevalence and influencing factors of latent tuberculosis infection among elderly residents in nursing homes in Qingdao

doi:10.19982/j.issn.1000-6621.20250140

Abstract

Abstract:

Objective: To assess the prevalence of latent tuberculosis infection (LTBI) among elderly residents of nursing homes in Qingdao, identify factors associated with LTBI, and propose targeted strategies for the prevention and control of tuberculosis in institutional settings. Methods: A cross-sectional study was conducted between June and August 2024 in Qingdao, China. One central urban district and one suburban district were selected using simple random sampling. Based on institutional size and willingness to participate, seven nursing homes were included. Elderly residents were screened for LTBI using interferon-gamma release assays (IGRA) and chest radiography. Demographic data of the participants and operational characteristics of the nursing homes were also collected. Results: Among 425 elderly residents surveyed, the prevalence of LTBI was 26.59% (113/425). Univariate analysis revealed a significantly higher LTBI prevalence among males (30.53%, 80/262) compared to females (20.25%, 33/163; χ²=5.450, P=0.020). The highest infection rate was observed in the 70-79-year age group (35.29%, 42/119), and the likelihood of LTBI increased with age (OR=1.02, 95%CI: 1.00-1.04). Residents of suburban nursing homes exhibited a significantly higher LTBI prevalence (31.34%, 63/201) than those in urban facilities (22.32%, 50/224; χ²=4.418, P=0.036). Similarly, individuals living in nursing homes where tuberculosis cases had been reported within the past decade showed a higher LTBI prevalence (31.34%, 63/201) than those in institutions without such history (22.32%, 50/224; χ²=4.418, P=0.036); the prevalence of LTBI among elderly individuals receiving only life care services was 31.34% (63/201), significantly higher than that among those receiving both life care and medical care (22.32%, 50/224; χ²=4.418, P=0.036). Residents in facilities with a caregiver-to-resident ratio of 6-7 had a significantly lower LTBI prevalence (17.97%, 23/128) compared to those in institutions with a ratio of ≥8 (31.32%, 63/201; χ²=7.317, P=0.026). Multivariate logistic regression analysis further indicated that a caregiver-to-resident ratio of 6-7 was independently associated with a reduced risk of LTBI (OR=0.50, 95%CI: 0.30-0.85). Conclusion: The prevalence of LTBI among elderly nursing home residents in Qingdao is notably high. A higher caregiver-to-resident ratio was identified as an independent risk factor for LTBI. Strengthening human resource allocation and optimizing staff-to-resident ratios in nursing homes may play a critical role in reducing tuberculosis transmission and improving infection control in institutional care settings.

Key words: Aged, Mycobacterium tuberculosis, Infection, Factor analysis, statistical

CLC Number:

Yan Yueming, Chen Meng, Li Xuekui, Wang Zhongdong, Sun Haiyan, Dai Xiaoqi, Song Song, Xu Honghong, Zhang Menghan, Wang Zhi, Lyu Kunzheng. Prevalence and influencing factors of latent tuberculosis infection among elderly residents in nursing homes in Qingdao[J]. Chinese Journal of Antituberculosis, 2025, 47(9): 1148-1153. doi: 10.19982/j.issn.1000-6621.20250140

Figures/Tables 1

特征	人数[名 (构成比,%)]	LTBI者[例 (感染率,%)]	χ²值	P值	单因素分析
特征	人数[名 (构成比,%)]	LTBI者[例 (感染率,%)]	χ²值	P值	OR值	95%CI值	P值
性别			5.450	0.020
男性	262(61.65)	80(30.53)			1.73	1.09~2.75	0.020
女性	163(38.35)	33(20.25)			1.00
年龄组(岁)			9.999	0.040	1.02	1.00~1.04	0.049
50~59	82(19.29)	13(15.85)			1.00
60~69	97(22.82)	23(23.71)			1.65	0.78~3.51	0.194
70~79	119(28.00)	42(35.29)			2.90	1.44~5.84	0.003
80~89	96(22.59)	27(28.13)			2.08	0.99~4.36	0.053
90~99	31(7.30)	8(25.81)			1.85	0.68~5.01	0.229
入住养老院时间(年)			2.403	0.301	1.05	0.97~1.13	0.240
1~4	185(43.53)	45(24.32)			0.59	0.30~1.16	0.124
5~9	192(45.18)	51(26.56)			0.66	0.34~1.29	0.225
≥10	48(11.29)	17(35.42)			1.00
生活自理情况			2.487	0.288
自理	162(38.12)	37(22.84)			1.00
半自理	185(43.53)	56(30.27)			1.47	0.91~2.38	0.120
完全不能自理	78(18.35)	20(25.64)			1.17	0.62~2.18	0.633
失智情况			0.226	0.634
否	301(70.82)	82(27.24)			1.00
是	124(29.18)	31(25.00)			0.89	0.55~1.44	0.634
地域			4.418	0.036
郊区(平度市)	201(47.29)	63(31.34)			1.59	1.03~2.45	0.036
城区(李沧区)	224(52.71)	50(22.32)			1.00
养老院近10年是否发现过结核病患者			4.418	0.036
是	201(47.29)	63(31.34)			1.59	1.03~2.45	0.036
否	224(52.71)	50(22.32)			1.00
养老院经营形式			5.003	0.082
公办	64(15.06)	12(18.75)			1.00
民营	160(37.65)	38(23.75)			1.35	0.65~2.79	0.418
公办民营	201(47.29)	63(31.34)			1.98	0.99~3.96	0.054
养老院床位规模(张)			3.517	0.319
≥500	243(57.18)	71(29.22)			1.70	0.78~3.70	0.183
300~499	39(9.18)	7(17.95)			0.90	0.30~2.69	0.849
100~299	97(22.82)	26(26.80)			1.51	0.64~3.54	0.349
<100	46(10.82)	9(19.57)			1.00
养老院每床建筑面积(m²)			6.937	0.074
≥40	201(47.29)	63(31.34)			1.17	0.67~2.03	0.579
30~<40	113(26.59)	21(18.58)			0.58	0.30~1.13	0.112
25~<30	22(5.18)	4(18.18)			0.57	0.18~1.85	0.348
<25	89(20.94)	25(28.09)			1.00
养老院照护类型			4.418	0.036
生活照护	201(47.29)	63(31.34)			1.59	1.03~2.45	0.036
生活照护+医疗护理	224(52.71)	50(22.32)			1.00
养老院老人与护工人数之比			7.317	0.026
≥8	201(47.29)	63(31.34)			1.17	0.68~1.99	0.573
6~7	128(30.12)	23(17.97)			0.56	0.30~1.06	0.073
4~5	96(22.59)	27(28.13)			1.00

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