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Clin Microbiol Infect. 2019 Feb 7. pii: S1198-743X(19)30046-1. doi: 10.1016/j.cmi.2019.01.021. [Epub ahead of print]

Tuberculosis infection among the elderly in 20,486 rural residents aged 50-70 years old in Zhongmu County, China.

Author information

1
NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China, 100730.
2
The Sixth People's Hospital of Zhengzhou, Zhengzhou, P.R. China, 450061.
3
The Centers for Disease Prevention and Control of Zhongmu County, Zhengzhou, P.R. China, 451470.
4
Guangdong Key Laboratory for Diagnosis &Treatment of Emerging Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen University School of Medicine, Shenzhen, P.R. China, 518112.
5
NHC Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China, 100730. Electronic address: gaolei@ipbcams.ac.cn.

Abstract

OBJECTIVES:

Elderly in rural China has been known to be at increased risk of contracting tuberculosis (TB) infection and developing active disease. This study aims to estimate the burden of TB infection and to identify potential targeted subgroups for infection control.

METHODS:

As a part of the investigation of an interventional study, 50-70 years old rural residents in Zhongmu County were targeted for TB infection testing by QuantiFERON-TB Gold In-Tube (QFT). Questionnaires and physical examinations were conducted to acquire their demographic information and health status.

RESULTS:

A total of 20,486 subjects were included in the analysis of TB infection. The prevalence of QFT positivity was 20.79% (4,259/20,486) and 50 participants (0.24%) were reported with indeterminate results. A positive dose-response relation was found for QFT positivity with smoking intensity. As compared with non-drinkers, the risk of TB infection was lower among participants with moderate alcohol consumption (<10 g/day) with adjusted odds ratio (OR) of 0.82 (95% confidence interval (CI), 0.71-0.94). In addition, male, with a history of prior TB or silicosis, and hepatitis B/C virus infection were associated with increased risk of TB infection. Indeterminate QFT result was related to underweight with adjusted OR of 3.18 (95% CI, 1.09-9.26).

CONCLUSIONS:

Our result supported that there was a high burden of TB infection among elderly in rural area. Smokers, individuals with a history of prior TB or silicosis, and those with hepatitis B/C infection should be prioritized for TB infection control to reduce the risk of disease development from a new infection.

PMID:
30738995
DOI:
10.1016/j.cmi.2019.01.021

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