Clinical study on early screening of close contacts of pathogen-positive pulmonary tuberculosis patients in Baoding from 2023 to 2025._Chinese Journal of Respiratory and Critical Care Medicine

Authors：

LIU Bing ¹ , ZHANG Yuchen ² , ZHANG Bin ³ , YAN Yan ⁴ , ZHANG Shuo ⁵ ,  YANG Zhao ⁶

1. Department of Tuberculosis, Baoding People's Hospital, Baoding, Hebei 071000, P. R. China;
2. Total Quality Management Office, Baoding People's Hospital, Baoding, Hebei 071000, P. R. China;
3. Baoding People's Hospital, Baoding, Hebei 071000, P. R. China;
4. Department of Maternal Population Health Care, Baoding Maternal and Child Health Hospital, Baoding, Hebei 071000, P. R. China;
5. Department of Organization and Human Resources, Baoding Central Blood Station, Baoding, Hebei 071000, P. R. China;
6. Department of Traditional Chinese Medicine, Baoding People's Hospital, Baoding, Hebei 071000, P. R. China;

Corresponding?author：

YANG Zhao, Email: zhaoyangyy56@163.com

Keywords：

Tuberculosis; close contacts; screening; risk factors; prediction model; receiver operating characteristic curve

DOI：

10.7507/1671-6205.202607075

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To analyze the screening effect and tuberculosis detection characteristics of close contacts with pathogen-positive tuberculosis in Baoding city, and build an infection risk prediction model based on risk factors, so as to provide reference for accurate screening and intervention. Methods A retrospective observational study design was used to collect the data of screening of tuberculosis patients and close contacts of pathogen-positive tuberculosis patients in Baoding "Tuberculosis Information Management System" from March 2023 to March 2025, and a retrospective analysis was conducted. A total of 83 cases of registered pathogen-positive pulmonary tuberculosis patients were enrolled, and 1208 cases of close contacts were identified, among which 1136 cases were actually screened, and the screening completion rate was 94.04%. According to the screening of suspicious symptoms and the detection of tuberculosis, they were divided into a positive group (n=102) and a negative group (n=1034). The general clinical data and clinical characteristics of the two groups were compared, and the risk factors of positive results of close contacts were analyzed by multivariate logistic regression analysis. At the same time, a prediction model was constructed, and the receiver operating characteristic (ROC) curve of subjects was drawn to analyze the value of predicting positive results of close contacts. Results The proportion of patients with body mass index (BMI), family annual income<50000 yuan, high-intensity contact, average daily contact time ≥ 4 hours, cumulative contact time ≥6 months, persistent cough time ≥2 weeks, weight loss ≥5% in the last three months, combined with immune system diseases, smoking history and no BCG vaccination in positive group was higher than that in negative group (all P<0.05). The results of multivariate logistic regression analysis showed that BMI (OR=0.832, 95%CI 0.738～0.938) was the protective factor for the positive results of close contacts, and the annual household income was less than 50,000 (OR=1.770, 95%CI 1.030～3.040), high-intensity contact (OR=1.940, 95%CI 1.071～3.624), cumulative contact time ≥6 months (OR=2.210, 95%CI 1.26～4.050), persistent cough time ≥2 weeks (OR=2.380, 95%CI 1.424～3.977) and non-BCG vaccination (OR=2.208, 95%CI 1.163～4.191) were the risk factors (P<0.05). The regression equation model was established: logit(P)= –2.931 + BMI×–0.184 + annual family income<50 000 × 0.571+high-intensity contact×0.678 + cumulative contact time ≥6 months × 0.793 + persistent cough time ≥2 weeks × 0.867 + combined immune system diseases × 1.264. ROC curve showed that when logit(P)>12.84, the area under the curve (AUC) was 0.789. Conclusions High BMI is a protective factor for screening positive close contacts of pathogen-positive pulmonary tuberculosis patients, and low annual family income, high intensity and long-term exposure, persistent cough, immune system diseases, smoking history and non-BCG vaccination are risk factors. Logistic regression prediction model based on the above factors has good discrimination ability and clinical practical value, which can provide reference for grading screening and individualized intervention of close contacts of tuberculosis. However, it should be noted that the protective effect of BCG vaccination on adult pulmonary tuberculosis is still controversial, and the relevant conclusions of this study should be carefully explained in combination with the specific population background and immune status.

1.	Trajman A, Campbell JR, Kunor T, et al. Tuberculosis[J]. Lancet, 2025, 405(10481): 850-866.
2.	Guerrieri M, Bargagli E, Cassai L, et al. Pulmonary tuberculosis in non-HIV adults: an evergreen old-fashioned disease in high-income countries. A narrative review[J]. Expert Rev Respir Med, 2024, 18(11): 861-872.
3.	Li T, Zhang B, Du X, et al. Recurrent pulmonary tuberculosis in China, 2005 to 2021[J]. JAMA Netw Open, 2024, 7(8): e2427266.
4.	Zhou W, Lu H, Lin J, et al. Coexisting lung cancer and pulmonary tuberculosis: a comprehensive review from incidence to management[J]. Cancer Rep (Hoboken), 2025, 8(5): e70213.
5.	Zhang C, Liu Y, Yao Y, et al. Tuberculosis infection among close contacts of patients with pulmonary tuberculosis in China: a population-based, multicentered study[J]. Clin Microbiol Infect, 2024, 30(9): 1176-1182.
6.	Chen H, Zhang H, Cheng J, et al. Adherence to preventive treatment for latent tuberculosis infection in close contacts of pulmonary tuberculosis patients: a cluster-randomized controlled trial in China[J]. Int J Infect Dis, 2024, 147: 107196.
7.	中華人民共和國國家衛生和計劃生育委員會. 肺結核診斷標準(WS 288-2017)[J]. 新發傳染病電子雜志, 2018, 3(1): 59-61.
8.	中國防癆協會結核病控制專業分會, 中國防癆協會老年結核病防治專業分會, 《中國防癆雜志》編輯委員會. 中國社區肺結核主動篩查循證指南[J]. 中國防癆雜志, 2022, 44(10): 987-997.
9.	Mendelsohn SC, Andrade BB, Mbandi SK, et al. Transcriptomic signatures of progression to tuberculosis disease among close contacts in Brazil[J]. J Infect Dis, 2024, 230(6): e1355-e1365.
10.	Matias GL, Sales MVF, Andrade GS, et al. Diagnosis and treatment of latent tuberculosis infection among household contacts in inland Bahia, Brazil: a cross-sectional follow-up study[J]. Sao Paulo Med J, 2024, 143(1): e2023339.
11.	Jude S, Abedi AJ, Mehnaz S, et al. Burden and associated factors of tuberculosis among household contacts of sputum positive tuberculosis patients of Aligarh[J]. Indian J Community Med, 2025, 50(1): 181-186.
12.	Syed RR, Catanzaro DG, Hillery N, et al. Understanding tuberculosis transmission and progression: a prospective cohort study of index cases and close contacts in Moldova[J]. PLoS One, 2024, 19(12): e0313270.
13.	Wongchana T, Songthap A. Factors affecting tuberculosis (TB) prevention behaviors among household contacts in Phitsanulok Province, northern Thailand: implications for TB prevention strategy plan[J]. BMC Infect Dis, 2024, 24(1): 1429.
14.	Wada PY, Costa AG, Araújo-Pereira M, et al. Possible sex difference in latent tuberculosis infection risk among close tuberculosis contacts[J]. Int J Infect Dis, 2022, 122: 685-692.
15.	張永強, 楊歡歡, 王亞亞, 等. 保定市156所學校入學新生結核病篩查情況[J]. 中國感染控制雜志, 2024, 23(1): 95-99.
16.	Reichler MR, Khan A, Yuan Y, et al. Duration of exposure among close contacts of patients with infectious tuberculosis and risk of latent tuberculosis infection[J]. Clin Infect Dis, 2020, 71(7): 1627-1634.
17.	Ma Z, Duan S, Wang W, et al. Surveillance of close contacts of patients with infectious tuberculosis: a prospective cohort study[J]. Antimicrob Resist Infect Control, 2024, 13(1): 59.
18.	Wang W, Liu A, Liu X, et al. Mycobacterium tuberculosis infection in school contacts of tuberculosis cases: a systematic review and meta-Analysis[J]. Am J Trop Med Hyg, 2024, 110(6): 1253-1260.
19.	Xiao X, Chen J, Jiang Y, et al. Prevalence of latent tuberculosis infection and incidence of active tuberculosis in school close contacts in Shanghai, China: Baseline and follow-up results of a prospective cohort study[J]. Front Cell Infect Microbiol, 2022, 12: 1000663.
20.	Tavitian-Exley I, Kyaw WM, Kang-Yang LL, et al. Risk factors for tuberculosis among close IGRA-negative contacts of persons with infectious tuberculosis in Singapore[J]. Int J Infect Dis, 2024, 147: 107166.
21.	張燦有, 夏愔愔, 陳卉, 等. 基于社區的老年人肺結核主動篩查: 一項基于多中心隊列研究的策略與效果分析[J]. 中國防癆雜志, 2025, 47(7): 846-854.
22.	Du Y, He Y, Zhang H, et al. Declining incidence rate of tuberculosis among close contacts in five years post-exposure: a systematic review and meta-analysis[J]. BMC Infect Dis, 2023, 23(1): 373.

1. Trajman A, Campbell JR, Kunor T, et al. Tuberculosis[J]. Lancet, 2025, 405(10481): 850-866.
2. Guerrieri M, Bargagli E, Cassai L, et al. Pulmonary tuberculosis in non-HIV adults: an evergreen old-fashioned disease in high-income countries. A narrative review[J]. Expert Rev Respir Med, 2024, 18(11): 861-872.
3. Li T, Zhang B, Du X, et al. Recurrent pulmonary tuberculosis in China, 2005 to 2021[J]. JAMA Netw Open, 2024, 7(8): e2427266.
4. Zhou W, Lu H, Lin J, et al. Coexisting lung cancer and pulmonary tuberculosis: a comprehensive review from incidence to management[J]. Cancer Rep (Hoboken), 2025, 8(5): e70213.
5. Zhang C, Liu Y, Yao Y, et al. Tuberculosis infection among close contacts of patients with pulmonary tuberculosis in China: a population-based, multicentered study[J]. Clin Microbiol Infect, 2024, 30(9): 1176-1182.
6. Chen H, Zhang H, Cheng J, et al. Adherence to preventive treatment for latent tuberculosis infection in close contacts of pulmonary tuberculosis patients: a cluster-randomized controlled trial in China[J]. Int J Infect Dis, 2024, 147: 107196.
7. 中華人民共和國國家衛生和計劃生育委員會. 肺結核診斷標準(WS 288-2017)[J]. 新發傳染病電子雜志, 2018, 3(1): 59-61.
8. 中國防癆協會結核病控制專業分會, 中國防癆協會老年結核病防治專業分會, 《中國防癆雜志》編輯委員會. 中國社區肺結核主動篩查循證指南[J]. 中國防癆雜志, 2022, 44(10): 987-997.
9. Mendelsohn SC, Andrade BB, Mbandi SK, et al. Transcriptomic signatures of progression to tuberculosis disease among close contacts in Brazil[J]. J Infect Dis, 2024, 230(6): e1355-e1365.
10. Matias GL, Sales MVF, Andrade GS, et al. Diagnosis and treatment of latent tuberculosis infection among household contacts in inland Bahia, Brazil: a cross-sectional follow-up study[J]. Sao Paulo Med J, 2024, 143(1): e2023339.
11. Jude S, Abedi AJ, Mehnaz S, et al. Burden and associated factors of tuberculosis among household contacts of sputum positive tuberculosis patients of Aligarh[J]. Indian J Community Med, 2025, 50(1): 181-186.
12. Syed RR, Catanzaro DG, Hillery N, et al. Understanding tuberculosis transmission and progression: a prospective cohort study of index cases and close contacts in Moldova[J]. PLoS One, 2024, 19(12): e0313270.
13. Wongchana T, Songthap A. Factors affecting tuberculosis (TB) prevention behaviors among household contacts in Phitsanulok Province, northern Thailand: implications for TB prevention strategy plan[J]. BMC Infect Dis, 2024, 24(1): 1429.
14. Wada PY, Costa AG, Araújo-Pereira M, et al. Possible sex difference in latent tuberculosis infection risk among close tuberculosis contacts[J]. Int J Infect Dis, 2022, 122: 685-692.
15. 張永強, 楊歡歡, 王亞亞, 等. 保定市156所學校入學新生結核病篩查情況[J]. 中國感染控制雜志, 2024, 23(1): 95-99.
16. Reichler MR, Khan A, Yuan Y, et al. Duration of exposure among close contacts of patients with infectious tuberculosis and risk of latent tuberculosis infection[J]. Clin Infect Dis, 2020, 71(7): 1627-1634.
17. Ma Z, Duan S, Wang W, et al. Surveillance of close contacts of patients with infectious tuberculosis: a prospective cohort study[J]. Antimicrob Resist Infect Control, 2024, 13(1): 59.
18. Wang W, Liu A, Liu X, et al. Mycobacterium tuberculosis infection in school contacts of tuberculosis cases: a systematic review and meta-Analysis[J]. Am J Trop Med Hyg, 2024, 110(6): 1253-1260.
19. Xiao X, Chen J, Jiang Y, et al. Prevalence of latent tuberculosis infection and incidence of active tuberculosis in school close contacts in Shanghai, China: Baseline and follow-up results of a prospective cohort study[J]. Front Cell Infect Microbiol, 2022, 12: 1000663.
20. Tavitian-Exley I, Kyaw WM, Kang-Yang LL, et al. Risk factors for tuberculosis among close IGRA-negative contacts of persons with infectious tuberculosis in Singapore[J]. Int J Infect Dis, 2024, 147: 107166.
21. 張燦有, 夏愔愔, 陳卉, 等. 基于社區的老年人肺結核主動篩查: 一項基于多中心隊列研究的策略與效果分析[J]. 中國防癆雜志, 2025, 47(7): 846-854.
22. Du Y, He Y, Zhang H, et al. Declining incidence rate of tuberculosis among close contacts in five years post-exposure: a systematic review and meta-analysis[J]. BMC Infect Dis, 2023, 23(1): 373.

Chinese Journal of Respiratory and Critical Care Medicine

Latest ArticlesClinical study on early screening of close contacts of pathogen-positive pulmonary tuberculosis patients in Baoding from 2023 to 2025.

Abstract Full text Figures/Tables Video References Cited by

Format

Content