SynthesisBMC infectious diseases2019
Tuberculosis outbreaks among students in mainland China: a systematic review and meta-analysis.
Synthesis in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed.
- Responding to a protracted tuberculosis outbreak: lessons from multiple rounds of investigation in a Chinese boarding school.Annals of medicine · 2026Article
- Student-Led Health Education Intervention Package Enhanced Tuberculosis Prevention in Colleges: A Quasi-Experimental One-Group Pre-Test/Post-Test Study.Risk management and healthcare policy · 2026Article
- Tuberculosis outbreak in a pre-primary and primary school in Barcelona, Spain.Frontiers in public health · 2026Article
- Epidemiological characteristics of tuberculosis among migrant populations and key predictors of migratory cases in Zhejiang Province.Frontiers in public health · 2026Article
- A clustered pulmonary Tuberculosis outbreak at a technical school in Shenzhen, China.Frontiers in pediatrics · 2026Article
- Comparative agreement between tuberculin skin test and QuantiFERON-TB Gold In-Tube across different levels of exposure in a college-based tuberculosis outbreak.Frontiers in public health · 2026Article
- Nationwide whole-genome sequencing reveals local transmission of Mycobacterium tuberculosis in Poland, 2003-2020.BMC infectious diseases · 2025Article
- Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, China.BMC infectious diseases · 2025Article
- The burden and trends of infectious diseases among children aged 14 and below in China from 1990 to 2021: a systematic analysis from the 2021 global burden of disease study.Frontiers in public health · 2025Article
- Transmissibility and control of tuberculosis in school outbreaks: a modeling study based on four outbreaks in China.BMC infectious diseases · 2024Article
- Epidemiological Characteristics and Spatiotemporal Clustering of Pulmonary Tuberculosis Among Students in Southwest China From 2016 to 2022: Analysis of Population-Based Surveillance Data.JMIR public health and surveillance · 2024Article
- Analysis of the epidemiological characteristics and influencing factors of tuberculosis among students in a large province of China, 2008-2018.Scientific reports · 2024Article
- Gender-Specific Association Between Perceived Stigma Toward Tuberculosis and Acceptance of Preventive Treatment Among College Students With Latent Tuberculosis Infection: Cross-Sectional Analysis.JMIR public health and surveillance · 2023Article
- An overview of tuberculosis outbreaks reported in the years 2011-2020.BMC infectious diseases · 2023Review
- Epidemiological cluster identification using multiple data sources: an approach using logistic regression.Microbial genomics · 2023Article
- Factors associated with refusal of preventive therapy after initial willingness to accept treatment among college students with latent tuberculosis infection in Shandong, China.BMC infectious diseases · 2023Article
- Transmission ofFrontiers in public health · 2023Article
- Regional and epidemiological characteristics of tuberculosis and treatment outcomes in West China.Frontiers in public health · 2023Article
- The role of Xpert MTB/RIF using bronchoalveolar lavage fluid in active screening: insights from a tuberculosis outbreak in a junior school in eastern China.Frontiers in public health · 2023Article
- Spatial-temporal analysis of pulmonary tuberculosis among students in the Zhejiang Province of China from 2007-2020.Frontiers in public health · 2023Article
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Authors and funding
11 authors.
Funding
Abstract
backgroundIn recent years, tuberculosis outbreaks in schools have occurred more frequently in China than in other parts of the world, and have posed a public health threat to students and their families. This systematic review aimed to understand the epidemiological characteristics of tuberculosis (TB) outbreaks and analyze the factors associated with TB outbreaks in schools in China.
methodsWe conducted this systematic review following the standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The meta-analysis was performed with STATA using a random effects model.
resultsWe included 107 studies involving 1795 student patients with TB in mainland China. The results of the systematic analysis indicated that TB outbreaks were more frequently reported in senior middle schools and in Eastern China. The outbreaks mainly occurred during the winter and spring, and the median outbreak duration was 4 months. The meta-analysis showed that the total attack rate and the class attack rate of tuberculosis outbreaks among students were 4.60% (95% CI 3.80 to 5.70%) and 22.70% (95% CI 19.20 to 27.00%), respectively. Subgroup analysis showed that outbreaks that occurred at universities or colleges had a relatively higher attack rate than those occurred in senior middle schools. The prevalence of latent tuberculosis infection (LTBI) among close contacts was 23.70% (95% CI 19.50 to 28.90%). The median case-finding interval was 2 months, and 47.40% of the index cases had a case-finding delay.
conclusionThe results of our review indicated that school TB outbreaks were reported most frequently in senior middle schools in China. The attack rates of outbreaks at universities or colleges were higher than those in senior middle schools. The TB outbreaks in schools usually occurred over prolonged periods. The case-finding delay in the index cases must be reduced to prevent transmission in classes and schools. Effective surveillance and screening of presumptive TB cases in schools should be strengthened to reduce outbreaks in schools.
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