Evidence map›Paper›PMID 37506258›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023

Mass Tuberculosis Screening Among the Elderly: A Population-Based Study in a Well-Confined, Rural County in Eastern China.

Zhengfang Hu, Kui Liu, Meng Zhou, Xineng Jiang, Yaling Feng, Zhicheng Yu, Yuhao Li, Songhua Chen, Qian Wu, Wei Wang and 6 more

Open access · hybridAbstract read
In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 2 countries.

Zhengfang HuDepartment of Communicable Disease Control and Prevention, Lanxi Municipal Center for Disease Control and Prevention, Jinhua, Zhejiang Province, People's Republic of China.
Kui LiuDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Meng ZhouDepartment of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
Xineng JiangDepartment of Communicable Disease Control and Prevention, Lanxi Municipal Center for Disease Control and Prevention, Jinhua, Zhejiang Province, People's Republic of China.
Yaling FengDepartment of Communicable Disease Control and Prevention, Lanxi Municipal Center for Disease Control and Prevention, Jinhua, Zhejiang Province, People's Republic of China.
Zhicheng YuDepartment of Communicable Disease Control and Prevention, Lanxi Municipal Center for Disease Control and Prevention, Jinhua, Zhejiang Province, People's Republic of China.
Yuhao LiDepartment of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.
Songhua ChenDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Qian WuDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Wei WangDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
C Robert HorsburghDepartment of Epidemiology, School of Public Health, Boston University, Boston, MA, USA.
Yu ZhangDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Lin ZhouDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Bin ChenDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Chonggao HuDepartment of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, People's Republic of China.
Leonardo MartinezDepartment of Epidemiology, School of Public Health, Boston University, Boston, MA, USA.ORCID 0000-0003-0954-8489
Zhejiang Center for Disease Control and Prevention · CNBoston University · USZhejiang University · CN

Funding

National-Zhejiang Health Commission Major S&T ProjectZhejiang Provincial Medical and Health Project
6 · The paper itself

Abstract

backgroundMass tuberculosis (TB) screening has been recommended in certain high-risk populations. However, population-based screening interventions have rarely been implemented. Whether mass screening improves health equity is unknown.

methodsWe implemented a mass TB screening intervention among elderly persons (>60 years old) in Lanxi County, China. Standardized questionnaires, physical examinations, and chest radiographs (CXRs) were administered to all participants. Systematic testing with computed tomography, smear, culture, or Xpert was performed among persons with an abnormal CXR. We assessed TB prevalence per 100 000 persons and constructed multivariable regression models among subgroups that were and were not screened. Medical insurance was categorized as participation in either a basic program with limited coverage or a more comprehensive coverage program.

resultsIn total, 49 339 individuals (32% of the elderly population in Lanxi) participated in the screening. One hundred fifteen screened persons were diagnosed with TB (233 cases per 100 000 persons), significantly higher than persons not screened (168 cases among 103 979 person-years; prevalence-to-case notification ratio, 1.44 [95% confidence interval {CI}, 1.14-1.83]). This increase was largely driven by diagnosis of asymptomatic disease during mass screening (n = 57 [50% of participants with TB]). Participants with basic medical insurance were much more likely to be diagnosed through mass screening than by passive detection (adjusted odds ratio, 4.52 [95% CI, 1.35-21.28]).

conclusionsIn a population-based, mass TB screening intervention encompassing >30% of the elderly population in a county in rural China, case finding was 44% higher than background detection, driven by diagnosis of TB without recognized symptoms. Importantly, mass screening identified TB in people with limited healthcare options who were less likely to be found through background case detection.

Indexed as

TuberculosisAgedChinaHumansMass ScreeningMiddle AgedPrevalenceRisk Factorsactive case findingelderlymass screeningtuberculosis

Identifiers

PMID37506258
PMCPMC10654880
OpenAlexW4385377389

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.