ArticleFrontiers in public health2026
Transmission dynamics and attributable burden of tuberculosis among young and middle-aged adults in urban Shanghai: a genomic epidemiology study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: China remains a high tuberculosis (TB) burden country, and large urban centers such as Shanghai continue to face persistent transmission challenges driven by high population mobility. Whole-genome sequencing (WGS) provides high-resolution discrimination between recent transmission and reactivation; however, evidence at the district level remains limited. This study aimed to integrate WGS with epidemiological data to characterize local TB transmission dynamics in Xuhui District, Shanghai, and to identify demographic risk factors for recent transmission. Methods: A retrospective study was conducted among culture-positive pulmonary TB cases diagnosed between August 2021 and February 2025. WGS was performed for all available Results: Among 170 genotyped patients, the Beijing lineage predominated (90.0%, 153/170). Fluoroquinolone resistance mutations were detected in 12.4% of strains. Demographic disparities in sex and age were observed between local and migrant residents (both Conclusion: Recent TB transmission in Xuhui District was predominantly driven by younger and middle-aged populations. Although students represent a high-risk subgroup, the broader working-age population contributed most to the overall transmission burden. These findings highlight the importance of integrating school-based interventions with community-level strategies targeting the active workforce in order to effectively interrupt transmission.
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