ArticleFrontiers in public health2026
Pre-screening village tuberculosis notification rates and the yield of interferon-gamma release assay testing in a rural health-examination campaign in Xinjiang, China.
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: Southern Xinjiang has a high tuberculosis (TB) burden, but the yield of interferon-gamma release assay (IGRA) testing within its annual rural health-examination program has not been quantified. We estimated IGRA positivity among adult campaign participants and assessed whether positivity increased with the village TB notification rate recorded before screening. Methods: This service-embedded cross-sectional study included adults who received IGRA testing during the annual health-examination campaign implemented across all 22 villages and farm units of Zhanmin Township in July-August 2024. Exclusion of 12 indeterminate results and two duplicate records left 3,742 unique adults. The principal exposure was the pre-screening average annual village TB notification rate (January 2021-June 2024). Logistic generalized estimating equations accounted for village clustering, adjusted for prespecified individual covariates, and used a Mancl-DeRouen small-sample covariance correction. Village-level regression, burden-group comparisons, and 1,000 village-cluster bootstrap resamples complemented the principal analysis. Results: Overall, 1,006 of 3,742 participants were IGRA positive (26.88%, 95% CI 25.49-28.33%); village-specific positivity ranged from 19.13 to 39.67%. High-burden villages contributed 39.56% of positive results while accounting for 33.27% of participants. Pooled positivity was 31.97% in high-burden villages, compared with 24.51 and 24.19% in low- and medium-burden villages. Each increase of 100 notifications per 100,000 was associated with 15.3% higher adjusted odds of positivity (OR 1.153, 95% CI 1.043-1.275; Conclusion: IGRA positivity was common among campaign participants and increased with pre-screening village notification rates. Within the annual health-examination program, the continuous notification rate can be combined with individual risk factors to inform the scheduling of IGRA outreach and clinical assessment while maintaining access in every village. The 26.88% estimate pertains to participants and should not be interpreted as township prevalence.
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