Current status of preventive treatment for tuberculosis and factors affecting its completion rate in China, 2021-2024

doi:10.20199/j.issn.1672-2302.2025.06.002

Abstract

Abstract:

Objective To understand the current status and trends of tuberculosis preventive treatment (TPT) in China from 2021 to 2024, so as to provide a reference for optimizing TPT strategies. Methods Relevant data on TPT from 2021 to 2024 were extracted from the National Tuberculosis Surveillance Report for 31 provinces and the Xinjiang Production and Construction Corps across China. The analysis covered the number of people who undergone TPT, treatment regimens, and completion rates. Henan, Jiangsu, and Xinjiang were selected as the survey provinces using convenience sampling method. Relevant anonymous data on latent tuberculosis infection (LTBI) patients who received TPT from 2023 to 2024 were collected across the three provinces. A Firth’s penalized maximum likelihood estimation approach was used to identify the influencing factors associated with TPT completion. Results From 2021 to 2024, a total of 214 803 individuals received TPT, with annual numbers of 37 419, 37 514, 52 836, and 87 034, respectively. Between 2022 and 2024, a total of 137 891 individuals received short-course regimens, corresponding to 29 723, 41 623, and 66 545 individuals per year. From 2021 to 2023, a total of 88 670 individuals completed the TPT, with completion rates of 60.86%, 65.71%, and 78.06%, respectively. Among those who received TPT between 2022 and 2024, the highest proportion were students with close contact (42.06%, 74 605/177 384), and the highest utilization rate of the short-course regimen was among newly infected individuals in detention facilities (93.14%, 2 824/3 032). The top three provinces for TPT uptake from 2021 to 2024 were Sichuan (n=20 265; 9.43%), Guizhou (n=18 631; 8.67%), and Jiangsu (n=17 839; 8.30%). From 2022 to 2024, 19 provinces achieved a short-course utilization rate above 80.00%, with the highest in Hainan (99.57%, 689/692). In terms of the survey on influencing factors of TPT completion status, relevant data were collected from 853 cases of LTBI patients who received TPT, among whom 792 cases completed the full course, resulting in an overall completion rate of 92.85%. Multivariate analysis demonstrated that individuals receiving TPT at grassroots medical institutions had higher completion rates than those at disease prevention and control centers (OR=4.90, 95%CI: 1.32-18.05). Additionally, the course completion rate was significantly higher for the TPT regimen using Vaccae than for 3H₂P₂ (OR=4.86, 95%CI: 1.03-27.14). Conclusion In recent years, China has made substantial progress in scaling up TPT, with rapid expansion of short-course regimens. However, considerable disparities persist across regions and populations. Future efforts should focus on further expanding TPT coverage, optimizing the promotion mechanisms for the short-course regimen, and enhancing the accessibility, standardization, and adherence to TPT.

Key words: Tuberculosis, Latent tuberculosis infection, Preventive treatment, Influencing factors

CLC Number:

LI Jinhao, WEN Yaxin, GE Fangjun, HU Dongmei, XU Caihong. Current status of preventive treatment for tuberculosis and factors affecting its completion rate in China, 2021-2024[J]. Journal of Tropical Diseases and Parasitology, 2025, 23(6): 324-329.

Figures/Tables 5

Table 1

Table 2

Table 3

Implementation of TPT among different regions in China, 2021-2024

地区	TPT接受情况		2022—2024年TPT短程方案使用情况			2021—2023年疗程完成情况
地区	接受人数	构成比（%）	TPT接受人数	TPT短程方案使用人数	使用率（%）	TPT接受人数	完成人数	完成率（%）
四川	20 265	9.43	18 524	15 187	81.99	13 009	8 460	65.03
贵州	18 631	8.67	15 304	12 760	83.38	13 334	8 771	65.78
江苏	17 839	8.30	13 446	12 037	89.52	11 231	8 278	73.71
新疆	16 938	7.89	15 635	15 131	96.78	7 680	6 364	82.86
河南	15 278	7.11	12 770	8 913	69.80	9 118	7 598	83.33
浙江	14 763	6.87	14 322	11 525	80.47	2 359	1 964	83.26
湖南	14 545	6.77	11 012	6 661	60.49	9 417	6 997	74.30
广西	11 907	5.54	8 395	7 236	86.19	8 186	5 183	63.32
云南	11 011	5.13	8 828	7 692	87.13	6 795	5 101	75.07
安徽	10 927	5.09	9 542	8 473	88.80	6 694	5 552	82.94
山东	10 681	4.97	8 915	4 059	45.53	6 842	4 556	66.59
广东	7 860	3.66	5 498	3 856	70.13	4 887	3 023	61.86
陕西	5 689	2.65	4 289	3 135	73.09	4 370	2 469	56.50
湖北	5 258	2.45	4 284	3 854	89.96	3 374	2 918	86.48
河北	5 180	2.41	4 173	3 067	73.50	3 014	1 706	56.60
宁夏	4 632	2.16	4 260	289	6.78	1 745	1 091	62.52
江西	4 027	1.87	2 823	2 631	93.20	3 176	2 046	64.42
重庆	3 232	1.50	2 461	1 141	46.36	2 024	1 362	67.29
天津	2 593	1.21	1 998	1 859	93.04	1 571	513	32.65
甘肃	2 218	1.03	1 355	802	59.19	1 698	783	46.11
内蒙古	2 104	0.98	1 805	1 524	84.43	1 656	1 192	71.98
辽宁	1 919	0.89	1 347	1 174	87.16	1 415	988	69.82
西藏	1 577	0.73	1 567	866	55.26	1 256	128	10.19
青海	1 361	0.63	1 285	1 192	92.76	571	88	15.41
福建	881	0.41	704	645	91.62	597	438	73.37
山西	862	0.40	673	372	55.27	557	376	67.50
北京	852	0.40	687	631	91.85	517	393	76.02
海南	737	0.34	692	689	99.57	251	161	64.14
上海	514	0.24	500	276	55.20	40	23	57.50
吉林	254	0.12	100	97	97.00	182	50	27.47
黑龙江	128	0.06	50	48	96.00	98	50	51.02
新疆生产建设兵团	140	0.07	140	69	49.29	105	48	45.71
合计	214 803	100.00	177 384	137 891	77.74	127 769	88 670	69.40

Table 3

Table 4

Table 5

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人群类别	TPT接受情况		TPT短程方案使用情况		2022—2023年疗程完成情况
人群类别	接受人数	构成比（%）	使用人数	使用率（%）	TPT接受人数	完成人数	完成率（%）
阳性密接者	31 275	17.63	23 585	75.41	15 531	9 570	61.62
艾滋病相关人群	1 026	0.58	658	64.13	576	358	62.15
学生密接者	74 605	42.06	60 172	80.65	45 939	34 422	74.93
羁押场所新近感染者	3 032	1.71	2 824	93.14	1 448	795	54.90
其他人群	67 446	38.02	50 652	75.10	26 856	20 751	77.27
合计	177 384	100.00	137 891	77.74	90 350	65 896	72.93

人群特征	TPT接受情况		TPT完成情况		人群特征	TPT接受情况		TPT完成情况
人群特征	接受人数	构成比（%）	完成人数	完成率（%）	人群特征	接受人数	构成比（%）	完成人数	完成率（%）
年龄（岁）					疾病预防控制中心	53	6.21	47	88.68
0~19	295	34.58	279	94.58	定点医院	639	74.91	592	92.64
20~39	154	18.05	142	92.21	基层医疗卫生机构	161	18.87	153	95.03
40~59	208	24.38	186	89.42	感染检测结果
≥60	196	22.98	185	94.39	PPD强阳性	443	51.93	405	91.42
性别					PPD中度阳性	91	10.67	87	95.60
男性	421	49.36	398	94.54	PPD一般阳性	45	5.28	45	100.00
女性	432	50.64	394	91.20	TBST阳性	203	23.80	186	91.63
民族					IGRA阳性	71	8.32	69	97.18
汉族	464	54.40	436	93.97	TPT方案
其他民族	389	45.60	356	91.52	3H₂P₂	458	53.69	420	91.70
文化程度					6~9H	17	1.99	16	94.12
高中及以下	710	83.24	657	92.54	3HR	192	22.51	173	90.10
大专及以上	143	16.76	135	94.41	Vaccae	186	21.81	183	98.39
提供TPT的机构

人群特征	β值	SE值	Wald χ²值	P值	OR（95%CI）值	人群特征	β值	SE值	Wald χ²值	P值	OR（95%CI）值
年龄（岁）						疾病预防控制中心					1.00
0~19					1.00	定点医院	0.52	0.52	0.97	>0.05	1.68（0.55~4.72）
20~39	-0.14	0.44	0.10	>0.05	0.87（0.36~2.18）	基层医疗卫生机构	1.59	0.63	6.36	<0.05	4.90（1.32~18.05）
40~59	-0.22	0.39	0.32	>0.05	0.80（0.36~1.76）	感染检测结果
≥60	0.51	0.44	1.30	>0.05	1.66（0.68~4.11）	PPD强阳性					1.00
性别						PPD中度阳性	-0.08	0.56	0.02	>0.05	0.92（0.32~3.28）
男性					1.00	PPD一般阳性	0.93	1.53	0.37	>0.05	2.54（0.22~356.00）
女性	-0.40	0.27	2.15	>0.05	0.67（0.39~1.16）	TBST阳性	-0.49	0.50	0.95	>0.05	0.62（0.22~1.70）
民族						IGRA阳性	0.64	0.83	0.59	>0.05	1.89（0.40~15.86）
汉族						TPT方案
其他民族	0.30	0.65	0.21	>0.05	1.35（0.34~5.12）	3H₂P₂					1.00
文化程度						6~9H	-0.44	1.12	0.15	>0.05	0.65（0.07~8.91）
高中及以下					1.00	3HR	-0.02	0.52	0.01	>0.05	0.98（0.32~2.76）
大专及以上	0.43	0.48	0.81	>0.05	1.53（0.59~4.26）	Vaccae	1.58	0.77	4.24	<0.05	4.86（1.03~27.14）
提供TPT的机构