Abstract:

Objective To understand the occurrence law and epidemiological characteristics of epidemic cluster of tuberculosis in schools in Hubei Province, so as to provide evidence for effective control and prevention of tuberculosis prevalence in school campus. Methods Descriptive epidemiological methods were used to statistically analyze the distribution characteristics, etiology of the first case, and how the first case was identified from the epidemic cluster of tuberculosis in local schools in various regions of Hubei Province from 2018 to 2022. Results In total, 108 events of cluster of tuberculosis epidemic in schools were reported in Hubei Province from 2018 to 2022, including 3 public health emergencies. The events reported were 30, 28, 16, 20 and 14 during the five years, and the public health emergency was 2 in 2019 and 1 in 2020. A total of 588 cases were reported, yet no death occurred. High incidence of cluster epidemic appeared during April and June, when 46 events were reported, accounting for 42.59% of the total epidemics. The epidemic clustered in top three areas were Wuhan City (47 events, 43.52%), Enshi Prefecture (10 events, 9.26%) and Jingzhou City (8 events, 7.41%). The aggregated epidemic was most found in the high school students of their third year, with 25 (23.15%) epidemics reported, followed by sophomore and junior (19 epidemics, 17.59%, respectively). Pathogen-positive epidemic was seen in 65 cases (excluding drug-resistant cases) with first onset, which accounted for 60.19%. Eight cases were associated with drug resistance, accounting for 7.41%. Ninety-two cases with first onset were identified via self-referral due to symptom (85.19%). Of the first case identified by self-referral due to symptom, the median number (quartile) from the date of onset to the date of visit was 19 (3,64) days, and the delay rate of visit was 53.26% (49/92). Conclusion Schools should strengthen health education on tuberculosis, cultivate adolescents to develop good living habits, and improve teachers and students' ability to recognize tuberculosis. Administration of disease control should increase their proactive screening efforts and promptly detect signs of the epidemic. Targeted prevention and control should be carried out according to the characteristics of clustered epidemics in different regions.

Key words: Tuberculosis, Cluster epidemic, School, Epidemiological characteristics, Hubei Province