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