{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:29:06Z","timestamp":1779114546110,"version":"3.51.4"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The management of latent tuberculosis infection (LTBI) is a key action for the realization of the \u201cEnd tuberculosis (TB) Strategy\u201d worldwide, and it is important to identify priority populations. In this prospective cohort study, we evaluated the prevalence of LTBI and incidence of active TB among close contacts and explored the suitable TB control strategy in schools.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We designed a cohort with 2 years of follow-up, recruiting freshman\/sophomore TB patients\u2019 close contacts from three administrative districts in Shanghai. These were chosen based on different levels of TB incidence reported in 2019. Questionnaires were included and all participants received both tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT) at baseline, then tracked the outcomes of them during the follow-up period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The prevalence of LTBI was 4.8% by QFT. Univariate analysis showed that the risk of LTBI was higher in those contacting bacteriologically confirmed patients or did not have BCG scars, including smokers. The risk increased with poor lighting and ventilation conditions at contact sites. Multivariate analysis showed that those contacting with bacteriologically confirmed patients (OR=4.180; 95%CI, 1.164-15.011) or who did not have BCG scars (OR=5.054; 95%CI, 2.278-11.214) had a higher risk of being LTBI, as did the current smokers (OR=3.916; 95%CI, 1.508-10.168) and those who had stopped smoking (OR=7.491; 95%CI, 2.222-25.249). During the 2-year follow-up period, three clinically diagnosed cases of TB were recorded, the 2-year cumulative incidence was 0.4% (95%CI 0.1-1.2), the median duration for TB occurrence was 1 year, the incidence rate of active TB was 2.0 per 1000 person-years with a total of 1497.3 observation person-years. For those LTBI, no one initiated preventive treatment, in the QFT (+) cohort, 1 TB case was observed, 71 person-years with an incidence rate of 14.1 14.1 (95%CI 2.5-75.6) per 1000 person-years, in the TST (+++) cohort, 2 TB cases were observed 91.5 person-years with an incidence rate of 21.9 (95%CI 6.0-76.3) per 1000 person-years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results suggest that school close contacts are one of the key populations for LTBI management. Measures should be taken to further reduce the prevalence of LTBI and the incidence of active TB among them.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2022.1000663","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T13:10:36Z","timestamp":1663938636000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Prevalence of latent tuberculosis infection and incidence of active tuberculosis in school close contacts in Shanghai, China: Baseline and follow-up results of a prospective cohort study"],"prefix":"10.3389","volume":"12","author":[{"given":"Xiao","family":"Xiao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liping","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yameng","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihong","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianyuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheyuan","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lixin","family":"Rao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng\u2019an","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qichao","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"784","DOI":"10.1093\/cid\/cir951","article-title":"Risk of progression to active tuberculosis following reinfection with mycobacterium tuberculosis","volume":"54","author":"Andrews","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2020.101947","article-title":"The role of antibodies in bacille calmette guerin-mediated immune responses and protection against tuberculosis in humans: A systematic review","volume":"131","author":"Bright","year":"2021","journal-title":"Tuberculosis (Edinb)."},{"key":"B3","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1038\/nri.2017.69","article-title":"Heterogeneity in tuberculosis","volume":"17","author":"Cadena","year":"2017","journal-title":"Nat. Rev. Immunol."},{"key":"B4","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1542\/peds.96.1.29","article-title":"The efficacy of bacillus calmette-guerin vaccination of newborns and infants in the prevention of tuberculosis: Meta-analyses of the published literature","volume":"96","author":"Colditz","year":"1995","journal-title":"Pediatrics."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e00021","DOI":"10.1128\/CMR.00021-18","article-title":"Incipient and subclinical tuberculosis: A clinical review of early stages and progression of infection","volume":"31","author":"Drain","year":"2018","journal-title":"Clin. Microbiol. Rev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1128\/IAI.00709-10","article-title":"Exposure to cigarette smoke inhibits the pulmonary T-cell response to influenza virus and mycobacterium tuberculosis","volume":"79","author":"Feng","year":"2011","journal-title":"Infect. Immun."},{"key":"B7","first-page":"480","article-title":"Risk factors for clustering of tuberculosis cases: A systematic review of population-based molecular epidemiology studies","volume":"12","author":"Fok","year":"2008","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1183\/09031936.00070812","article-title":"Contact investigation for tuberculosis: A systematic review and meta-analysis","volume":"41","author":"Fox","year":"2013","journal-title":"Eur. Respir. J."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1053","DOI":"10.1016\/S1473-3099(17)30402-4","article-title":"Incidence of active tuberculosis in individuals with latent tuberculosis infection in rural China: Follow-up results of a population-based, multicentre, prospective cohort study","volume":"17","author":"Gao","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1186\/s12879-019-3942-2","article-title":"High incidence and low case detection rate among contacts of tuberculosis cases in shanghai, China","volume":"19","author":"Guo","year":"2019","journal-title":"BMC Infect. Dis."},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002152","article-title":"The global burden of latent tuberculosis infection: A re-estimation using mathematical modelling","volume":"13","author":"Houben","year":"2016","journal-title":"PloS Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jinf.2012.03.018","article-title":"Use of the T-SPOT.TB assay to screen latent tuberculosis infection among the TB contacts in shanghai, china. J","volume":"65","author":"Hu","year":"2012","journal-title":"Infect."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1064","DOI":"10.1093\/eurpub\/ckt105","article-title":"Prevalence of latent tuberculosis infection and its risk factors in schoolchildren and adolescents in shanghai, China","volume":"23","author":"Hu","year":"2013","journal-title":"Eur. J. Public Health"},{"key":"B14","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1111\/j.1365-2753.2008.00970.x","article-title":"Comparison of QuantiFERON TB-g-test to TST for detecting latent tuberculosis infection in a high-incidence area containing BCG-vaccinated population","volume":"15","author":"Kariminia","year":"2009","journal-title":"J. Eval. Clin. Pract."},{"key":"B15","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1056\/NEJM199604113341501","article-title":"Transmission of multidrug-resistant mycobacterium tuberculosis during a long airplane flight","volume":"334","author":"Kenyon","year":"1996","journal-title":"N. Engl. J. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1086\/338342","article-title":"Molecular evidence of endogenous reactivation of mycobacterium tuberculosis after 33 years of latent infection","volume":"185","author":"Lillebaek","year":"2002","journal-title":"J. Infect. Dis."},{"key":"B17","volume-title":"The guideline of tuberculosis control and prevention in China","author":"Liu","year":"2021"},{"key":"B18","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.ijid.2021.06.053","article-title":"Association of BMI, diabetes, and risk of tuberculosis: A population-based prospective cohort","volume":"109","author":"Lu","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0017984","article-title":"The tuberculin skin test versus QuantiFERON TB gold\u00ae in predicting tuberculosis disease in an adolescent cohort study in south Africa","volume":"6","author":"Mahomed","year":"2011","journal-title":"PloS One"},{"key":"B20","doi-asserted-by":"publisher","first-page":"916","DOI":"10.3949\/ccjm.72.10.916","article-title":"Respiratory tract infections: Another reason not to smoke","volume":"72","author":"Murin","year":"2005","journal-title":"Cleve. Clin. J. Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1542\/peds.2008-0611","article-title":"Comparison of T-SPOT.TB assay and tuberculin skin test for the evaluation of young children at high risk for tuberculosis in a community setting","volume":"123","author":"Nicol","year":"2009","journal-title":"Pediatrics."},{"key":"B22","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1093\/aje\/kwt246","article-title":"Estimated rate of reactivation of latent tuberculosis infection in the united states, overall and by population subgroup","volume":"179","author":"Shea","year":"2014","journal-title":"Am. J. Epidemiol."},{"key":"B23","first-page":"1049","article-title":"Tobacco and tuberculosis: A qualitative systematic review and meta-analysis","volume":"11","author":"Slama","year":"2007","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1016\/S0140-6736(05)67534-4","article-title":"Effect of BCG vaccination on risk of mycobacterium tuberculosis infection in children with household tuberculosis contact: A prospective community-based study","volume":"366","author":"Soysal","year":"2005","journal-title":"Lancet"},{"key":"B25","first-page":"200","article-title":"Does the efficacy of BCG decline with time since vaccination","volume":"2","author":"Sterne","year":"1998","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"B26","first-page":"S424","article-title":"Integrated counseling and screening for tuberculosis and HIV among household contacts of tuberculosis patients in an endemic area of HIV infection: Chiang rai, Thailand","volume":"7","author":"Suggaravetsiri","year":"2003","journal-title":"Int. J. Tuberc. Lung Dis."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1186\/s12879-021-06609-3","article-title":"The yield of tuberculosis contact investigation in low- and middle-income settings: a systematic review and meta-analysis","volume":"21","author":"Velleca","year":"2021","journal-title":"BMC Infect. Dis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e511","DOI":"10.1093\/pubmed\/fdv186","article-title":"The need to implement effective new entrant tuberculosis screening in children: evidence from school \u201coutbreak\u201d","volume":"38","author":"Williams","year":"2016","journal-title":"J. Public Health (Oxf)."},{"key":"B29","volume-title":"Latent tuberculosis infection: Updated and consolidated guidelines for programmatic management","year":"2018"},{"key":"B30","volume-title":"Global tuberculosis report 2021","year":"2021"},{"key":"B31","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1111\/j.1440-1843.2009.01690.x","article-title":"Genetic susceptibility in tuberculosis","volume":"15","author":"Yim","year":"2010","journal-title":"Respirology."}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.1000663\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T13:10:54Z","timestamp":1663938654000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2022.1000663\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,23]]},"references-count":31,"alternative-id":["10.3389\/fcimb.2022.1000663"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2022.1000663","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,23]]},"article-number":"1000663"}}