Tropical medicine and health · 2026
Context-dependent risk stratification using a tuberculin skin test induration threshold of ≥ 15 mm in school tuberculosis screening in Hangzhou, China: a historical cohort study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Meng Xiangjie, Tang Yin, Shou Jun, Jiang Nan, Zhang Yu
Аннотация
BACKGROUND: Larger tuberculin skin test (TST) reactions are associated with higher tuberculosis (TB) risk, but the operational value of the ≥ 15 mm threshold among adolescents who already have a TST induration ≥ 10 mm during routine school screening is less well characterised in high-BCG coverage settings. We assessed whether TST induration ≥ 15 mm provided incremental risk stratification information for secondary school students and interpreted this threshold across routine screening, outbreak contact and previously cured TB contexts.
METHODS: We conducted a historical cohort study using school-based TB screening and TB management data from Yuhang District, Hangzhou, China. The primary cohort included 6077 students aged 12-18 years who were screened between September 2023 and November 2025 with a baseline TST induration ≥ 10 mm and no active TB at screening. Students were classified as having a TST ≥ 15 mm or a TST 10-14 mm. The incidence of active pulmonary TB was ascertained by deterministic linkage with TB management systems. Students in the 2020-2022 TST ≥ 15 mm routine-screening descriptive cohort, school-outbreak contacts and previously cured TB patients were analysed descriptively and were not included in the primary inferential comparison.
RESULTS: In the primary cohort, four incident active pulmonary TB cases occurred among students with TSTs ≥ 15 mm (0.25%; 169.03 per 100 000 person-years), whereas none occurred among students with TSTs 10-14 mm. The adjusted incidence density ratio was 22.74 (95% CI 2.42-3015.62; P = 0.004), with wide uncertainty due to sparse events. The 2020-2022 TST ≥ 15 mm routine-screening descriptive cohort had a similarly low absolute incidence (128.64 per 100 000 person-years). In the outbreak contact cohort, the incidence among TST ≥ 15 mm contacts was 438.68 per 100 000 person-years; this estimate was interpreted descriptively because baseline definitions and preventive-treatment coverage differed.
CONCLUSIONS: A TST induration of ≥ 15 mm was associated with a higher incidence of active pulmonary TB in students than a TST of 10-14 mm, but the absolute risk after routine screening remained low. The threshold should be interpreted as a context-dependent risk marker that can support, but should not replace, the assessment of exposure history, previous TB and time since screening.
METHODS: We conducted a historical cohort study using school-based TB screening and TB management data from Yuhang District, Hangzhou, China. The primary cohort included 6077 students aged 12-18 years who were screened between September 2023 and November 2025 with a baseline TST induration ≥ 10 mm and no active TB at screening. Students were classified as having a TST ≥ 15 mm or a TST 10-14 mm. The incidence of active pulmonary TB was ascertained by deterministic linkage with TB management systems. Students in the 2020-2022 TST ≥ 15 mm routine-screening descriptive cohort, school-outbreak contacts and previously cured TB patients were analysed descriptively and were not included in the primary inferential comparison.
RESULTS: In the primary cohort, four incident active pulmonary TB cases occurred among students with TSTs ≥ 15 mm (0.25%; 169.03 per 100 000 person-years), whereas none occurred among students with TSTs 10-14 mm. The adjusted incidence density ratio was 22.74 (95% CI 2.42-3015.62; P = 0.004), with wide uncertainty due to sparse events. The 2020-2022 TST ≥ 15 mm routine-screening descriptive cohort had a similarly low absolute incidence (128.64 per 100 000 person-years). In the outbreak contact cohort, the incidence among TST ≥ 15 mm contacts was 438.68 per 100 000 person-years; this estimate was interpreted descriptively because baseline definitions and preventive-treatment coverage differed.
CONCLUSIONS: A TST induration of ≥ 15 mm was associated with a higher incidence of active pulmonary TB in students than a TST of 10-14 mm, but the absolute risk after routine screening remained low. The threshold should be interpreted as a context-dependent risk marker that can support, but should not replace, the assessment of exposure history, previous TB and time since screening.