Association between the risk of tuberculosis outbreak in schools and the visit interval of index cases
Objective To analyze the relationship between the risk of tuberculosis outbreaks in schools and the visit interval of index cases,so as to provide a scientific reference for predicting the risks of tuberculosis outbreak and making preventive measures.Methods A total of 630 index cases from school tuberculosis outbreaks were studied during January,2015 to December,2022.Data on demographics,consultation history,etiological diagnosis,and methods of detection were collected.Restricted Cubic Splines(RCS),unconditional Logistic regression,and the receiver operating characteristic curve(ROC curve)were used for analysis.Re-sults The RCS fitted curve showed that the risk of a tuberculosis outbreak linearly increased when the consultation interval for etio-logically negative patients exceeded 5.79 days,or for etiologically positive patients exceeded 8.37 days.After multi-factor adjust-ment,for every additional day in the visit interval of the index case,the odds ratio(OR)value for a high-risk outbreak was 1.10(95％CI=1.07-1.13)(P＜0.05).When analyzed by tertiles of visit intervals,compared to an interval of＜14 days,the OR values(95％CI)for high-risk outbreaks in schools with intervals of 14-＜28 days and ≥ 28 days were 10.32(3.04-35.10)and 82.58(28.42-239.95),respectively(P＜0.01),indicating a trend of increasing outbreak risk with longer visit intervals.Based on the ROC curve analysis,the optimal threshold for predicting a high-risk school tuberculosis outbreak was 23.5 days,with an area under the curve(AUC)of 0.93(95％CI=0.89-0.98).Conclusion An extended visit interval of index cases is a good early waming in-dicator for high-risk tuberculosis outbreaks in schools and could be considered a key factor in early intervention and risk control strategies.
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NSTL
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