Adolescent tuberculosis associated with tuberculosis exposure in classrooms and dorm rooms in Guangxi, China. (January 2019) - Pan, Dongxiang
Highlights: More than 90% of adolescent students study in boarding school with around 60 classmates and 10 dorm roommates in Guangxi. Student who shares the same class with an index TB case increases their risk for TB by 8 times. Student who shares both a classroom and dorm room with the index case increases the risk for TB by 29 times. A reduction in the number of students sharing the same classroom and sharing dorm room is highly recommended. Abstract: Objective: Quantify tuberculosis (TB) risk attributable to dorm room exposure in addition to classroom exposure. Methods: Adolescent school contact investigations were conducted for every reported index TB case, and similar contact investigations were conducted in selected community-control classes from November 2016 to October 2017 in Guangxi, China. Results: A total of 6263 contacts of 112 index TB cases and 6130 classmates of 112 controls were investigated. There were 14, 12, and 2 new active TB cases detected among classmates/non-roommates of index cases, classmates/roommates of index cases, and control classmates, respectively. Compared with control contacts, the adjusted relative risk (95% confidence interval (CI)) and population attributable fraction (PAF) for being a classmate/non-roommate of the index case increased the risk of active TB diagnosis to 8.44 (95% CI: 1.31–54.48) and 44.1%. The adjusted RR and PAF for being a classmate/roommate of the index case was 29.37 (95% CI: 3.80, 227.11) and 41.4%. Being classmates/roommates significantly increased the risk of TB compared to a classmate/non-roommate of the index case (RR = 3.48, 95% CI: 1.64, 7.40). Conclusion: The additional risk of TB due to exposure in the dorm room should be taken into account in planning of TB prevention and control in boarding schools.