Tuberculosis among Full-Time Teachers in Southeast China, 2005⁻2016

Objective: To explore the incidence rate and characteristics of tuberculosis (TB) among full-time teachers from 2005 to 2016 in southeast China and to provide a basis for TB prevention and control measures in schools. Methods: Information about full-time teachers with TB was obtained from the National Tuberculosis Information Management System (NTIMS). Population data were collected from the Zhejiang Statistical Yearbook and the Zhejiang Education Yearbook. The TB incidence rates and epidemiological characteristics of full-time teachers were analyzed and the Chi-square test was used to analyze influencing factors of epidemiological characteristics and clinical characteristics, case-finding delay, and treatment outcomes. Results: A total of 1795 teachers with TB were reported from 2005 to 2016, and the annual incidence rate was 28.87 per 100,000. The average annual PTB (pulmonary TB) incidence rate among full-time teachers was 25.43/100,000 from 2005 to 2016 and the average annual PTB incidence rate among students was 15.40/100,000 from 2005 to 2016. The highest average incidence rates were observed in the QZ (Quzhou) and HZ (Hangzhou) districts. The male-to-female ratio of the patients was 0.95:1. Approximately half of the patients were 15⁻40 years old. The mean case-finding interval was 45.3 days. Multivariable logistic regression analysis of TB case-finding delay among full-time teachers revealed that the older (OR = 1.44, 95% CI = 1.18⁻1.76, p < 0.01), not local (OR = 1.81, 95% CI = 1.20⁻2.73, p < 0.01), retreatment (OR = 2.06, 95% CI = 1.39⁻3.08, p < 0.01) and extra-pulmonary tuberculosis (OR = 1.71, 95% CI = 1.13⁻2.61, p = 0.01) cases were at high risk of case-finding delay. Compared to physical examination, patients detected by referrals and tracking (OR = 2.26, 95% CI = 1.16⁻4.38, p = 0.02) and patients who directly visited the designated TB hospital (OR = 2.00, 95% CI = 1.03⁻3.88, p = 0.04) were more prone to case-finding delay. The cure rate of full-time teachers with TB was 77.10%. The cure rates differed significantly between groups classified based on age, case-finding patterns, diagnostic results, treatment classifications, and strategies of patient management. Conclusion: The TB incidence rate among full-time teachers decreased from 2005 to 2016, but teachers suffered a higher risk of TB than students. Western Zhejiang was a hotspot for TB incidence among full-time teachers. Female teacher and young and middle-aged teacher cases account for the majority of the reported patients. There was a case-finding delay among full-time teachers with TB. We should conduct regular physical examinations and strengthen full-course supervision to reduce the risk of TB patients with case-finding delay and increase the TB cure rate.