Cross-sectional study of preventive treatment for students with latent tuberculosis infection in Shanghai, China

Tuberculosis preventive treatment (TPT) has been initiated systematically in Shanghai supported by a public health project. This study aimed to evaluate the acceptance of TPT, identify the factors related to its refusal, and find an optimal way to promote TPT among student tuberculosis (TB) contacts.

We screened contacts of the TB index case from a TB outbreak on campus. A two-step approach of first conducting a lecture of TB health literacy, followed by one-on-one TPT consultations was used to mobilise TPT among students with latent TB infection (LTBI). A semistructured questionnaire was designed between the lecture and the one-on-one TPT consultations, covering general demographic information, awareness of core TB knowledge and willingness to accept TPT, along with the reasons for refusal. Logistic regression analysis was used to identify the risk factors for refusing TPT.

A total of 52 contacts were identified with LTBI. After the lecture on TB health literacy, their scores on the core TB knowledge was 14.0±2.3. Students had a poor awareness rate of TB knowledge in the part of TB treatment and policy (70.2%) and Mycobacterium tuberculosis infection preventive measures and LTBI (67.3%) compared with the average rate (84.3%). The acceptance rate of TPT reached 42.3% at the end of the two-step promotion. The main reasons for refusing TPT included: (1) the duration for TPT was too long and follow-up management was too cumbersome; (2) the confidence in their own immunity and belief in their low risk of TB and (3) the fear of side effects of TPT.

The two-step approach of first conducting a lecture of TB health literacy, followed by one-on-one TPT consultations, is effective for mobilising TPT. To further implement TPT, we recommend making the scientific popularisation for LTBI in a more easy-to-understand way and optimising the management of TPT.