Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, China

Abstract Background Tuberculosis (TB) can easily spread among students and can lead to an outbreak once there is an infection in a school. Outbreaks of drug-resistant TB (DR-TB) in schools have occasionally been reported, but the profile of DR-TB in students in a province has rarely been described....

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Main Authors: Jiying Xu, Yanqiu Zhang, Guojie Wang, Jianguo Jiang, Wenqiong Du, Saige Chen, Dan Meng, Wenshuai Suo, Yan Zhuang, Kan Wang, Weidong Wang, Dongyang Zhao
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Infectious Diseases
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Online Access:https://doi.org/10.1186/s12879-025-11408-1
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author Jiying Xu
Yanqiu Zhang
Guojie Wang
Jianguo Jiang
Wenqiong Du
Saige Chen
Dan Meng
Wenshuai Suo
Yan Zhuang
Kan Wang
Weidong Wang
Dongyang Zhao
author_facet Jiying Xu
Yanqiu Zhang
Guojie Wang
Jianguo Jiang
Wenqiong Du
Saige Chen
Dan Meng
Wenshuai Suo
Yan Zhuang
Kan Wang
Weidong Wang
Dongyang Zhao
author_sort Jiying Xu
collection DOAJ
description Abstract Background Tuberculosis (TB) can easily spread among students and can lead to an outbreak once there is an infection in a school. Outbreaks of drug-resistant TB (DR-TB) in schools have occasionally been reported, but the profile of DR-TB in students in a province has rarely been described. This study was conducted to determine the prevalence of DR-TB and factors associated with it in students in Henan Province, China. Methods We retrospectively reviewed the data of 3527 pulmonary TB patients among students with culture-confirmed Mycobacterium tuberculosis (M.tb) isolates collected from the Tuberculosis Information Management System of the China Disease Prevention and Control Information System from 2015 to 2021. Prevalence of DR-TB was analyzed. Comparisons between categorical variables were analyzed using the chi-square test or Fisher’s exact test as appropriate. Logistic regression models were used to identify the factors associated with DR-TB. Results Any DR-, RR (rifampin resistance)- and MDR (multi-drug resistance) -TB rates in students were 10.46%, 7.91% and 6.10%, respectively. And they all showed a downward trend from 2015 to 2021 (p < 0.001). Previously treated cases were 7.30 (95% CI: 5.30, 10.05), 8.60 (95% CI: 6.14,12.14) and 9.43 (95% CI: 6.64,13.40) times more likely than the new cases to be diagnosed with Any DR-TB, RR-TB and MDR-TB, respectively. Patients from schools in the western region of Henan had greater odds of having Any DR- (AOR = 2.06, 95% CI: 1.31, 3.24), RR- (AOR = 2.81, 95% CI: 1.66, 4.76) and MDR-TB (AOR = 2.07, 95% CI: 1.13, 3.80) than those from schools in the northern region. Males had a 1.40-fold (95% CI: 1.11, 1.78), 1.34-fold (95% CI: 1.02, 1.75) greater likelihood of being diagnosed with Any DR- and RR-TB, respectively. The risk of being diagnosed with MDR-TB was 1.42 (95% CI: 1.00, 2.02) times greater in students migrant between prefectures of the province than in the locals. Conclusion The prevalence of DR-TB among students with PTB in Henan, China, significantly decreased from 2015 to 2021. Previous treated cases and those in west-region schools in Henan were at greater risk of being diagnosed with Any DR-, RR- and MDR-TB. In addition, males were more likely to be diagnosed with Any DR- and RR-TB. It requires further study that whether those who migrated between prefectures of the province were more likely to be diagnosed with MDR-TB.
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spelling doaj-art-baadb82e40a9413fbf8a1b8a20fa5f0e2025-08-20T04:01:52ZengBMCBMC Infectious Diseases1471-23342025-08-0125111010.1186/s12879-025-11408-1Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, ChinaJiying Xu0Yanqiu Zhang1Guojie Wang2Jianguo Jiang3Wenqiong Du4Saige Chen5Dan Meng6Wenshuai Suo7Yan Zhuang8Kan Wang9Weidong Wang10Dongyang Zhao11Institute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionDepartment of Medicine, Henan Medical CollegeInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionDepartment of Human Resources, Henan Provincial Center for Disease Control and PreventionInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionInstitute of Tuberculosis Control and Prevention, Henan Provincial Center for Disease Control and PreventionAbstract Background Tuberculosis (TB) can easily spread among students and can lead to an outbreak once there is an infection in a school. Outbreaks of drug-resistant TB (DR-TB) in schools have occasionally been reported, but the profile of DR-TB in students in a province has rarely been described. This study was conducted to determine the prevalence of DR-TB and factors associated with it in students in Henan Province, China. Methods We retrospectively reviewed the data of 3527 pulmonary TB patients among students with culture-confirmed Mycobacterium tuberculosis (M.tb) isolates collected from the Tuberculosis Information Management System of the China Disease Prevention and Control Information System from 2015 to 2021. Prevalence of DR-TB was analyzed. Comparisons between categorical variables were analyzed using the chi-square test or Fisher’s exact test as appropriate. Logistic regression models were used to identify the factors associated with DR-TB. Results Any DR-, RR (rifampin resistance)- and MDR (multi-drug resistance) -TB rates in students were 10.46%, 7.91% and 6.10%, respectively. And they all showed a downward trend from 2015 to 2021 (p < 0.001). Previously treated cases were 7.30 (95% CI: 5.30, 10.05), 8.60 (95% CI: 6.14,12.14) and 9.43 (95% CI: 6.64,13.40) times more likely than the new cases to be diagnosed with Any DR-TB, RR-TB and MDR-TB, respectively. Patients from schools in the western region of Henan had greater odds of having Any DR- (AOR = 2.06, 95% CI: 1.31, 3.24), RR- (AOR = 2.81, 95% CI: 1.66, 4.76) and MDR-TB (AOR = 2.07, 95% CI: 1.13, 3.80) than those from schools in the northern region. Males had a 1.40-fold (95% CI: 1.11, 1.78), 1.34-fold (95% CI: 1.02, 1.75) greater likelihood of being diagnosed with Any DR- and RR-TB, respectively. The risk of being diagnosed with MDR-TB was 1.42 (95% CI: 1.00, 2.02) times greater in students migrant between prefectures of the province than in the locals. Conclusion The prevalence of DR-TB among students with PTB in Henan, China, significantly decreased from 2015 to 2021. Previous treated cases and those in west-region schools in Henan were at greater risk of being diagnosed with Any DR-, RR- and MDR-TB. In addition, males were more likely to be diagnosed with Any DR- and RR-TB. It requires further study that whether those who migrated between prefectures of the province were more likely to be diagnosed with MDR-TB.https://doi.org/10.1186/s12879-025-11408-1TuberculosisDrug resistanceStudent
spellingShingle Jiying Xu
Yanqiu Zhang
Guojie Wang
Jianguo Jiang
Wenqiong Du
Saige Chen
Dan Meng
Wenshuai Suo
Yan Zhuang
Kan Wang
Weidong Wang
Dongyang Zhao
Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, China
BMC Infectious Diseases
Tuberculosis
Drug resistance
Student
title Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, China
title_full Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, China
title_fullStr Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, China
title_full_unstemmed Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, China
title_short Drug resistance among students with pulmonary tuberculosis: a study based on screening in Henan, China
title_sort drug resistance among students with pulmonary tuberculosis a study based on screening in henan china
topic Tuberculosis
Drug resistance
Student
url https://doi.org/10.1186/s12879-025-11408-1
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