title: Annual risk of tuberculosis infection in rural China: a population-based prospective study.
abstract: Prospective population data on the incidence of tuberculosis (TB) infection has been sparsely reported in the global literature.A population-based prospective study was conducted in rural China to investigate the annual risk of TB infection, and its persistence using serial tuberculin skin tests (TSTs) and an interferon-γ release assay. In total, 13 580 eligible participants from four rural sites, identified as TST negative (<10 mm) or QuantiFERON-TB Gold In-Tube (QFT) (an interferon-γ release assay) negative from a baseline survey, were included in the first year's follow-up examination.The annual conversion rate of QFT among the study sites ranged between 2.1% and 4.9% (average 3.1%), and the incidence of TST conversion ranged between 6.0% and 31.1% (average 14.5%). During the second year's follow-up, infection persistence was investigated using 390 subjects with QFT conversions. Among them, 49.7% (164 out of 330) were found to be consistently QFT positive. Both the conversion and the persistence of QFT positivity were found to be significantly increased with increasing age.In conclusion, the annual TB infection rate was suggested to be ∼1.5% based on persistent positive results after QFT conversion in rural China. Therefore, infection control among those high-risk populations, including the elderly, should be prioritised for TB control in China.
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China These authors contributed equally These authors contributed equally.
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
authors.affiliation: Hunan Provincial Institute of Tuberculosis Prevention and Control, Changsha, China These authors contributed equally.
authors.forename: Liqiong
authors.initials: L
authors.lastname: Bai
authors.affiliation: The Sixth People's Hospital of Zhengzhou, Zhengzhou, China These authors contributed equally.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Liu
authors.affiliation: Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, China These authors contributed equally.
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.affiliation: Gansu Provincial Center for Diseases Control and Prevention, Lanzhou, China These authors contributed equally.
authors.forename: Xinhua
authors.initials: X
authors.lastname: Wang
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China These authors contributed equally.
authors.forename: Xiangwei
authors.initials: X
authors.lastname: Li
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China These authors contributed equally.
authors.forename: Jiang
authors.initials: J
authors.lastname: Du
authors.affiliation: Guangdong Key Laboratory for Emerging Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, China These authors contributed equally.
authors.forename: Xinchun
authors.initials: X
authors.lastname: Chen
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Haoran
authors.initials: H
authors.lastname: Zhang
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Henan
authors.initials: H
authors.lastname: Xin
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Sui
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Hengjing
authors.initials: H
authors.lastname: Li
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Haoxiang
authors.initials: H
authors.lastname: Su
authors.affiliation: Gansu Provincial Center for Diseases Control and Prevention, Lanzhou, China.
authors.forename: Jian
authors.initials: J
authors.lastname: He
authors.affiliation: Zhongmu County Center for Diseases Control and Prevention, Zhongmu, China.
authors.forename: Shouguo
authors.initials: S
authors.lastname: Pan
authors.affiliation: Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Peng
authors.affiliation: Hunan Provincial Institute of Tuberculosis Prevention and Control, Changsha, China.
authors.forename: Zuhui
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Dept of Medicine, University of California, San Diego, CA, USA.
authors.forename: Antonino
authors.initials: A
authors.lastname: Catanzaro
authors.affiliation: Aeras, Rockville, MD, USA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Evans
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Zongde
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Beijing Chest Hospital, Capital Medical University, Beijing Key Laboratory for Drug Resistant Tuberculosis Research, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ma
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Mufei
authors.initials: M
authors.lastname: Li
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Boxuan
authors.initials: B
authors.lastname: Feng
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
authors.affiliation: Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Guan
authors.affiliation: Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Shen
authors.affiliation: Danyang City Center for Diseases Control and Prevention, Danyang, China.
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Danyang City Center for Diseases Control and Prevention, Danyang, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhu
authors.affiliation: Gansu Provincial Center for Diseases Control and Prevention, Lanzhou, China.
authors.forename: Shumin
authors.initials: S
authors.lastname: Yang
authors.affiliation: Gansu Provincial Center for Diseases Control and Prevention, Lanzhou, China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Si
authors.affiliation: Longxi County Center for Diseases Control and Prevention, Longxi, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Hunan Provincial Institute of Tuberculosis Prevention and Control, Changsha, China.
authors.forename: Yunhong
authors.initials: Y
authors.lastname: Tan
authors.affiliation: Xiangtan County Center for Diseases Control and Prevention, Xiangtan, China.
authors.forename: Tianzhu
authors.initials: T
authors.lastname: Chen
authors.affiliation: Aeras, Rockville, MD, USA.
authors.forename: Chen
authors.initials: C
authors.lastname: Chen
authors.affiliation: Chinese Center for Disease Prevention and Control, Beijing, China.
authors.forename: Yinyin
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Chinese Center for Disease Prevention and Control, Beijing, China.
authors.forename: Shiming
authors.initials: S
authors.lastname: Cheng
authors.affiliation: Jiangsu Provincial Center for Diseases Control and Prevention, Nanjing, China These authors contributed equally.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Xu
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, and Centre for Tuberculosis, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China These authors contributed equally zdsys@vip.sina.com.
authors.forename: Qi
authors.initials: Q
authors.lastname: Jin
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D059425:Interferon-gamma Release Tests; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology*; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D017678:Sex Distribution; D014374:Tuberculin Test; D055815:Young Adult