Feasibility of eliminating tuberculosis by shortening the diagnostic delay: A retrospective analysis and modelling study in China during the pre-COVID-19 era
Qiao Liu,
Qiuping Chen,
Yichao Guo,
Shanshan Yu,
Jia Rui,
Kangguo Li,
Huimin Qu,
Laurent Gavotte,
Roger Frutos,
Tianmu Chen
Affiliations
Qiao Liu
State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, Fujian Province, PR China
Qiuping Chen
State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, Fujian Province, PR China; CIRAD, URM 17, Intertryp, Montpellier, France; Université de Montpellier, Montpellier, France
Yichao Guo
State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, Fujian Province, PR China
Shanshan Yu
State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, Fujian Province, PR China
Jia Rui
State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, Fujian Province, PR China; CIRAD, URM 17, Intertryp, Montpellier, France; Université de Montpellier, Montpellier, France
Kangguo Li
State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, Fujian Province, PR China
Huimin Qu
State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, Fujian Province, PR China
Laurent Gavotte
Espace-Dev, Université de Montpellier, Montpellier, France
State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University, Xiamen City, Fujian Province, PR China; Corresponding author. State Key Laboratory of Vaccines for Infectious Disease, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Intergration in Vaccine Research, School of Public Health, Xiamen University 4221-117 South Xiang’an Road, Xiang’an District, Xiamen City, Fujian Province, PR China.
Objective: Delays in the diagnosis and treatment of pulmonary tuberculosis (PTB) can increase the risk of transmission, thereby posing a significant risk to public health. Early diagnosis is considered to play a crucial role in eliminating TB. Rapid testing, active case finding, and health education are effective strategies for reducing tuberculosis diagnosis delays (TDDs). This study aimed to quantitatively compare the impact of reducing the TDD on incidence rates among student and non-student groups, thus exploring the efficacy of shortening the TDD for ending the TB epidemic and providing a reference for achieving the target incidence rate for ending TB. Methods: We used unsupervised hierarchical clustering analysis and non-parametric tests to characterize the epidemiological characteristics of TDD. Additionally, a dynamic transmission model was used to quantify the impact of shortening the TDD on the incidence rates of TB among the two groups. Results: There was an initial increase in the TDD, followed by a decrease. Longer TDDs were observed in the northeastern region of China. Farmers, middle and high school students, middle-aged, elderly individuals and males exhibited relatively longer TDDs. A significant reduction in the incidence rate of PTB was observed when the TDD was decreased by 50 %. However, only reducing the TDD among non-students could achieve the goal of ending TB (i.e., achieving a minimum reduction of 63.00 %). Conclusions: TDD remains a serious risk to public health, and non-students were shown to experience longer TDD. Shortening the TDD is crucial for reducing the incidence rates of TB, especially among non-students. It is essential to develop a highly sensitive and effective system for eliminating TB among non-students.
