Objective: To understand delay in treatment student tuberculosis (TB) patients in Wuhan from 2011 to 2018, and to provide a reference for prevention and control measures of tuberculosis in schools. Methods: The medical cases of students with tuberculosis in Wuhan recorded by the national tuberculosis management information system during 2011-2018 were analyzed for the delay and change trend of medical treatment of students with tuberculosis, and Logistic regression was used to analyze influencing factors. Results: The median number of student TB patients seeking treatment in Wuhan was 9(3,21) days, and 51.14% of student TB patients were delayed. From 2011 to 2018, the overall delay rate of TB patients in students decreased slowly and then gradually increased, decrea sing from the highest rate (56.4%) in 2011 to the lowest one (45.6%) in 2014, and then gradually increased to 53.8% in 2018, there was no significant difference in the delay rate between the first and the second four years(χ2=2.84, P=0.09); The delay rate of different gender students was the same as that of the whole. The fluctuation of female students was slightly obvious, but the difference was not statistically significant(χ2=0.07, P>0.05); Among the students of different age groups, the delay rate of 13-18 years old was the lowest(χ2=87.23, P<0.01). The delay rate of 19-22 years old and university groups of different school levels showed a slow decline, while that of other age groups and other school level groups showed an overall upward trend. The results of multivariate logistic regression analysis showed that the main factors affecting the delay rate of medical treatment were the remote urban area(OR=1.84, 95%CI=1.56-2.16), the ethnic minorities (OR=2.73, 95%CI=1.46-5.09) and the age of 13-18(OR=0.57, 95%CI=0.33-1.00). Conclusion Delay in treatment of TB patients in Wuhan is not optimistic, with more than half of the students have delayed in treatment, the main factors that affect the high rate of TB patients’ treatment delay are the students in the far urban areas and ethnic minorities. It is very important to take targeted prevention and control measures to guide the students to actively seek medical treatment according to the time, the place and the person.

Tuberculosis is recognized as a chronic respiratory infectious disease and still one of the important public health issues in the world.Douglas reported an unique seasonal pattern (summer peak) of tuberculosis,when compared with most other respiratory diseases in 1996.Since then,there had been many other researchers notified various patterns of seasonality on TB.This paper reviewed all the studies published in the last five years and analyzed the current findings on seasonal variability and influencing factors,in order to explore the risk factors to provide evidence for prevention and control strategies on tuberculosis.

Objective: To determine the knowledge, attitudes and practices (KAP) regarding tuberculosis prevention and control among college students in Wuhan, China, while analyzing the factors affecting tuberculosis prevention behavior. Methods: Referring to the National KAP Questionnaire for Tuberculosis Prevention and Control among College Students, which was designed by China Center for Disease Control and Prevention, 22 colleges and universities in Wuhan were selected using a judgment sampling method, and a questionnaire survey was carried out through the online questionnaire platform. The formation of tuberculosis prevention and control behavior among this population was analyzed by single factor and multi factor Logistic regression. Results: The total awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan was 79.69%; the awareness rate of core knowledge was 79.28%, and the passing rate was 92.46%. The correct attitude holding rate was 89.69%, while the passing rate was 90.56%. In respect to correct behavior, the formation rate was 72.11%, with a passing rate of 96.62%. The multivariate Logistic regression analysis showed that the following factors were more likely to promote tuberculosis prevention and control behaviors that met the target: female college students ( OR =1.86); college students whose father had a primary school education level, junior high school and equivalent, high school and equivalent, and junior high school students ( OR =2.94, 3.05, 3.17, 3.24 ); no history of tuberculosis ( OR =3.32); the passing knowledge of core knowledge ( OR =9.91), and the passing attitude holding score ( OR =7.35)( P <0.05). Conclusion The overall awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan is acceptable,the mainly influenced factors are gender, history of tuberculosis, awareness rate of core knowledge about prevention and control, attitudes and cognition, and parents educational background.

Objective: To analyze the epidemiological characteristics and assoicated factors of tuberculosis (TB) aggregation in schools in Wuhan from 2017 to 2020, and to provide scientific basis for school based TB prevention and control strategies. Methods: Questionnaire star was used to collect data on tuberculosis prevention and control in various schools in Wuhan. Multivariate logistic regression analysis was used to analyze the influencing factors of tuberculosis aggregation in schools. Results: A total of 37 outbreaks of tuberculosis aggregation in schools were reported in Wuhan from 2017 to 2020, which involved 28 different schools, including 24 colleges and universities and 4 senior high schools, 176 cases were reported, among which 39 were positive for pathogens and 17 cases of rifampicin resistant, and the median duration of single cluster epidemic was 48 (28, 368) days, universities were more prone to cluster outbreaks than middle schools ( χ 2=75.27, P <0.01), the incidence in male was higher than that of in female in cluster outbreak ( χ 2=22.82, P =0.00). The results of multivariate Logistic regression analysis showed that boarding school ( OR =5.12), TB screening at school entry ( OR =3.27), etiology tracking and registrationin school ( OR =7.28), treatment and isolation of sick students on time ( OR =9.12), whether the dormitories and classrooms were often ventilated ( OR =4.97), and whether the management of school suspension and return was strictly implemented ( OR =4.68) were associated with the occurrence of TB cluster outbreak( P <0.05). Conclusion Schools should actively strive for policies and funding, strictly implement TB screening and physical examination for freshmen, as well as the management of contact tracing and registeration, targeted TB health education, guidance for teachers and students for cleaning, disinfection and hand hygiene, timely treatment and reporting of suspected symptoms, to prevent the occurrence of TB clustering outbreaks.

Objective To analyze and evaluate the implementation effect of tuberculosis prevention and control program in Wuhan, and to provide reference for scientific formulation of tuberculosis prevention and control measures. Methods Using the National Tuberculosis Information Management System, descriptive statistical analysis was carried out on the medical record information of pulmonary tuberculosis patients registered in Wuhan , 2016 - 2021. Results A total of 34 937 cases of pulmonary tuberculosis were registered in Wuhan , with an average annual incidence rate of 49.85/100 000. The incidence rate showed a downward trend year by year, with a statistically significant difference in 2016—2021 (χ²_trend = 708.387, P<0.001). The patients mainly came from referrals, accounting for 71.86%, and the proportion of referrals varied significantly among different years (χ²=355.541, P<0.001). The diagnosis type was mainly pathogenic negative, accounting for 49.12%. The proportion of pathogenic negative had statistically significant difference among different years (χ²=1 354.830, P<0.001). The proportion of patients cured and completed the course of treatment reached 93.98%, with statistically significant differences in the proportions among different years (cured, χ²=1 080.252, P<0.001; completed the treatment course, χ²= 933.655, P<0.001). The sputum examination rate of newly diagnosed patients in each year reached over 90%, and the overall completion rate reached over 95%. The proportion of positive pathogens showed an increasing trend year by year. Conclusion The overall epidemic situation of tuberculosis in Wuhan is declining year by year, and tuberculosis prevention and control work has achieved remarkable results. Active screening in key areas and populations should be strengthened, and prevention and control strategies should be formulated by emphasizing the key and difficult points.

Objective: To analyze the epidemiological characteristics, trend and related factors of tuberculosis patients that delayed for care, in Wuhan from 2008 to 2017. Methods: Data regarding tuberculosis (TB) patients was collected from the tuberculosis management information system (TMIS), a part of the China information system for disease control and prevention from 2008 to 2017. A total of 64 208 tuberculosis patients, aged 0 to 95 years were included for the analysis. Unconditional logistic regression method was used to estimate those factors that associated with this study. Results: Days of delay among TB patients appeared as M=10 (P₂₅-P₇₅: 3-28) day, in Wuhan, 2008-2017. The prevalence of the delay was 52.5% (33 703/64 208), presenting a downward trend from 2008 to 2017 (trend χ²=10.64, P<0.001), but the proportions of women and ≥65 year-olds were gradually increasing. Results from the multivariate logistic regression analysis showed that factors as: patients living far away from the city vs. near the city (OR=1.29, 95%CI: 1.25-1.35), and age above 45 years vs. younger than 25 years (the age 45-64 years group vs. aged less than 25 years group, OR=1.22, 95%CI: 1.15-1.29; the age 65 or above group vs. aged less than 25 years group, the OR=1.30, 95%CI: 1.22-1.39) were under higher risk on the delay of seeking care. Occupation, way of case-finding and classification of tuberculosis patients also appeared as influencing factors on this issue. Conclusions Prevalence on the delay of care was 52.5% among tuberculosis patients in Wuhan, 2008-2017, but with an annual decrease. Attention should be paid to female, wrinkly or elderly tuberculosis patients regarding the delay of care on TB, in Wuhan.

Objective To explore the epidemic characteristics and spatial clustering of pulmonary tuberculosis in Wuhan from 2011 to 2019, and to provide a scientific basis for formulating intervention strategies and measures. Methods Descriptive statistical analysis was conducted on the epidemic characteristics of tuberculosis data in Wuhan registered in the national tuberculosis information management system in the last 9 years, and spatial autocorrelation analysis was performed on the incidence of tuberculosis in 155 communities or in the city using Arcgis10.5 software. Results From 2011 to 2019, there were 56,432 cases of tuberculosis reported in Wuhan, and the annual average reported incidence rate of tuberculosis was 59.24/100 000. The overall incidence rate showed a fluctuating downward trend, with an average annual decline rate of 1.99%. The ratio of the number of cases between men and women was 2.35:1, and the incidence rate in males was higher than that in females (χ²=285.36，P<0.001). The 45-64 years old group had the largest number of patients, accounting for 35.33% of the total. The peak incidence of the disease was from March to June, while the lowest was from December to February of the next year. The main occupations were housekeepers, house and unemployed workers, and farmers and retirees, accounting for 31.93%, 18.81% and 12.84% of the total number of cases, respectively. Spatial correlation analysis showed that there was a positive spatial autocorrelation in the incidence of tuberculosis in Wuhan from 2011 to 2019 (Moran's I>0,P<0.001), and the high-high aggregation areas of tuberculosis were mainly distributed in Erqi community, Baibuting community, Liujiaoting community, Yijiadun community, Heping Street, Changqian Street, Tonghu farm, Yuxian Town, Zhifang Town, Wulijie Town, Fenghuang Street, Liji Street, and Daoguanhe Street. Conclusion The overall epidemic situation of pulmonary tuberculosis in Wuhan showed a slow downward trend. The main population and the clustering time of cases were relatively fixed, and the overall epidemic showed a certain spatial clustering. Active screening should be carried out for high-risk populations and high-aggregation areas, and effective prevention and control strategies should be developed based on time and location classification.