Research Article The Dynamic Change of Tuberculosis Infection Prevalence in Village Doctors: 6-Year Follow-Up of a Cohort Study from Rural China
by Zihan Li1,2*, Zisen Liu3*, Henan Xin1,2, Weitao Duan3, Boxuan Feng1,2, Yijun He1,2, Bin Zhang3, Dakuan Wang3, Jiaoxia Yan3, Yaqi Zhao1,2, Yilin Yu1,2, Lei Gao1,2, Jiang Du1,2†, Xuefang Cao1,2†
1NHC Key Laboratory of Systems Biology of Pathogens, National Institute of Pathogen Biology, and Center for Tuberculosis Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
2Key Laboratory of Pathogen Infection Prevention and Control (Ministry of Education), National Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
3Center for Disease Control and Prevention of Zhongmu County, Zhengzhou, P. R. China
* These authors contributed equally to the article
† These authors contributed equally to the article
*Corresponding authors: Xuefang Cao, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, No.16 Tianrong Street, 102629, Beijing, China.
Prof. Jiang Du, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, No 16 Tianrong Street, 102629, Beijing, China.
Received Date: 09 September 2026
Accepted Date: 17 September 2026
Published Date: 21 September 2026
Citation: Li Z, Liu Z, Xin H, Duan W, Feng B, et al. (2026) The Dynamic Change of Tuberculosis Infection Prevalence in Village Doctors: 6-Year Follow-Up of a Cohort Study from Rural China. Infect Dis Diag Treat 10: 289. DOI: 10.29011/2577-1515.100289
Abstract
Background: The incidence of tuberculosis (TB) decreased significantly in recent years in China. However, the declining in the burden of tuberculosis infection (TBI) among village doctors have not been systematically evaluated. This study aims to evaluate the change of TBI prevalence among the registered village doctors in Zhongmu County during the past 6 years. Methods: An open cohort design was employed for a 6-year follow-up study of registered village doctors in Zhongmu County, Henan Province. After excluding active tuberculosis, the tuberculosis infection status of each participant was determined using the interferon-gamma release assay (IGRA). Results: A total of 509 eligible participants were included in the final analysis, with a QFT-Plus positivity rate of 20.63%. Compared to the age- and gender-standardized TBI prevalence determined by QFT-Plus in 2017, the prevalence of TBI was observed to be decreased from 24.80% to 14.32% in 2023. The acquisition of TBI in 6 years was assessed by the conversion rate of QFT-Plus result in 384 participants who participated in both the 2017 and 2023 surveys. The rate of QFT-Plus conversion was 2.63% (7/266), and the rate of QFT-Plus reversion was 32.17 % (37/115). Participants who were older than 50 years (p = 0.0438), worked with more than 26 years of service as village doctors (p = 0.0204), and had a BMI < 18.5 kg/m3 (p = 0.0263) were found to be associated with an increased risk of QFT-Plus conversion. In addition, never smokers were observed to be associated with significantly higher reversion rate as compared with current smokers, with adjusted OR of 5.62 (95% CI: 1.15-27.34). Conclusion: The results showed that the prevalence of TBI among village doctors in Zhongmu County decreased significantly, but it was still higher than that of the general population. Tuberculosis infection control measures of village doctors and village medical institutions should be strengthened.
Keywords: Mycobacterium tuberculosis; Village doctors; QuantiFERON-TB Gold Plus.
List of Abbreviations: TB: Tuberculosis; MTB: Mycobacterium tuberculosis; TBI: Tuberculosis infection; IGRA: interferon gamma release assay; QFT-Plus: QuantiFERON-TB Gold Plus; TST: tuberculin skin test; BMI: body mass index; COVID-19: Coronavirus disease 2019; AM: alveolar macrophage.
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