Case Study: The Strategy and Implementation of Preventive Treatment for TB Infected College Students in Beijing

Abstract

Preventive treatment is a powerful tool to reduce the risk of progression to active tuberculosis (TB) in the TB infected, improve the quality of life in high-risk subjects infected with TB, and control the spread of TB in the population. In a TB outbreak, preventive treatment for close contacts with strong tuberculin skin test (TST) reactions can significantly reduce secondary cases. Standardized measures are being developed in Bejing to improve preventive treatment for children infected with TB, patients coinfected with TB and HIV, and the TB infected suffering from diabetes. A TB control project had been impletmented in Beijing in the colleges from 2004 to 2007 by administering a free TST to incoming freshmen and then offering treatment or preventive treatment as appropriate to those with positive results. In total, 750,948 college freshmen were screened and 105,123 students had a strong TST reaction. Among these, 803 active TB cases were diagnosed with active TB, registered, and given treatment. Only 10 % of the students with a strong TST reaction but without active infection accepted preventive treatment, despite education efforts. Though protection rate among the students who accepted preventive treatment was 75 %, due to the low rate of treatment acceptance, the project’s overall reduction of risk of developing TB in students with strong TST reaction was about 7.5 %.