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The epidemiology of pulmonary tuberculosis in children in Mainland China, 2009–2015
  1. Ruling Yang1,2,
  2. Mengyang Liu3,4,
  3. Hui Jiang4,5,6,
  4. Yingjie Zhang7,
  5. Jinfeng Yin8,
  6. Qihuan Li3,4,
  7. Qing Li4,5,6,
  8. Yue Liu3,4,
  9. Xiaonan Wang3,4,
  10. Hongmei Xu1,2,
  11. Yang Yang9,
  12. Weimin Li4,5,6,
  13. Xiuhua Guo3,4
  1. 1Infection Department of the Children's Hospital, National Clinical Research Center for Child Health and Disorders, The Children's Hospital of Chongqing Medical University, Chongqing, China
  2. 2Chongqing Key Laboratory of Child Infection and Immunity, The Children's Hospital of Chongqing Medical University, Chongqing, China
  3. 3Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
  4. 4Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
  5. 5National Tuberculosis Clinical Lab of China, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Beijing, China
  6. 6Beijing Key Laboratory in Drug Resistance Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
  7. 7Chinese Center for Disease Control and Prevention, Beijing, China
  8. 8School of Statistics, Renmin University of China, Beijing, China
  9. 9Department of Biostatistics, University of Florida, Gainesville, Florida, Armenia
  1. Correspondence to Professor Xiuhua Guo, Capital Medical University, Beijing 100069, China; statguo{at}; Professor Weimin Li; lwm_18{at}

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Tuberculosis (TB) is a serious infectious disease that affects children worldwide, especially infants and children aged less than 15 years. According to the latest report issued by the WHO in 2018, children with TB comprise approximately 10% (aged <15 years) of all TB cases, and thus, approximately 1 million new cases of TB emerge in children globally.1 However, the number of reported cases of child TB greatly differed from the number of estimated cases. It has been estimated that almost two-thirds of all children with active TB have not been reported.2 The low reporting rate of child TB is partially due to the low detection rate. Therefore, the prevention and control of TB in children still faces enormous challenges.

In China, the data on the prevalence of TB in children are still from the fourth nationwide random survey of TB reported 19 years ago.3 4 To date, few large-scale epidemiological studies relating to TB in children have been performed in China. The characteristics of TB in children differ from those in adults. The diagnosis of TB in children is more difficult than that in adults because most cases are bacteriologically negative and often have non-specific clinical symptoms and signs.5 6

In 2005, the Chinese Center for Disease Control and Prevention (CDC) developed a web-based Tuberculosis Information Management System (TBIMS) to collect real-time TB data, including on child TB, in 31 provinces in Mainland China.7 However, only the notification of pulmonary TB (PTB) is mandatory under the Chinese Law of Preventing and Controlling Infectious Disease. Based on these data, we reported the incidence of children with PTB notified in China and assessed its epidemiological characteristics from 2009 to 2015 in order to formulate the effective and precise strategy for prevention and treatment.



Child TB was defined as …

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  • RY and ML are joint first authors.

  • Correction notice This article has been updated since it was published online. Ruling Yang and Mengyang Liu are the joint first authors.

  • Contributors RY and ML conceptualised and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. YZ, HJ, JY, QL, QL, YL, XW, HX and YY designed the data collection instruments, collected the data, carried out the initial analyses, and reviewed and revised the manuscript. XG and WL conceptualised and designed the study, coordinated and supervised the data collection, and critically reviewed the manuscript for important intellectual content.

  • Funding National Key Research and Development Program (2018YFC2000300), National Science and Technology Major Project of China (2018ZX10302302001004).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request.

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