Commit, Invest and Deliver: TowardsAchieving End Tuberculosis Strategy Goals Through Active Case Finding andPreventive Treatment in China

Caihong Xu¹; Yanlin Zhao^1,#

1. National Key Laboratory of Intelligent Tracking and Forecastingfor Infectious Diseases, Chinese Center for Disease Control and Prevention,Beijing, China.

^# Corresponding authors: Yanlin Zhao, Zhaoyl@chinacdc.cn.

This paper addresses the World Tuberculosis(TB) Day 2025 theme, "Yes! We can end TB! Commit, Invest, Deliver".Through comprehensive analysis of China's TB epidemic landscape and associatedchallenges, we align with the "National TB Prevention and Control Plan(2024–2030)" which emphasizes that building Zero-TB communities throughthe integration of "active case finding" and "TB preventivetreatment (TPT)" represents a viable pathway toward ending the TBepidemic. Active case finding serves as a critical intervention for earlydetection and transmission reduction, while TPT constitutes an essentialstrategy for decreasing latent TB infection incidence. By facilitating therapid expansion of Zero-TB communities through governmental commitment,strategic resource allocation, and coordinated implementation, we anticipateachieving the ultimate goal of TB epidemic elimination.

承诺、投入与行动：基于主动发现和预防性治疗助力中国实现终结结核病战略目标

徐彩红¹；赵雁林^1,#

1. 传染病溯源预警与智能决策全国重点实验室，中国疾病预防控制中心，北京，中国。

^# 通信作者：赵雁林，Zhaoyl@chinacdc.cn。

本文聚焦于 2025 年世界防治结核病日的主题 “是的！我们能够终结结核病！承诺、投入、行动”。通过深入分析中国当前结核病的流行现状及面临的挑战，依据《全国结核病防治规划（2024-2030年）》的要求，强调如何通过整合“主动发现”与“结核病预防性治疗”两项关键措施，推动无结核社区建设。主动发现是实现结核病患者早期干预、减少结核病传播的关键，结核病预防性治疗是降低潜伏性结核感染发病的重要手段。通过政府的承诺、资源的投入以及全面的行动，推动无结核社区的快速推广，有望实现终结结核病流行的目标。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.068

SerotypeDistribution, Virulence, and Antibiotic Resistance Genomic Characterization ofGroup B Streptococcus — China, 1998–2024

Xiaodong Ren^1,2; Xiao Liu²; Yanqing Che^1,2;Luyao Yang^1,2; Yixin Mao^2,3; Mengjie Li^1,2; ZhiwenSun²; Xuemei Bai²; He Gao²; Yimin Wang^1,#;Duochun Wang^2,#.

1. School of Public Health, Lanzhou University,Lanzhou City, Gansu Province, China;

2. National Institute for Communicable DiseaseControl and Prevention, Chinese Center for Disease Control and Prevention,Beijing, China;

3. National Key Laboratoryof Intelligent Tracking and Forecasting for Infectious Diseases, China CDC KeyLaboratory of Environment and Population Health, National Institute ofEnvironmental Health, Chinese Center for Disease Control and Prevention,Beijing, China.

^# Corresponding author:Yimin Wang, wangyimin@lzu.edu.cn; Duochun Wang, wangduochun@icdc.cn.

Streptococcus agalactiae, or group BStreptococcus (GBS), can cause severe infections in humans, yet comprehensivegenomic characterization from China remains limited. This study presents anextensive genomic analysis of GBS isolates collected in China from 1998 to2024.GBS genomes were obtained frompublic databases and through de novo sequencing. Serotype confirmation wasconducted via pan-genomic analysis, phylogenetic relationships were establishedusing maximum-likelihood methodology, and virulence and antibiotic resistancegenes were identified through the Virulence Factor Database and ComprehensiveAntibiotic Resistance Database. Statistical analyses were performed using SPSS26.0, primarily employing Fisher exact tests.Analysis of 747 GBS genomes revealed eight serotypes (Ia, Ib, II,III, IV, V, VI, VII) and nontypeable strains. Serotypes III, Ib, Ia, V, and IIconstituted 96.65% of all isolates. GBS prevalence remained low from 1998–2011but increased substantially after 2012. Geographic distribution demonstratedsignificant regional heterogeneity. Phylogenetic analysis categorized the 747genomes into five distinct lineages, with lineage 5 being predominant. Sixvirulence factor categories encompassing 56 virulence-associated genes wereidentified, with 33 genes present in nearly all genomes. Twenty-sevenantibiotic resistance genes spanning nine drug classes were detected,particularly those conferring resistance to peptide and macrolide antibiotics,indicating widespread antimicrobial resistance mechanisms in GBS.GBS infections in China exhibitserotype distributions similar to global patterns but with notable regionalvariations. This comprehensive genomic characterization provides criticalinsights for developing targeted prevention strategies and treatment approachesfor GBS infections in China.

无乳链球菌血清型分布、毒力和抗生素耐药性基因组特征— 中国，1998–2024年

任小东^1,2；刘晓²；车艳晴^1,2；杨露瑶^1,2；毛怡心^2,3；李梦洁^1,2；孙志文²；白雪梅²；高鹤²；王益民^1,#；王多春^2,#。

1. 公共卫生学院，兰州大学，兰州市，甘肃省，中国；

2. 传染病预防控制所，中国疾病预防控制中心，北京，中国；

3. 传染病溯源预警与智能决策全国重点实验室，环境与人群健康重点实验室，环境与健康相关产品安全所，中国疾病预防控制中心，中国，北京。

^# 通信作者:王益民，wangyimin@lzu.edu.cn；王多春，wangduochun@icdc.cn。

无乳链球菌（B族链球菌，GBS）可引发严重的感染，但中国GBS基因组特征的研究较少。本研究对1998-2024年间中国的GBS进行了广泛的基因组特征分析。我们通过公共数据库及对本地菌株测序得到了中国GBS的基因组序列。通过基因组分析确认GBS血清型，基于最大似然法构建了系统发育树，利用毒力因子数据库和综合抗生素耐药性数据库分别预测了毒力基因和耐药基因。使用SPSS 26.0进行统计分析，主要为Fisher确切概率法。747株GBS中，共识别出8种血清型（Ia、Ib、II、III、IV、V、VI和VII）以及无法分型的菌株，5种血清型（III、Ib、Ia、V和II）占96.65%。1998-2011年间，GBS病例报道的数量相对较少，但自2012年起显著增加。血清型分布存在地域差异。系统发育树将747株GBS分为5个谱系，谱系5包含的菌株最多（n = 281，血清型III，184株；Ib，76株）。发现6类毒力因子，涉及56个毒力相关基因，其中33个几乎存在于所有基因组中。还发现了27个抗生素耐药基因，涉及9类抗菌药物，几乎所有基因组均携带编码肽类和大环内酯类抗生素的基因，构成了GBS的基本耐药机制。中国的GBS感染值得关注，其血清型分布与全球相似，但各区域间分布存在差异，值得进一步研究。本研究为有效预防和治疗中国的GBS提供了重要的基因组学见解。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.069

The Spatiotemporal Epidemiology andInfluencing Factor Analysis of Leptospirosis — Anhui Province, China, 2004–2023

Yueran Lian¹; Haiyan Qiu²;Haijian Zhou²; Dongxue Li²; Qing Li³; XinmiaoWu^2,4; Zengliang Wang¹; Zhijie Zhang^5,6; CuicaiZhang^2,#; Biao Kan^1,2,#

1. School of Public Health, ShandongUniversity, Jinan City, Shandong Province, China;

2. National Key Laboratory of IntelligentTracking and Forecasting for Infectious Diseases, National Institute forCommunicable Disease Control and Prevention, Chinese Center for Disease Controland Prevention, Beijing, China;

3. Anhui Provincial Center for DiseaseControl and Prevention, Hefei City, Anhui Province, China;

4. School of Public Health, XinjiangMedical University, Urumqi City, Xinjiang Uygur Autonomous Region, China;

5. Department of Epidemiology and HealthStatistics, Fudan University, Shanghai, China;

6. Shanghai Institute of Infectious Diseaseand Biosecurity, Fudan University, Shanghai, China.

^# Corresponding author: CuicaiZhang, zhangcuicai@icdc.cn; Biao Kan, kanbiao@icdc.cn.

Leptospirosishas historically been a severe public health concern across multiple Chineseprovinces. Despite an overall decline in incidence in recent years, the diseasecontinues to exhibit fluctuations and occasionally triggers localizedoutbreaks. This study aimed to characterize the demographic and spatiotemporalpatterns of leptospirosis in Anhui Province — a historically significantepidemic region — from 2004 to 2023, to investigate potentialclimatic and environmental risk factors, and toidentify critical targets for disease prevention and control.Spatiotemporal cluster analysis wasconducted using SaTScan software. Spearman correlationanalysis was performed using SPSS to examine the short-term lagged effects ofrainfall, temperature, and normalized difference vegetation index (NDVI) onleptospirosis incidence in the high-risk counties of Huaiyuan and Jingde.A total of 458 leptospirosis caseswere reported across Anhui Province during the 20-year study period.Middle-aged individuals (40–59 years), males, and agricultural workersconstituted the primary high-risk populations. Spatiotemporal scanningidentified nine adjacent hotspots in southern Anhui during 2004–2012, with asubsequent shift to Huaiyuan County in the northern Huaihe River Basin during2016–2021. Significant associations were observed between leptospirosisincidence and temperature, rainfall, and NDVI in both Huaiyuan and Jingdecounties.This study revealedsignificant spatial heterogeneity, distinct spatiotemporal clustering patterns,and potential environmental risk factors for leptospirosis in Anhui Provinceduring 2004–2023. These findings provide critical information regarding targetregions, high-risk populations, and environmental factors to inform earlywarning systems and enhance prevention and control strategies for leptospirosis.

钩端螺旋体病时空流行病学及影响因素分析—安徽省，中国， 2004–2023年

连悦然¹；邱海燕²；周海健²；李冬雪²；李青³；吴鑫淼^2,4；王增亮¹；张志杰^5,6；张翠彩^2,#；阚飙^1,2,#

1.公共卫生学院，山东大学，济南市，山东省，中国；

2.传染病溯源预警与智能决策全国重点实验室，传染病预防控制所，中国疾病预防控制中心，北京，中国；

3.安徽省疾病预防控制中心，合肥市，安徽省，中国；

4.公共卫生学院，新疆医科大学，乌鲁木齐市，新疆维吾尔自治区，中国；

5.流行病学与卫生统计系，复旦大学，上海，中国；

6.上海市传染病与生物安全研究所，复旦大学，上海，中国。

^# 通信作者：张翠彩，zhangcuicai@icdc.cn；阚飙，kanbiao@icdc.cn。

历史上钩端螺旋体病曾在中国多省流行严重，近年来发病率下降但仍存在波动、甚至引起局部暴发。本文针对既往流行的高发省安徽省，分析近二十年以来该省钩端螺旋体病流行的人口学和时空分布特征，探索影响钩端螺旋体病发病的可能气候和环境关联因素，从而进一步识别、控制该病流行的风险防控点。利用 SaTScan 软件进行时空扫描分析。利用 SPSS软件开展Spearman 相关分析，探讨降水、气温、归一化植被指数 (NDVI) 对怀远和旌德地区钩端螺旋体病的短期滞后效益影响。2004-2023 年安徽省共报告钩端螺旋体病 458 例。中年人群(40-59岁)、男性和农民是安徽省主要高危人群。2004-2012 年南部山区存在 9 个互相毗邻的空间聚集区，而在2016-2021 年空间聚集区转向淮河流域北部的怀远地区。怀远和旌德地区钩端螺旋体病发病与气温、降雨和 NDVI 密切相关。本研究揭示了 2004-2023 年安徽省钩端螺旋体空间异质性、时空聚集性特性和可能的高危影响因素，这些重要的目标地区、高危人群和风险因素为钩端螺旋体病的预警和进一步防控提供重要依据。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.070

Differences Betweenthe Local and Migrant Populations in Healthcare Service Use and Direct Cost ofTuberculosis Treatment — Shanghai Municipality, China, 2020–2021

Weixi Jiang^1,&; JingChen^2,&; Zhexun Lou³; Yufei Jia³; ShenglanTang³; Xiao Xiao²; Xin Shen²; Xin Chen^2,#;Qian Long^3,#

1School of Public Health, Fudan University, Shanghai, China;

2Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China;

3 Global Health Research Center,Duke Kunshan University, Suzhou City, Jiangsu Province, China.

^& Joint first authors.

^# Corresponding authors: Xin Chen, chenxin@scdc.sh.cn; Qian Long, qian.long@dukekunshan.edu.cn.

Tuberculosis(TB) disproportionately impacts socially vulnerable populations, includingmigrants. This study aimed to investigate the utilization of TB care servicesand the financial burden on TB patients during 2020–2021 in Shanghai and toexamine differences between local and migrant patients. A retrospective surveywas conducted in three districts of Shanghai among drug-sensitive TB patientswho initiated treatment on or after January 24, 2020, and had completedtreatment by the time of the interview in 2021. The study used a designedsampling ratio of 1:1 for both local and migrant populations, and examined theuse of outpatient and inpatient care, as well as the direct costs of treatment.Descriptive analyses and statistical tests were utilized to assess differencesin patient characteristics between locals and migrants, with and without aresidence permit. Logistic regression was used to examine the impact of migrantstatus on service usage and financial burden, after adjusting for demographicand socio-economic factors. The study included a total of 196 TB patients,comprising 88 locals and 108 migrants. No significant differences in theaverage number of outpatient visits were observed between migrant and localpatients. Migrants with a residence permit (RP) had the highest hospitalizationrate (92.86%), followed by migrants without an RP (86.84%), and then localpatients (79.55%). The median out-of-pocket (OOP) payment for the entiretreatment course, including medical and non-medical costs, was 15,845 yuan formigrants without an RP, with descending amounts for migrants with an RP, andthen local patients (P<0.001). The proportion of patients incurringOOP payments exceeding 20% of their annual household income was also highestamong migrants without an RP (57.14%). Regression analysis indicated thatmigrants without an RP faced the highest financial risk during TB treatment.Even migrants with an RP showed significantly higher financial risk compared tolocal patients (P<0.05). During 2020-2021, the utilization of TB carein Shanghai was high among both local and migrant TB patients. Nevertheless,significant financial burdens were more pronounced among migrant patientswithout RP.

本地与流动人口结核病医疗服务利用及直接费用的差异研究— 上海直辖市，中国，2020–2021年

江蔚曦^1,&；陈静^2,&；楼哲汛³；贾宇飞³；汤胜蓝³；肖筱²；沈鑫²；陈昕^2,#；龙倩^3,#

1. 公共卫生学院，复旦大学，上海，中国；

2. 上海市疾病预防控制中心，上海，中国；

3. 全球健康研究中心，昆山杜克大学，苏州市，江苏省，中国。

^&共同第一作者。

^# 通信作者：陈昕，chenxin@scdc.sh.cn；龙倩，qian.long@dukekunshan.edu.cn。

结核病对社会弱势群体（包括流动人口）的影响尤为显著。本研究旨在探究2020-2021年上海市结核病患者的医疗服务利用情况及其所致经济负担，并比较本地与流动人口患者间的差异。本研究在上海市三个行政区开展回顾性调查，纳入了2020年1月24日及之后开始治疗、并于2021年访谈时已完成治疗的药物敏感性结核病患者。研究采用1:1抽样设计匹配本地与流动人口样本，分析其门诊与住院服务利用情况及治疗直接成本。通过描述性分析和统计检验比较本地患者、持居住证与无居住证流动人口的患者特征差异，并采用Logistic回归模型校正人口学与社会经济因素后，评估流动人口身份对医疗服务利用及经济负担的影响。本研究共纳入196例结核病患者（本地88例，流动人口108例）。流动人口与本地患者的门诊就诊次数无显著差异。持居住证的流动人口住院率最高（92.86%），其次为无居住证流动人口（86.84%）和本地患者（79.55%）。全程治疗（含医疗与非医疗费用）的自付费用中位数最高为无居住证流动人口群体（15,845元），其次为持居住证流动人口，本地患者最低（P<0.001）。自付费用超过家庭年收入20%的患者比例在无居住证流动人口中最高（57.14%）。回归分析表明，无居住证流动人口在结核病治疗期间面临最高的经济风险，且持居住证流动人口的经济风险亦显著高于本地患者（P<0.05）。2020-2021年期间，上海市本地与流动人口结核病患者的医疗服务利用率均较高，但无居住证流动人口的经济负担显著更为突出。

Formore information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.072

Using Phylogenetic Analysis to DetectNational and International Dimensions of Hepatitis C Virus 1b TransmissionClusters — China, 1989–2021

He Jiang^1,&; Shujia Liang ^2,&; Xiuling Wu ¹; JinghuaHuang ³; Bo Li¹; Xuanhua Liu ³; Qin Meng¹; Shuai Tang ³; Qiuying Zhu ^3,#; Guanghua Lan^1,#

1.Guangxi Key Laboratory of AIDS Prevention and Control and AchievementTransformation, Guangxi Center for Disease Prevention and Control, NanningCity, Guangxi Zhuang Autonomous Region, China;

2.Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Guangxi Center for Disease Prevention and Control, Nanning City, Guangxi ZhuangAutonomous Region, China;

3.Guangxi Key Laboratory for Major Infectious Diseases Prevention and Control andBiosafety Emergency Response, Guangxi Center for Disease Prevention andControl, Nanning City, Guangxi Zhuang Autonomous Region, China.

^&Joint first authors.

^# Correspondingauthors: Qiuying Zhu, gxcdcafs@wsjkw.gxzf.gov.cn; Guanghua Lan,gxcdcafs@wsjkw.gxzf.gov.cn.

Data oninter-regional transmission clusters of Hepatitis C Virus (HCV) helps optimizetargeted preventive strategies. This study aims to detect the national andinternational dimensions of HCV 1b transmission clusters. Available publishedHCV 1b nonstructural protein 5B sequences sampled between 1989 and 2021 werecollected, including 1,750 sequences from China and 482 comparable sequencesfrom other countries. Network-based and tree-based approaches were introducedto detect transmission clusters and infer their relationships. Three distincttransmission cluster patterns were identified across China: a large clusterwith nationwide distribution, two medium clusters predominantly in the Centraland Eastern China, and 103 small clusters scattered across 19 provincial-leveladministrative divisions. No genetic linkages were found between Chinesesequences and those from other countries. The medium clusters exhibited asimilar expansion risk compared with the large cluster [adjusted odds ratios (aOR)=1.247,95% confidence interval (CI): 0.862, 1.804, P=0.241], but showedsignificantly lower inter-provincial transmission (aOR=0.255, 95% CI:0.077, 0.798, P=0.019). The small clusters demonstrated faster expansion [adjustedhazard ratios (aHR)=1.327, 95% CI: 1.050, 1.676, P=0.018] andmarkedly reduced inter-provincial transmission (aOR=0.006, 95% CI:0.002, 0.014, P<0.001) compared to the large cluster. The NortheastChina groups showed significantly higher interprovincial transmission riskcompared to the Central China groups (aOR=11.461, 95% CI: 2.262, 87.014,P=0.006). This study emphasizes the urgent need to establish a nationalmolecular epidemiological surveillance network for detecting hiddentransmission chains and monitoring the emergence of variants.

利用系统发育分析探测1b型丙型肝炎病毒的国内和国际传播簇 — 中国，1989–2021年

江河^1,&；梁淑家^2,&；吴秀玲¹；黄精华³；李博¹；刘玄华³；孟琴¹；唐帅³；朱秋映^3,#；蓝光华^1,#

1. 广西艾滋病防控与成果转化研究重点实验室, 广西壮族自治区疾病预防控制中心, 南宁市, 广西壮族自治区, 中国;

2. 广西病毒性肝炎防治研究重点实验室, 广西壮族自治区疾病预防控制中心, 南宁市, 广西壮族自治区, 中国;

3. 广西重大传染病防控与生物安全应急响应重点实验室, 广西壮族自治区疾病预防控制中心, 南宁市, 广西壮族自治区, 中国。

^&共同第一作者。

^# 通信作者：朱秋映，gxcdcafs@wsjkw.gxzf.gov.cn；蓝光华，gxcdcafs@wsjkw.gxzf.gov.cn。

掌握丙型肝炎病毒（HCV）跨区域传播簇数据有助于优化制订针对性的预防策略。本研究旨在探测1b型HCV的国内和国际传播簇。本研究收集了1989年至2021年间采集并已公开发表的1b型HCV的非结构蛋白5B序列，包括1750条采自中国的序列和482条采自其他国家的可比序列。传播簇以及相互关系通过基于分子网络和基于进化树的方法探测和推断。在国内维度，本研究探测到三种不同模式的传播簇：（1）1个跨越全国的大型传播簇；（2）2个中型传播簇，主要分布在中部和东部地区；（3）103个小型簇，分散在19个省级行政区。未探测到国内和其他国家序列之间的基因连接。虽然中型传播簇的扩张风险与大型传播簇相似（aHR=1.247，95%CI:0.862，1.804，P=0.241），但其省际传播风险较低（aOR=0.255，95% CI: 0.077，0.798，P=0.019）。小型传播簇的扩张速度比大型传播簇快（aHR=1.327，95% CI:1.050，1.676，P=0.018），但其省际传播风险较低（aOR=0.006，95% CI: 0.002，0.014，P<0.001）。东北地区传播簇的省际传播风险比中部地区传播簇高（aOR=11.461，95% CI: 2.262，87.014，P=0.006）。该研究强调，急需建立全国层面的HCV分子流行病学监测网络，以探测隐藏的传播链并监测可能出现的病毒变异株。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.073

Current Status and Factors of VaccineHesitancy in Tetanus Vaccination Among Traumatic Patients — China, 2024

Xuan Chen1; Mengjie Zhang1; Yang Zhao2;Qiaosheng Xue3; Yingjun Xu4; Liping Zuo5; Zhijun Wang6; Yingli Tang2; YufengCai7; Xiangde Zheng8; Cheng Liu1; Si Liu1,#; Chuanlin Wang9

1. Department of Emergency, PekingUniversity First Hospital, Beijing, China;

2. Department of Emergency, Norinco GeneralHospital, Xi’an City, Shaanxi Province, China;

3. Department of Emergency, Qingdao EighthPeople's Hospital, Qingdao City, Shandong Province, China;

4. Department of Emergency, QingdaoChildren and Women's Hospital, Qingdao City, Shandong Province, China;

5. Department of Emergency, The FirstPeople's Hospital of Lanzhou City, Lanzhou City, Gansu Province, China;

6. Department of Emergency, ChangshuHospital Affiliated to Nanjing University of Chinese Medicine, Changshu City,Jiangsu Province, China;

7. Department of Emergency, DezhouMunicipal Hospital, Dezhou City, Shandong Province, China;

8. Emergency Department, Dazhou City CenterHospital, Sichuan Province, Dazhou City, Sichuan Province, China;

9. Department of Emergency Surgery, PekingUniversity People's Hospital, Beijing, China.

# Corresponding author: Si Liu,docleo@pku.edu.cn.

Tetanus remains a significant public healthconcern in China, with a notable proportion of injured patients decliningtetanus vaccination. This study aims to investigate the prevalence anddeterminants of tetanus vaccine hesitancy and identify effective strategies toaddress this critical public health challenge. We calculated tetanus vaccinehesitancy rates among trauma patients presenting at eight hospitals acrossChina from April 1 to June 30, 2024. A comprehensive questionnaire survey wasconducted from June 3 to June 27, 2024, targeting patients aged 11 years andolder who had open wounds requiring tetanus immunization but refusedvaccination. The survey assessed participants' sociodemographiccharacteristics, knowledge, attitudes, and practices regarding tetanus andtetanus vaccines. Statistical analyses included Pearson's Chi-squared tests,multiple response analyses, and goodness of fit tests. Among 8,993 traumapatients requiring tetanus vaccination, 26.78% declined immunization. Analysisof 503 consecutively collected questionnaires revealed low overall awareness oftetanus and tetanus vaccines, with only 20.1% of respondents demonstratingcomprehensive knowledge of tetanus-related questions. The predominant reasonfor vaccine hesitancy (34.5%) was the perception that post-injury tetanus riskwas minimal. Across all age groups, medical institutions and healthcareprofessionals were consistently identified as the most effective sources fortetanus prevention information. This study demonstrates that enhancing publicawareness about tetanus and its vaccines while addressing complacency arefundamental to reducing vaccine hesitancy. Targeted educational interventionsdelivered by healthcare institutions and professionals can significantlyimprove public knowledge and acceptance of tetanus vaccination.

外伤患者破伤风疫苗犹豫现状及影响因素— 中国，2024年

陈璇1；张梦杰1；赵阳2；薛乔升3；徐迎军4；左利平5；王志军6；唐映利2；蔡玉峰7；郑祥德8；刘珵 1；刘斯1,#；王传林9

1.急诊科，北京大学第一医院，北京，中国；

2.急诊科，兵器工业总医院，西安市，陕西省，中国；

3.急诊医学部，青岛市第八人民医院，青岛市，山东省，中国；

4.急诊科，青岛市妇女儿童医院，青岛市，山东省，中国；

5.急诊科，兰州市第一人民医院，兰州市，甘肃省，中国；

6.急诊医学科，南京中医药大学常熟附属医院，常熟市，江苏省，中国；

7.急诊科，德州市立医院，德州市，山东省，中国；

8.急诊科，四川省达州市中心医院，达州市，四川省，中国；

9.急诊外科，北京大学人民医院，北京，中国。

# 通讯作者: 刘斯，docleo@pku.edu.cn。

破伤风在中国仍是一个重要的公共卫生问题，一些外伤患者拒绝接种破伤风疫苗。本研究旨在了解我国破伤风疫苗犹豫的现状，分析疫苗犹豫的影响因素，寻找有效的应对方法。计算2024年4月1日至6月30日就诊于中国8家医院的外伤患者破伤风疫苗犹豫率。于2024年6月3日至27日，对年龄11岁及以上、有开放性伤口、需要接种破伤风疫苗但拒绝接种的患者进行问卷调查。调查内容包括参与者的社会人口学特征、对破伤风和破伤风疫苗的认识、态度和做法。采用卡方检验、多重响应分析、拟合优度检验进行统计学分析。共有26.78%的外伤患者拒绝接种破伤风疫苗。本研究共收集503份问卷。参与者对破伤风及破伤风疫苗的总体知晓率较低(仅20.1%的调查对象完全知晓与破伤风相关的4个问题)。本研究中疫苗犹豫的主要原因(34.5%)是调查对象认为外伤后发生破伤风的风险低。所有年龄组的参与者均认为医疗机构和医务人员是获得破伤风预防知识的最有效来源。提高公众对破伤风疾病及破伤风疫苗的认识、消除外伤者的自满情绪是减少疫苗犹豫的关键。医疗机构和卫生保健专业人员的有效宣教可以提高公众对破伤风疫苗认知度和接受度。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.071