Abstract: Objective To evaluate the effectiveness of preventive medication in preventing the development of tuberculosis among school students with latent tuberculosis infection and to provide a scientific basis for the necessity of preventive treatment for these students by conducting a two-year follow-up study on 272 cases of latent tuberculosis infection identified at the tuberculosis clinic of Nanning Fourth People's Hospital from 2021 to 2022. Method Students diagnosed with latent tuberculosis infection following tuberculosis screening at Nanning Fourth People's Hospital from January 2021 to January 2022 were divided into an intervention group (preventive medication group) and a control group (non-preventive medication group). The intervention group consisted of 149 individuals, and the control group consisted of 123 individuals, aged 3 to 18 years. General characteristics such as age, gender, boarding status, and history of tuberculosis contact were collected, and the subjects were followed up for 24 months to analyze the incidence of tuberculosis in both groups and to further analyze the risk factors for developing active tuberculosis. Result During the 24 months follow-up, 2 cases out of 149 in the intervention group progressed to active tuberculosis (with 1 case occurring within 1 year), in the control group of 123, a total of 10 cases progressed to active tuberculosis (with 8 cases occurring within 1 year). A statistically significant difference in the incidence of tuberculosis was observed when comparing the two groups at 12 months and 24 months of follow-up (P<0.05). Logistic regression analysis of the factors associated with the development of active tuberculosis from school latent tuberculosis infectors showed that preventive anti-tuberculosis treatment was a protective factor against the progression of latent tuberculosis to active tuberculosis (OR=0.071, P<0.05), and having a history of pulmonary tuberculosis contact was a risk factor for the progression of latent tuberculosis to active tuberculosis (OR=5.546, P<0.05). Follow up results showed that latent tuberculosis patients who did not take preventive medication were more likely to develop symptoms within one year (P=0.019). Conclusion Proactive screening for tuberculosis in schools to identify latent tuberculosis infectors early, and initiating preventive treatment as soon as possible, especially for those with a history of close contact with pulmonary tuberculosis, and conducting preventive treatment within 1 year of confirming recent tuberculosis infection, can reduce the incidence of tuberculosis and help reduce the spread of tuberculosis in schools.

Key words: Schools, Latent tuberculosis infection, Preventive treatment, Influencing factors