Table of Content

20 February 2010, Volume 32 Issue 2

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The analysis on characteristic of HIV positive among TB patients in Guangxi

Dong Baiqing,Wang Xiwen,Liu Feiying,Cui Zhezhe,Zhou Changming

Chinese Journal of Antituberculosis. 2010, 32(2):  61-64. 

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Objective To understand the demographic characteristics of HIV infected people among newly registered tuberculosis patients in Guangxi Zhuang Autonomous Region in order to provide evidence basis for the future HIV prevention and control. Methods Systematic sampling Methods was adopted to investigate HIV infection status among tuberculosis patients in 15 sites with HIV epidemic. Results Among 2795 newly registered tuberculosis patients between September to December in 2009,there are a total of 54 HIV positive cases found. Among which, 49 cases were newly discovered, accounting for 90.7%; and the remaining 5 cases were known before,accounting for 9.3%. Among all HIV positive patients, 85.2% were male in gender,70.4% between 15 to 49 years old in age,57.5% with junior middle school education level, 85.2% married,79.6% from area with high HIV prevalence.  Conclusion s The HIV prevalence among newly registered tuberculosis patients in Guangxi Zhuang Autonomous Region was relatively high. Targeted intervention should be provided based on the demographic characteristic of HIV positive cases among tuberculosis patients.

Investigation and analysis on professionals of institute of TB prevention and control institutions in Guizhou Province

Chen Huijuan,Li Yang，Shang Yu

Chinese Journal of Antituberculosis. 2010, 32(2):  65-69. 

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Objective To understand the human resources status at provincial, prefecture and county level of tuberculosis prevention and control institutions in Guizhou province.  Methods All professionals at all levels of TB control institutions were investigated by questionnaires from Sep. to Oct. in 2007.  Results The sex and age structures of professionals at all levels are reasonable, but the number of professional was inadequate, the ratio of professional in institutes of tuberculosis prevention and control to service population was 1∶68636, number of posts per capita were 1.6, 21.1% of the professionals undertook 3 posts. The proportion of highly educated professionals and staff with senior title was low. The proportion of professionals with bachelor degreeor above was 16.8%,and the proportion with senior title was 3.5%.In terms of on-job training received, the proportion of provincial and prefecture level is high. 73.9% of county level staff members had received on-job training. Status of training varied between different posts. In county level institutions, the number of temporary staff members accounted for 7.6%. Conclusion s The quantity and quality of human resource at every level of tuberculosis prevention and control institutions in Guizhou province was inadequate. Therefore, financial and human input should be strengthened, and more efforts should be made to stabilize the workforce in order to ensure the quality of TB control work.

The effects of WB/DIFD China TB control project in Kaili city

Wu Shengyuan,Lei Jianhua

Chinese Journal of Antituberculosis. 2010, 32(2):  70-73. 

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Objective To evaluate the role of the WB/DIFD China TB Control Projectin tuberculosis control programin Kaili city,and provide constructive suggestions for tuberculosis control work in Kaili.  Methods According to the requirements of the final evaluation scheme of WB/DFID project issued by Ministry of Health, uniform forms were filled and self-examination and assessment work were completed. Data were collected and collated, and all questionairs were input in the computer for analysis.  Results Kaili city had the full implementation of DOTS strategy in 2002.During 2002—2008, the number of infectious tuberculosis patients found exceeded the requirements of the project objectives; cure rate of new smear-positive pulmonary tuberculosis was 86.0%. Conclusion s Through the implementation of WB/DFID project, Kaili achieved goals of TB control program, and established mechanisms for sustainable development. However, the TB epidemic is still serious, TB control work need to be strengthened further.

Analysis of mode of tuberculosis case-finding in Cangshan County of Shandong province

Chen Xiangjun,Chen Peixue,Wang Jijiang,Tao Tao,Hu Yi

Chinese Journal of Antituberculosis. 2010, 32(2):  73-76. 

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Objective To describe mode of tuberculosis case-finding in Cangshan county of Shandong province and explore Methods to improve tuberculosis case-finding.  Methods The data of tuberculosis reporting during 2003—2007 in Cangshan county were obtained from the National Internet-based Reporting System of Notifiable Infectious Disease. Information of TB register of Cangshan tuberculosis Dispensary was also collected. χ² test was applied in the data analysis.  Results Of tuberculosis patients registered in Cangshan county, 1434(45.5%) directly visited tuberculosis dispensary, while 1326（42.1%）, 250(7.9%), 83（2.6%）and 58（1.8%) were detected by referral, routine recommendation, tracing and concentrated recommendation respectively. The proportion of tuberculosis suspects diagnosed as tuberculosis patients varied between different ways: for referral patients, the proportion was the greatest 54.8%; of the patients directly visiting TB dispensary, 11.4% were diagnosed as TB; only 1.8% of tuberculosis suspects visiting TB dispensary through concentrated recommendation were diagnosed as TB, which was the least. County-level health facilities were the main source of suspected TB patients referred to TB Dispensary.  Conclusion  Most tuberculosis patients were detected through referral and lower level recommendation. Another important source is patient’ self-visit. Future work should focus on to strengthen the construction of three level tuberculosis control network, and strengthen the awareness of referral and recommendation by medical staff; to strengthen public health education and improve potential of actively seeking medical treatment by suspected cases; Take the initiative to carry out screening in selected high-risk populations.

Analysis on tracking and verification situation of tuberculosis patients by direct reporting network of non-TB institutions in Huairou District,2007—2008

Cui Guoqiang

Chinese Journal of Antituberculosis. 2010, 32(2):  77-80. 

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Objective To analyze the situation of tracking and verification of tuberculosis patients by direct reporting network of non-TB institutions in order to better understand the accuracy of diagnosis and strengthen the referral management of pulmonary tuberculosis in Huairou District.  Methods Information on “register of tracking and verification” of Huairou TB institution was used for analysis.  Results Within Jan. 2007 to Dec. 2008, a total of 242 tuberculosis or suspected tuberculosis cases were reported by non-TB institutions in Huairou District. Among them, 168 cases went to TB institution by themselves, and 74 cases were tracked, and 63 were in place after follow-up. The proportion of patients in place after follow-up was 85.14% and overall number of patients in place was 231 (95.5%). As for verification, 133 cases were confirmed as active pulmonary tuberculosis, and 99 cases were excluded from active pulmonary tuberculosis. 109 cases were registered in Huairou TB institution and 11 were referred to TB institutions of patient’s county of origin for further treatment, 8 sought care in Beijing Chest Hospital, and 12 cases of other situation.  Conclusion Tracking and verification of tuberculosis and suspected tuberculosis patients by direct reporting network is an important means for tuberculosis case detection in order to ensure the timely treatment of tuberculosis patients and curb the source of infection and reduce the spread of tuberculosis.

lysis of monitoring results of HIV infection among TB patients in 16

Shi Sijiu,Fang Xuehui,Li Ling

Chinese Journal of Antituberculosis. 2010, 32(2):  82-85. 

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Objective To investigate the status of HIV infection among TB patients in Anhui province and provide scientific evidence for TB/HIV prevention and control.  Methods HIV antibody testing and investigation of TB-related information were carried out to all newly registered TB patients in TB dispensaries from September 1, 2007 to December 31, 2007 in 7 counties of the third round of Global Fund AIDS project and ramdom selected 9 counties of the remaining 79 counties in Anhui province.  Results 2 738 TB patients were detected, and eight were HIV positive,7 males and 1 female. The positive rate was 0.3%. Three infected HIV through heterosexual transmission,and 5 through paid blood.  Conclusion TB patients were the important groups who were prone to HIV infection. Therefore, the HIV antibody testing will help early detection of HIV/AIDS; the implementation of HIV testing among TB patients is cost-effective in relatively high AIDS epidemic areas.

Implementation experience of Inner Mongolia Global Fund Tuberculosis(TB) program round one

Gao Yulong

Chinese Journal of Antituberculosis. 2010, 32(2):  88-91. 

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Objective To access the degree of realization and the achieved effect of Inner Mongolia Global Fund Tuberculosis (TB) program round one phase 1 and 2, to sum up and analyze the experience of the project implementation process.  Methods Uniform scheme and questionnaires applied in national program evaluation were used to investigate and verify the implementation of program in municipality, prefecture and county level. Data were entered and analyzed with EpiData 3.1. Results Implementation of project led to the region 19.236 million RMB in investment funds. DOTS coverage has reached 100% in 2005. Discovered new smear-positive pulmonary tuberculosis patients 26354, detection rate was 79.2%; 24 340 new smear-positive patients were cured, the cure rate arrived at 92.4% accumulatively.  Conclusion The project make up for lack of prevention funds, driving the local input, impelled the implementation process of“TB prevention and control planning”; promoted government promise, introduced advanced management concepts and models, strengthened capacity-building, laid the foundation for sustainable development of TB control.

Status of tuberculosis health education in floating population with pulmonary tuberculosis

Li Xue,Jiang Shiwen

Chinese Journal of Antituberculosis. 2010, 32(2):  93-96. 

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Objective To understand the situation and needs of TB health education in floating population with pulmonary tuberculosis.  Methods Using a questionnaire to survey floating population of patients with tuberculosis. Content includes gender, age, educational level, occupation, the situation of TB knowledge as well as demand for health education.  Results Less than half TB patient among floating population had ever received health education before discovery of tuberculosis, and no significant difference was found between different educational levels, gender, age groups. The demand rate of TB prevention, treatment and government policy knowledge are all exceeded 70%. For the approach of TB knowledge acquisition, the top four ways were health worker publicity, radio and television, newspapers and magazines, and posters. There was significant statistical difference in different educational levels in terms of approach of TB knowledge acquisition.  Conclusion  Better understanding the health education needs could make the health education work more tailored to the target population, thereby contributing to tuberculosis case detection improvement in floating population.

A retrospective study in 366 cases with tuberculous meningitis

He Yueming,Lin Yiping,Qiu Qingnan,Zhuang Xibin,Huang Hongbo,Guo Weifeng,Huang Hong

Chinese Journal of Antituberculosis. 2010, 32(2):  97-100. 

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Objective To investigate the clinical and epidemiological features in patients with tuberculous meningitis (TBM), especially in migrant workers with TBM.  Methods We analyzed retrospectively the clinical data from 366 cases of TBM hospitalized from 1980 to 2008 by SPSS 11.5 statistical software.  Results (1)The group of migrant workers older than 14 years old with TBM accounted for 31.9% in the same age group of patients hospitalized druing the last 10 years. Most patients’age ranged from 16 to 38 years old. The children of migrant workers with TBM accounted for 71.4% in the same age group of patients hospitalized druing the last 10 years. (2) Cerebrospinal fluid(CSF) culture for mycobacterium tuberculosis was performed in 321 cases with 28 positive. CSF smear was performed in 60 cases with 4 positive. The common lesion sitewas basal ganglia among 70 cases(59.3%) in MRI or CT of brain. 76 cases(64.4%) were complicated with hydrocephalus. The finding rate of abnormal imaging in MRI was 84.7%, whichwere patching, small nodule, circled abnormal signal, equal or low signal in T₁W₁ and high signal in T₂W₁ and FLAIR. The finding rate of abnormal imaging in CT was 84.7%, which were patching, focal with low density, ventriculomegaly and hydrocephalus. Ring enhancement of exudative lesion was one of characteristics in MRI imaging. (3)Mortality in TBM was 14.2%. The causes of death were as follows: cerebral hernia in 30 cases(57.7%), septic shock in 10 cases(19.2%), systemic failure in 3 cases(5.77%) and gastrointestinal bleeding in 3 cases(5.77%). (4) Of 126 cases younger than 14 years old, 78 cases were from local and 12 cases were vaccinated by BCG(vaccinal scar in 3 cases), and 48 cases were children of migrant workers and 3 cases were vaccinated by BCG(vaccinal scar in 1 cases).  Conclusion  It is very important for diagnosis of TBM that the dectection rate of mycobaterium tuberculosis from CSF should be improved and other related detection Methods are developed. MRI should be one of the routine tool to diagnose TBM. The measures for successful treatment of TBM are rescue of cerebral hernia, effective anti-infection treatment, nutrition support, preventiong of gastrointestinal bleeding. Putting important attention to BCG vaccination and its quality can prevent effectively TBM. Because the incidence of TBM is increasing among migrant workers and their children and it is difficult to treat TBM. The point of tuberuclosis control should be on this kind of disease.

CT diagnosis on tuberculosis of chest wall

Zhang Lei,Zhou Yanhui

Chinese Journal of Antituberculosis. 2010, 32(2):  101-103. 

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Objective To study the value of computed tomography (CT) scan in diagnosis of tuberculosis of chest wall.  Methods All the 87 patients with chest wall tuberculosis in our hospital confirmed by postoperative pathohistology and received CT scan from November 2002 to March 2009, 15 cases of them receivedcontrast-enhanced CT scan.  Results Plain CT scan appearances had semicircular or flat soft tissure masses with a high-density margin and low density center, dumb-bell shaped and low-density central masses. Bone and joint destruction were found in 15 cases, local rib cortex defect in 9 cases, expansile osteolysis in 3 cases；Contrast-Enhanced CT appearances had margin enhancement in 14 cases，heterogeneous low density masses in one case which was clearly in contrast-enhanced CT scan.  Conclusion  CT scan is the great clinical value in diagnosing and differentiating tuberculosis of the chest wall.

Study on efficacy of antituberculosis drugs administratiom by fiberobronchoscopy and aerosol inhalation in endobronchial tuberculosis

Lu Lanying,Jing Qiusheng,Wang Weihua

Chinese Journal of Antituberculosis. 2010, 32(2):  104-107. 

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Objective To determine the efficacy of systemic antituberculosis chemotherapy combined with antituberculosis drugs administration by fiberobronchoscopy and aerosol inhalation in endobronchial tuberculosis.  Methods 228 patients with endobrochial tuberculosis were recuited and divided randomly into a study group with 116 cases and a control group with 112 cases. Systemic antituberculosis chemotherapy and antituberculosis drugs administration by fiberobronchoscopy and aerosol inhalation were given to the study group. The control group recieved systemic antituberculosis chemotherapy alone. The clinical outcomes after 2 months and 8 months’ treatment between two groups were compared.  Results At the end of 2 months and 8 months’ therapy, the improvement on clinical symptoms, radiographic and bronchoscopic manifestations and sputum negative convertion rate in the study group were significant higher than those in the control group(P<0.01, P<0.05). The efficacy on subtypes of granuloma and ulcer in the study group was better than that of control group(P<0.01, P<0.05).  Conclusion  The combination of systemic antituberculosis chemotherapy with antituberculosis drugs administration by fiberobronchoscopy andaerosol inhalation is more effective than that of systemic chemotherapy alone in endobronchial tuberculosis.

Quality analysis of AFB microscopy in general hospitals in Haidian district of Beijing

Ye Guoqing,Shen Xiuping,Zhong Chunmei,Cui Yawen,Lu Qiaoying

Chinese Journal of Antituberculosis. 2010, 32(2):  109-113. 

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Objective To evaluate the quality of AFB microscopy in general hospitals in Haidian district of Beijing and propose measures to improve the quality. Methods The technicians from 11 general hospitals were trained for standard operational procedure and Results interpretation and reporting of AFB examination. The method of EQA was done according to the quality assurance manual of NTP. Meanwhile, on-site investigation, evaluation and blinded reexamination was carried out to general hospitals.  Results There is significance difference in terms of workloads between different hospitals. Positive rates of AFB were not significant different between class-2 and class-3 hospitals. For reexamination, qualitative consistency rate was 97.7%, and quantitative consistency rate was 93.6%. Conclusion The quality of AFB microscopy varies between different general hospitals, therefore the capacity and quality should be further improved.

Further discussion on clinical value of serum tuberculosis antibody IgG in the first-treated patients with smear-positive pulmonary tuberculosis

Zhong Hongjian,Liu Laxiang,Zhu Fei,Chen Wensheng,Wen Shanshi,Zhao Angui

Chinese Journal of Antituberculosis. 2010, 32(2):  114-116. 

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Objective To reexplore the clinical value and influencing factors of serum tuberculosis antibody(TB-Ab) IgG in the first-treated patients with smear-positive pulmonary tuberculosis(TB). Methods The positive rate of serum TB-Ab-IgG in 1 911 first-treated patients with smear-positive TB were analyzed retrospectively and were compared with healthy people of in the same period.The relationships between positive rate of serum TB-Ab-IgG and some clinical features including the size of lesion,cavity wi...