Table of Content

20 August 2010, Volume 32 Issue 8

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Literature analysis of treatment outcome of Multi-drug resistant tuberculosis with different regimens

Du Jian,Xu Caihong,Li Qi,Jiang Xiaoying,Ma Yan,Gao Jingtao,Duanmu Hongjin,Fu Yu,Li Liang

Chinese Journal of Antituberculosis. 2010, 32(8):  7-12. 

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 Methods All the MDR treatment-related articles in “Medline” database published from 1996 to 2010 were searched. s of these papers were screened to find the full text of relevant articles. Final selection of articles was determined by inclusion and exclusion criteria.  Results A total of 1286 related English abstracts were searched originally, 28 articles were enrolled based on inclusion and exclusion criteria eventually. Among which 2 articles adopted standard treatment regimen, 1 with empirical regimen, 2 with National TB Program (NTP) standard short-course treatment regimen, and 23 with individualized regimen based on drug susceptibility test. Treatment success rate with individualized regimen is 61.2%, significantly higher than standardized MDR regimen of 52% and NTP standard short-course treatment of 39.2% (P<0.05). There is no statistical difference in treatment success rate between individualized regimen and empirical-based regimen (P>0.05). Conclusion Individualized treatment regimen should be adopted in regions where conditions permit; NTP recommended standard short course treatment is not enough for MDR-TB treatment.

estigation and analysis of the nationwide TB special

Li Weibin，Jiang Shiwen，Zhang Hui，Liu Xiaoqiu，Li Xinxu，Wang Lixia

Chinese Journal of Antituberculosis. 2010, 32(8):  19-21. 

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Objective To understand the basic situation of nationwide TB special hospitals, and their work in TB case-finding, registration, reporting, referral in order to further provide evidence base for cooperation between tuberculosis special hospitals and TB control institutions.  Methods Investigation forms were designed by NCTB and distributed to all eligible TB special hospitals through provincial CDC. NCTB made a summary and analysis of this investigation.  Results There are a total of 77 eligible TB special hospitals nationwide, among which hold 210000 professional and technical personnel, with predominance of middle and high level staff in terms of professional title (52.%); In 1_st Quarter 2007, there are a total of 269000 person-times of outpatients service, 32000 TB cases were reported to internet-based PTB reporting system, accounting for 9.6% of 335000 which is total cases reported in this system during same period. 26000 TB cases were referred to TB institutions, accounting for 9.7% of outpatient service of TB institutions.  Conclusion s TB specialist hospitals have a certain number of technical personnel and capacity in patient treatment, did a large amount of work for TB control in China.Therefore, there is a need to incorporate TB special hospitals into TB prevention and control system as soon as possible, and strengthen the cooperation between TB control institutions and TB special hospitals, establish an effective mechanism for long-term cooperation. This will be one of important component for future TB control work in China.

Equity study of TB control special fund in Guangdong province

Jiang Li,Zhong Qiu,Zhou Lin,Li Jianwei，Lian Yonge，Chen Yuhui

Chinese Journal of Antituberculosis. 2010, 32(8):  22-25. 

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Objective To understand the input of TB control special funding in Guangdong, and evaluate the fairness of TB control funding devotion.  Methods Questionnaire was used to investigate the TB control funding input of all TB institutes in each level. Lorenz curve and Gini coefficient is employed in evaluating the equity of TB control fund from population distribution, geographical and patients load distribution points of view.  Results The Gini coefficient of TB control fund is 0.40, 0.73 and 0.71 respectively by population, geographical and patients load distribution.  Conclusion s By population distribution, TB special funding achieved good fairness, however, in geographical and patients load distribution, the funding fairness is relatively poor.

 Registration trend analysis of new smear positive pulmonary tuberculosis patients in 17 years in Heilongjiang province

Fang Hongxia,Xie Yanguang,Qin Yubao,Sun Yanbo,Li Honghai,Yan Xinglu

Chinese Journal of Antituberculosis. 2010, 32(8):  27-30. 

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Objective To explore the registration trend of new smear positive tuberculosis in 17 years in Heilongjiang province since implementation of DOTS strategy.  Methods Quarterly reports of WB Heilongjiang TB project from April 1, 1992 to June 30, 2002 and National TB program from July 1, 2002 to December 31, 2008 were collected.  Results From 1992 to 2008, a total of 229053 cases of new smear positive were registered in whole province, the registration rate rose with the WB project implementation by year, peaked in 1997, then gradually dropped to the lowest point in 2002, then a rapid increase after 2002 until another small peak in 2004, again a slight decrease thereafter. The registration rate was higher in male than female, male peaked in 2008, while female in 2007, and both of them were lowest in 2002. In terms of age, after 1996, patients registration summit postponed to over 65, the age registration trend curves were different between male and female.  Conclusion s Under government’s attention and funds input, the overall trend of registration rate of new smear positive tuberculosis was stable in Heilongjiang Province. The registration rate was higher in male than female and summit in over 65. The age registration trend were different between male and female.

Factors affecting cure rate of tuberculosis patients in remote mountainous area of Shaanxi province

Xian Xiaoping,Xi Zhaoyan,Guo Liujia,Chen Guanghua,Ai Xianqin,ZhaoYan

Chinese Journal of Antituberculosis. 2010, 32(8):  33-37. 

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Objective To understand the factors affecting cure rate of tuberculosis patients in remote mountainous area of shaanxi province.  Methods This is a cross-sectional comparative study. Questionaire survey was conducted to patients, DOT supervisors and village doctors. The affecting factors were analyzed in cured and non-cured group.  Results The factors affecting the cure rate were low-income, low-eduction level, combination with complication, treatment in non-professional organization, treatment delay and interruption, unqualified review sputum, social discrimination, poor supervision etc.  Conclusion s Strengthening the government input, economy improvement, health education completeness, strengtheningTB control network construction and supervision, expansion of professional training and treatment, and attention and support of the whole society were basic strategies and measures of TB control.

Effect evaluation of health promotion activities through multi-sectoral cooperation on case detection improvement

Zhou Yang,Lv Shuhong，Yu Lan,Wang Xiaomei,Sima Yayun,Chen Lei,Yu Hao,Li Xiaoning,Xu Weiguo,Zhou Lin

Chinese Journal of Antituberculosis. 2010, 32(8):  33-17. 

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Objective To evaluate the effect of health promotion activities through multi-sectoral cooperation in rural areas.  Methods Data from project report and random sample questionnaire investigation in one western and one central province, and related project implementation information were analyzed.  Results The top four cooperation sections were women’s federation, education commission, publicity department and village committee. 69.7%, 63.7%, 60.7% and 59.2% project counties recognized their cooperation effect with these four sections respectively. The household coverage rate of publicity was 86.1%. 78.8% of villagers had ever received face to face publicity by women’s federation. Awareness rate of 6 items question related to TB knowledge was higher in these population rather than those who had not received publicity, 67.8% versus 52.3% (P<0.01). The survey on medical care seeking behavior showed that 66.1% of patients who sought medical care by themselves were due to publicity of village doctors or women’s federation.  Conclusion s Health promotion activities through multi-sectoral cooperation increased TB awareness rate in rural areas, and promoted seeking care behaviors of TB suspects, improved case detection rate of new smear positive PTB cases, and played important role in TB control prevention.

Efficacy and safety of Feitai capsule in adjuvant chemotherapy for new patients with smear positive pulmonary tuberculosis

Fan Lin,Shi Xiang,Gui Xuwei,Ge Yanping,Yang Yan,Jiang Ruihua,Gu Jin

Chinese Journal of Antituberculosis. 2010, 32(8):  38-41. 

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Objective To evaluate the efficacy and safety of feitai capsule,a kind of Chinese traditional medicine, as adjuvant treatment for new patients with smear positive pulmonary tuberculosis. Methods 120 new cases with smear positive pulmonary tuberculosis which were prospectively enrolled from June 2006-June 2007 were assigned into either to receive standard anti-TB regimen with feitai capsule(treatment arm) or to receive standard anti-TB regimen only (control arm). Index of efficacy for symptoms, rates of sputum conversion, X-rays focus absorption and cavity closed at the end of the second month and the sixth month during the course of treatment were recorded.  Results 57 cases in treatment group and 55 cases in the control completed the treatment. The therapeutic index, rates of sputum conversion, X-rays focus absorption and cavity closed in the treatment group were higher than those of control group after six months during the course of treatment(P<0.05). The rate of side effects on feitai capsule was only 5.26%(3/57). Conclusion s Fetai capsule can effectively alleviate the symptoms of TB patients, also improve the rate of focus absorption, cavity closed and sputum conversion, and long-term using is safe.

Epidemiological features of pulmonary tuberculosis (PTB) patients complicated with diabetes in Guangzhou

KUANG Hao-Bin, CHEN Qi-Chen, LI Hui-Fen, TAN Shou-Yong

Chinese Journal of Antituberculosis. 2010, 32(8):  44-47. 

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Objective To understand the epidemiological trends and features of PTB patients complicated with diabetes(TB-DM) in Guangzhou in order to provide evidence base for TB control strategies formulation.  Methods Information of PTB patients registered from 2004 to 2008 in Yuexiu, Liwang, Haizhu and Tianhe district were analyzed.  Results The total number of TB-DM in these four districts were 1047 from 2004 to 2008, accounting for 6.2% of total PTB patients over the same periods, the 5-year average annual registration rate is 6.22/100000, no significant changes within 5 years（P>0.05）. Male and female TB-DM accounted for 6.5% and 5.3% of PTB patients of same gender respectively(P<0.01). The age of TB-DM ranged from 19 to 91 with a median of 59 years old, majority was middle-aged and elderly patients over 40 years old. Among TB-DM patients, 632 (60.4%)cases were smear positive,415 cases smear negative (39.6%), 527 cases with cavity 527 (50.3%). The proportion of patients with smear positive result and cavity in TB-DM cases were both significantly higher than tuberculosis cases without diabetes (P<0.01). Patients discovery were mainly by outpatient attendance due to suspected symptoms, accounting for 89.2%.  Conclusion s The TB-DM incidence is relatively high, and mainly in middle-aged and elderly people, proportions of both smear positive and with cavity are high. All of these bring difficulties to TB control therefore there is a need to strengthen TB control work in this population.

Establishment and application of murine acute tuberculosis model by aerosol infection

Xu Jian,Lu Yu,Zheng Meiqin,Fu Lei,Zhao Weijie,Wang Bin,Li Peng

Chinese Journal of Antituberculosis. 2010, 32(8):  48-51. 

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Objective To establish and evaluate murine acute tuberculosis model by aerosol infection.  Methods BALB/c mice were challenged with different doses ofM. tuberculosisH37Rv by aerosol infection, and then treated for 15 doses by different compounds and drugs at 10 days after infection. At 3, 10 and 30 days after infection, the lungs of the mice were homogenized, serially diluted, and plated on 7H11 agar plates for enumerating the bacterial load. The severity of infection and the effect of the treatments were assessed by body weight, gross lung lesions and clony forming unit (cfu) in the lungs.  Results The cfu and histopathology in lungs of the mice showed that murine acute tuberculosis model were successfully established by aerosol infection. The 10⁶cfu/ml ofM. tuberculosisis suitable for this model. The treatment with Iisoniazid could reduce 5.95 lg cfu in comparison with that of untreated control at day 30 after infection. The active compound JYS-17 was screened out by the model.  Conclusion Murine acute tuberculosis model by aerosol infection can be used for early evaluating anti-tuberculosis compounds and drug.

 Application of LAMP method in rapid detection of Mycobacterium tuberculosis

LIN Shi-Ping, YANG Ying-Zhou, TAN Wei-Guo, LIN Yi-Man, WANG Hong-Fu

Chinese Journal of Antituberculosis. 2010, 32(8):  52-55. 

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Objective To develop a loop-mediated isothermal amplification (LAMP) method for the detection ofMycobacterium tuberculosis .  Methods 11 standard strains were used to develop the LAMP method in TB detection. The sensitivity and specificity of LAMP were evaluated using 47M. tuberculosisand nontuberculosis mycobacteria isolates and 13 food borne strains.  Results The detection limit of LAMP was 1pg of DNA, the specificity was 97.4%.  Conclusion s The LAMPis a rapid, sensitive, and specific method for the detection ofMycobacterium tuberculosis .