Table of Content

20 September 2010, Volume 32 Issue 9

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Evaluation on the reliability,validity and sensitivity of health needs scale for floating population with TB

Zhou Lin,Zhong Qiu,Gao Cuinan,Jiang Li,Chen Yuhui,Xu Zhuowei

Chinese Journal of Antituberculosis. 2010, 32(9):  12-15. 

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Objective To evaluate the reliability, validity and sensitivity of health needs scale for floating population with TB.  Methods All subjects were interviewed by using health needs scale. Reliability was analyzed by using Cronbach’α and split-half reliability coefficients. Validity was tested by factor analysis. Sensitivity was evaluated by comparison of experimental group and control group.  Results The Cronbach’ α of health needs scale α 0.6253 and 12 factors are above 1, which can explain 72.4% total variance. All scores of experimental group were higher than that of control group (P<0.05).  Conclusion s The health needs for floating population with TB was a valid tool for assessment of TB cases health needs but the scale of reliability and validity were not very good. The sensitivity for scale was better. The scale should require slight modification in the future.

The channel of acquiring TB knowledge among middle school students and factors affecting the acquisition in Shenzhen City

Hu Zengping,Tan Weiguo,Zhao Meigui,Wang Ying

Chinese Journal of Antituberculosis. 2010, 32(9):  15-18. 

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Objective To understand the channel of acquiring TB knowledge about TB among middle school students in Shenzhen City. Methods This is a cross-sectional study. A total of 16174 students from 24 middle schools in Shenzhen City were selected by stratified random cluster sampling method. Questionnaire survey was administered to all students enrolled to inquiry their channels of acquiring TB knowledge. There are five options in this questionnaire, namely, school education, media campaigns, hospital advocacy, extra-curricular reading and others.  Results School education, media campaigns and other are first three channels in TB knowledge acquisition. Education, gender, age, length of daily study duration, sleep duration, exercise duration, whether has study pressure and the family income were the factors affecting the channels of TB knowledge acquisition. Conclusion Health education in schools should focus on these features and relevant policy measures should be developed.

Study on knowledge,attitude and practice of tuberculosis and health education in Universities in Shanghai

Chen Jing,Shen Mei,Xia Zhen,Hong Jianjun,Zhang Jiaqi,Zhang Zurong,Li Xiangqun,Mei Jian

Chinese Journal of Antituberculosis. 2010, 32(9):  19-22. 

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Objective To explore the knowledge, attitude and practice (KAP) of university study in Shanghai, as well as the situation and obstacles to conduct health education in universities.  Methods 1026 students in six universities in two districts were sampled and investigated with the questionnaire; 23 qualitative in-depth interviews were also conducted to student TB patients, health workers in CDC, doctors working in university infirmary and university teachers.  Results The general awareness rate of key information on TB control is 57.6%, and that on suspected symptom and free policy is 30.2% and 21.7% respectively. About 77.4% of students never explore TB knowledge actively. Health education on TB control is facing several problems.  Conclusion s It’s emergent to strengthen health education in universities, which needs the collaboration between health and education section.

Evaluation of the effectiveness of psychological support and health education to tuberculosis patients by non-government organizations

Zhou Guichang,Liu Wenjun,Chen Qiulan,Wang Tiezhen,Liu Eryong,Wan Yanqin,Lv Qing,Zhou Lin,Chen Shiming

Chinese Journal of Antituberculosis. 2010, 32(9):  23-25. 

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Objective To evaluate the effectiveness of psychological support and health education to tuberculosis (TB) patients by non-government organization and to draw lessons from the pilots for further expansion.  Method To compare the knowledge and mood status of patients between before-and after-psychological support activity by questionnaire survey. To reveal the degree of satisfaction and suggestion of TB patients, health administrative staff, leader and clinical doctor from TB dispensary by personal interview.  Results The correct answer fill rate elevated obviously when they received health education(P<0.01); the mood status of patients has been improved obviously when they received psychological support (P<0.01). 93% of patients showed their satisfaction to the pilot activity; health administrative staff, leader and clinical doctor from TB dispensary agreed on the pilot work plan for psychological support and its significant effectiveness.  Conclusion The pilot of psychological support by NGOs of China Global Fund TB Program has gained great achievements, and this mode could be promoted in further expansion.

TB/HIV knowledge awareness among community residents

Lv Deliang,Yang Yingzhou,Tan Weiguo,Li Rongan，Lu Tanwang,Lv Jianwen,Xu Li,Zhao Meigui

Chinese Journal of Antituberculosis. 2010, 32(9):  26-32. 

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Objective To explore TB/HIV knowledge awareness among community residents and find the problems existed in order to provide baseline information and scientific basis for in-depth research and development of intervention measures.  Methods A multi-stage random sampling method was used from June to July 2010, 669 cases of Shenzhen community residences aged 15 or above were enrolled, and information were collected through self-filling questionnaire.  Results 89.4% of the respondents had ever heard of HIV/AIDS and tuberculosis simultaneously, whereas only 38.7% of the respondents had heard of TB/HIV co-infection. Moreover, only 13.0% of the respondents had received TB/HIV co-infection knowledge. A large part of the residents didn’t know the interaction between HIV/AIDS and TB, and lacked the consciousness of AIDS and TB screening. Only 69.2% of respondents thought that TB/HIV co-infection could be prevented. In addition to poor awareness to some non-HIV transmission routes, HIV and TB transmission routes is well understood by respondents.  Conclusion At present, community residents lack of TB/HIV dual infection related knowledge. The health education on TB/HIV co-infection is imperative to community residents.

The effect of "Cross-Regional Referral Health Education Model" among floating population with TB disease

Su Jingyi,Gao Cuinan,Li Yifen,Xu Zhuowei,He Liyan,Lin Yin

Chinese Journal of Antituberculosis. 2010, 32(9):  33-35. 

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Objective To analyze the effect of “Cross-Regional Referral Health Education Model” among Floating Population of TB patients Methods A total of 486 cases of floating population with TB disease were randomly divided into research and control groups. The research and control group were intervened with “Cross-regional referral health education model” and “Routine TB health education” respectively. TB knowledge awareness rate and treatment compliance of the two groups were compared to evaluate the effect of intervention.  Results The TB knowledge awareness rate was 95.52% in research group, which was significantly higher than that of 79.58% in control group (P<0.05). The treatment compliance rate was 88.21% in research group, significantly higher than that of 64.17% in the control groups (P<0.05).  Conclusion “Cross-Regional Referral Health Education Model” has profound effect in improving TB awareness and treatment compliance in floating population with TB disease. This model could be scaled up in TB cases management in floating population.

Analysis on the awareness rate of main tuberculosis symptoms in residents of some areas of Guangdong province

Chen Liang,Zhong Qiu,Jiang Li,Zhou Lin

Chinese Journal of Antituberculosis. 2010, 32(9):  36-39. 

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Objective To understand the awareness rate of main tuberculosis symptoms in residents of some areas of Guangdong province and factors affecting the awareness in order to providescientific basis for health promotion work in the future.  Methods We used cluster stratified random sampling method; three cities were randomly selected, number of residents selected were proportional to population in each city. Residents were investigated by household face-to-face interview through a uniform questionnaire on awareness situation of main tuberculosis symptoms and influence factors.  Results The awareness rate of main TB symptoms was only 51.0% among the study population. Logistic regression model showed that sex, education level and occupation were factors affecting the awareness rate. Awareness rate was higher in male than female (P<0.05), in residents with higher education level than in lower education level (P<0.01). For occupation, doctors, administrative personnel and teachers has higher awareness rate than commercial staff, lowest rate was in students, unemployed workers and farmers (P<0.01). Conclusion The awareness rate of tuberculosis symptoms was lower in the resident of Guangdong province; therefore we should carry out targeted health education work.

Effect analysis of TB control health education among school students in Yan Shan

Wang DongLing,Liu Guang

Chinese Journal of Antituberculosis. 2010, 32(9):  40-42. 

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Objective To evaluate the effect of TB health education among school students in Yan Shan in order to provide evidence basis for further health promotion work.  Methods Students were divided into three groups, namely high, middle, primary school group. Same questionnaire which contains 14 questions was used to investigate TB knowledge at baseline, as well as after 6 month’s health education after baseline investigation. 1531 and 1511 eligible questionnaires were received at baseline and after 6 month, the corresponding eligible rate of questionnaire was 99.4% and 99.6% respectively.  Results The overall awareness rate of TB was 43.4%. 5.81% of patients had 100% correct answers. For 3 major questions, including“How long is the indication of TB for cough and expectoration? Where best to seek medical care for suspected TB? Is there any free TB treatment policy in China?”, 26.7% of students got the correct answers to these 3 questions simultaneously. After 6 months’ education, awareness rate increased to 74.1%. 25.2% of students have full correct answers. 54.8% of students got the correct answers to the three questions listed above. Awareness rates are significantly different between baseline and after education except for primary students group.  Conclusion Health education has remarkable effect in promotion of TB awareness for school students.

Application of time series analysis for the prediction of incidence trend of tuberculosis in Guangdong province

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

Chinese Journal of Antituberculosis. 2010, 32(9):  43-47. 

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Objective To utilize the product seasonal model to predict the trend of TB and provide scientific evidence for formulating the related measures of prevention and cure.  Methods The product seasonal model was combined with ARIMA model and stochastic seasonal model by using the least square principle.  Results The ARIMA（0,1,1）（0,1,1）₄ model was established by the data from 1996 to 2008, and the effectiveness of prediction of this model showed to be good with the actual values in the 95％ confidence interval of predicted values.  Conclusion The ARIMA product seasonal model shows effective to predict the incidence of TB in Guangdong province, and the Results is in according to the current status of TB, moreover, it could provide information for us to take measures for TB prevention and control.

Assessment on quality of life in MDR-TB patients using SF-36 scales

Zhang Ming,Lou Peian,Liu Lin,Chen Peipei,Zhang Ya,Liu Jie,LiJunzheng

Chinese Journal of Antituberculosis. 2010, 32(9):  47-51. 

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Objective To evaluate the applicability of the SF-36 scales in measuring the quality of life of patients with multi-drug resistant pulmonary tuberculosis (MDR-TB), to analyze the factors affecting the quality of patient’s life.  Methods SF-36 instrument was used to measure and evaluate the quality of life of 100 MDR-TB patients and 200 healthy people. The reliability and validity of SF-36 were evaluated. Overall value and value of each domain before treatment, 3 month and 1 year after treatment start were measured for 100 patients. Treatment effect was evaluated by paired t test and analysis of variance. Simple and multiple stepwise regression analysis were made to evaluate factors affecting the quality of life.  Results The split-half reliability of scales was 0.96, Overall Cronbach’s а coefficients and coefficients in each domain were all larger than 0.7. There were significant differences for the overall scores of quality of life and scores in eight domains between the MDR-TB patients and the normal people(P<0.05); overall scores of quality of life and eight domains in 3 months or 1 year after treatment start were significantly higher than before treatment (P<0.05). After patient completed 1 year treatment, the scores of overall quality of life and in PF、PR、GH、VT、SF、ER、MH’s domains were lower than control groups (P<0.05).The main factors affecting the quality of life of MDR-TB patients were cultural level, kinds of drug resistant, irregular treatment and reduction of white blood cell counts.  Conclusion The SF-36 scales is applicable for measuring the quality of life of MDR-TB patients. The quality of life of MDR-TB patients decreased greatly, and increased significantly after treatment, but still could not recover to normal after 1 year therapy. The main factors affecting the quality of life of MDR-TB patients were cultural level, kinds of drug resistant, irregular treatment and reduction of white blood cell counts.

Cross-referral of HIV/AIDS suspected tuberculosis and influence factors

Lai Yuji，Cheng Shiming，Zhou Lin，Chen Qiulan，Li Dongmin，Wang Ning，Liu Eryong，Wang Dongmei

Chinese Journal of Antituberculosis. 2010, 32(9):  52-55. 

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Objective To understand the actual situation of referral between HIV and TB institutions and explore the factors affecting referral.  Methods HIV patients were screened by TB questionnaire by doctors of HIV institutions during post-HIV test counseling and follow-up. Patients with positive questionnaire were referred to TB institution for further TB examination. Patient’s arrival time after referral were recorded.  Results 130 cases of HIV patients with TB suspected symptoms were referral from HIV institution to TB institution. Referral arrival rate was64.6%(84/130),TB detection rate was 7.1%（6/84）. 36（42.9%） cases reached TB service on the same referral day, 32(38.1%) reached within 1 to 14 days, 8(9.5%) reached within 15 to 30 days and 8(9.5%) after 30 days.  Conclusion s It is important to establish the collaboration mechanism between HIV and TB institution in order to improve the referral rate and shorten the arrival time. Factors affecting referral arrival rate should be further researched.

Application of the morisky medication adherence scale on pulmonary tuberculosis patients

ZHANG Si-Yu, BAI Li-Qiong, TAN Hong-Zhuan, YANG Hua-Lin

Chinese Journal of Antituberculosis. 2010, 32(9):  55-58. 

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Objective To explore the feasibility of the Morisky Medication Adherence Scale 8-item version (MMAS 8-item version) being applied on pulmonary tuberculosis (PTB) patients, and to measure and compare the adherence of PTB patients treated with fixed-does combination (FDC) and blister pack drugs. Methods In a randomized controlled clinical trial, the experimental group (EG) treated with FDC and the control group (CG) treated with blister pack drugs. MMAS 8-item version was applied to patients in both groups by questionnaire survey. Results Cronbach’s coefficient was 0.64 in this study. There were 230 patients in EG, and 233 in CG.. The adherence in EG was significantly higher than CG (Z=-6.001, P=0.000). Conclusion The adherence of PTB patients treated with FDC was better than those paitents treated with blister pack drugs. The MMAS 8-item version has a good reliability and sensitivity, could be applied on the PTB patients.

Typical Survey on TB diagnosis,treatment and management in two TB hospital

Wang Ni,Zhou Lin,Chen Lei

Chinese Journal of Antituberculosis. 2010, 32(9):  59-61. 

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Objective Aim the result of the survey on TB diagnosis,treatment and management in TB hospital will helped to develop strategies on collaboration mechanism between TB hospitals and TB institutions.  Methods Using typical survey method, selected two provincial TB hospitals, looked up all the case history in 2007.  Results X-ray, clinical symptom and CT were the main diagnostic criteria, the rate of sputum examination is very low（χ²=17.7,P<0.05），Out of 374 cases, 334(89.3%) cases were prescribed second line anti-TB drugs, After hospital discharge only 30(8.0%) cases were transferred to the TB dispensary.  Conclusion The diagnosis,treatment and management lack of standardization, and there is need more input from the Gov. to establish the collaboration mechanism between TB hospitals and TB institutions.

TB and Gender in five provinces of China

Chen Wei，Wang Xuejing，Wang Lixia,Xu Biao

Chinese Journal of Antituberculosis. 2010, 32(9):  62-67. 

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Objective To understand the gender characteristic of notified TB cases in five provinces of China in order to promote accessibility and equity of health care service.  Method Using the descriptive and comparable approach, to analyze the difference of age, occupation, treatment outcome and the delay of diagnosis with different gender TB patients.  Results The sex ratio of TB patients in the east, the south and the middle is higher than the west and north. The average age is lower in the female than the male in most of provinces. Proportion of Non-farmer female is high, and there is no difference in treatment outcome between genders. The diagnosis delay was not different between genders, but was significantly different among five provinces with the lowest in Zhejiang and the longest in Heilongjiang. Gender, age and occupation is the risk factors affecting the diagnosis delay.  Conclusion s The age and occupation difference exists in the different gender TB patients, but difference is not significant in the treatment outcome and the delay of diagnosis.Elderly female patients and female rural farmers have poor accessibility to TB services.

Impact of non-therapeutic factors on TB treatment outcome of TB/HIV patients

Zhou Lin,Chen Lei,Wang Ni,Liu Eryong,He Jinge,Liu Feiying,Wang Qiaozhi,Xue Xiao

Chinese Journal of Antituberculosis. 2010, 32(9):  67-70. 

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Objective To understand the impact of non-therapeutic factors on TB treatment outcome of patients co-infected with TB/HIV disease.  Methods All newly discovered TB/HIV patients during 2007—2008 from 6 counties were observed, non-therapeutic factors including sex, age, occupation, education level, and marital status were analyzed.  Result Taking treatment success (cure and treatment completion), loss (treatment interruption) as outcome variables, 294 patients were included enrolled in this study. The majority of patients were middle-aged or youth male. HIV was mainly transmitted through intravenous drug use and sex. Nearly one third of patients had no regular employment, and their education level was primary school or even less, marital status was divorced or widowed. Patients with lower education level, divorced or widowed are more likely to interrupt the treatment.  Conclusion In order to reduce the interruption rate of TB treatment, we should pay more attention to patient’s psychological support and health education before and after treatment, especially for patients with non-regular employment, lower education level, divorced or widowed.

Effect analysis of global fund tuberculosis project on floating population in Shenzhen

Guan Hongyun,Yang Yingzhou,Lv Jianwen,Wu Qingfang,Xu Li,Lv Deliang

Chinese Journal of Antituberculosis. 2010, 32(9):  71-74. 

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Objective To analyze the implementing effect of global fund tuberculosis project on floating population in Shenzhen, and explore effective management pattern for the floating population.  Methods Data from internet bases infectious disease reporting system、TB register and financial statements were analyzed from Oct,2006 to Jun,2010.  Results A total of 13984 active pulmonary tuberculosis patients were found, among which 7871 cases of smear positive and 6113 cases of smear negative. The overall in place rate of patients reported by non-TB institutions increased from 56.1% to 86.5%. The DOT rate was 98.0%. The sputum conversion rate at the end of two month was 74.8%.The successful treatment rate of active pulmonary tuberculosis patients was 83.9%.The sputum conversion rate and successful treatment rate of the patients who transferred out was significantly lower than the patients who still stayed in Shenzhen（P<0.01）.The total use of project funds was 93.1%. Conclusion s A large number of pulmonary tuberculosis cases were diagnosed, treated and cured in the nearly four years, however because of a substantial increase in the mobile population, the treatment effect should be further improved.

TB screening questionnaire in diagnosis and ruling out active TB in people living with HIV/AIDS

Liu Eryong,Cheng Shiming,Zhou Lin,Wang Xuejing,Lai Yuji,Wang Dongmei,Yang Daowei,Li Tao,Wang Xiaochun,Ma Shiwen,Liu Gang,Hua Jianzhao

Chinese Journal of Antituberculosis. 2010, 32(9):  74-78. 

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Objective The purpose of this study is to determine the role of TB screening questionnaire in diagnosis and ruling out active TB in people living with HIV/AIDS, and provide reference for basic level doctors.  Methods HIV/AIDS patients were consecutively enrolled in 4 counties during Sep.2006 to Feb.2007. For each HIV/AIDS patient, TB suspicious symptoms were obtained through TB screening questionnaire, and part of patients received further clinical evaluation. Sensitivity, specificity, likelihood ratios, and post-test probability were analyzed for any single symptom, and combination of multiple symptoms. The gold standard is the diagnosis result by sputum smear, X ray, and clinical expert committee.  Results Current TB screening questionnaire adopted by China has 100% sensitivity and 65.6% specificity. The highest frequency of symptoms occurred in HIV/AIDS patients were: cough, night sweat, and fatigue. The probability of active TB increased significantly in patients with bloody sputum and those with recurrent fever. The single symptom of cough has the highest 92.1% sensitivity among all single symptoms, and its specificity is 73.8%. Cough negative is a strong indicator in ruling out active TB. 85.4% of HIV/AIDS patients have 1 to 3 symptoms. Active TB detected among them contributes to 78.6% of all diagnosed TB cases. For HIV/AIDS with only 1 TB suspicious symptom, the post test probability of active TB is 5%; while for those with 2 to 5 symptoms, this probability is around 12%. Therefore patient with 2 to 5 symptoms are equally important.  Conclusion TB screening questionnaire constitute a low-cost and effective tool to increase detection of active TB in people living with HIV/AIDS, especially in resource-constraint setting, simple and feasible screening could facilitate the detection.

The impact of Cross-regional referral and tracking management model on TB treatment interruption among floating population living with pulmonary tuberculosis

Xu Zhuowei,Gao Cuinan,Ma Shunying,Wu Jinyao,Huang Elin

Chinese Journal of Antituberculosis. 2010, 32(9):  79-81. 

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Objective To investigate the impact of “Cross-regional referral and tracking” and “Conventional cross-regional referral” management model on TB treatment interruption among floating population living with pulmonary tuberculosis (PTB).  Methods The floating population living with PTB was randomly divided into experimental and control groups, which implemented “Cross-regional referral and tracking” and “Conventional cross-regional referral” management model respectively. The impact of these two models on treatment interruption rate was analyzed.  Results The treatment interruption rate was 2.0% for experimental group, and 9.0% for control group. The two groups were significantly different (μ=3.04, P<0.01).  Conclusion s “Cross-regional referral and tracking” can significantly reduce the treatment interruption rate among floating population living with PTB.

Clinical analysis on 32 AIDS cases coinfected with tuberculous meningitis

Zhang Guoli,Su Huiyong,Zhou Jun,Yin Guangzhi,Yang Xuewen,Yao Zhenglin

Chinese Journal of Antituberculosis. 2010, 32(9):  84-87. 

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Objective To summary the clinical data from tuberculous meningitis (TBM) in patients coinfected with acquired immuno-deficiency syndrome (AIDS).  Methods We analyzed retrospectively 32 AIDS cases coinfected with tuberculous meningitis in our hospital from January 1999 to December 2009.  Results There were 30 cases with fever, 29 with headache, 18 with disorder of consciousness, 12 with spasm, 25 with meningismus, 27 with cough, and 25 with productive cough. All the patients had different degrees of AIDS-related presentation and were often coinfected with pulmonary tuberculosis (75%) and extra-pulmonary tuberculosis (12.5%). CD4 count was less than 200/mm³ in all cases. All the patients presented with increased cerebrospinal fluid pressure, WBC, protein and ADA, and with decreased sugar and chloride in the cerebrospinal fluid.  Conclusion s The AIDS patients coinfected with tuberculous meningitis have complex, severe and nonspecified clinical manifestation with high mortality and high disable rates. Antituberculosis plus corticoid and combination treatment with HARRT can decrease mortality, improve life quality and extend life-span.

Risk factors and pathogenic bacteria characteristics in the elderly with pulmonary tuberculosis complicated by HAP

Zhang Ridong,Chen Xiaoyan,Feng Tongming

Chinese Journal of Antituberculosis. 2010, 32(9):  89-91. 

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Objective To investigate risk factors and pathogenic bacteria characteristics in the elderly with pulmonary tuberculosis complicated by hospital-acquired pneumonia(HAP).  Methods We analyzed retrospectively 140 the elderly patients with pulmonary tuberculosis complicated by HAP.  Results HAP was closely related with chronic pulmonary disease, cadio-cerebrovascular disease, diabetes mellitus, malignant tumor, malnutrition, using broad spectrum antibiotic, and hospitalization more than three weeks. The major pathogenic bacteria of HAP was gram negative bacilli.Klebsiella pneumoniaeandpseudomonas aeruginosawere the most common bacilli. Conclusion It is important for intervention of risk factors to control HAP in the elderly patients with pulmonary tuberculosis. The common pathogenic bacteria of HAP in the elderly patients with pulmonary tuberculosis is gram negative bacilli. Empirical therapy with antibiotics can be given according to the pathogenic bacteria characteristics before acquring Results of drug sensitivity test.

Clinical analysis on sputum smear positive conversion in patients with pulmonary tuberculosis during regular treatment

Cao Wenli,Chen Zheng,Xu Qingjie,Han Yuefei,Wu Yin,Wang Jinling,Xiang Xi,Tu Dehua 

Chinese Journal of Antituberculosis. 2010, 32(9):  92-95. 

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Objective To analyse the causes related to sputum positive conversion in patients pulmonary tuberculosis during regular treatment.  Methods The data of sputum positive conversion in 53 patients with pulmonary tuberculosis during regular treatment was analyzed retrospectively.  Results Of 53 patients, 18 patients had sputum positive conversion. 8（44.4%） cases became sputum positive at the second month, which included 3（16.7%） cases with primary drug resistance.2 （11.1%）cases and 8 （44.4%）cases had sputum positive conversion at the third month and the fifth month respectively. In addition, there were 35 cases with smear and culture positive before treatment among 53 cases. 13 （37.1%）cases had sputum positive conversion in the third month,12 （34.3%） cases in the fifth month, and 8 （22.9%）cases, which 3 （7.7%）cases were progressive and 1 case with drug resistant was given high dose hormone due to immulogocial disease, were in the sixth month. There were another 2（5.7%） cases sputum positive conversion at the eighth month. The major factors which affect sputum positive conversion in patients with endobronchial tuberculosis, drug resistance, diabetes mellitus and retreatment.  Conclusion s It should be emphasized on monitoring sputum bacteria and finding cases with sputum positive conversion timely durmg the chemotherapy of tuberculosis.

Analysis on 111 cases with new smear positive pulmonary tuberculosis complicated by diabetes mellitus

Xin Yunqiao

Chinese Journal of Antituberculosis. 2010, 32(9):  97-100. 

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Objective To evaluate the clinical characteristics of new smear positive pulmonary tuberculosis complicated by diabetes mellitus, and to find case earlier and improve efficacy. Methods 111 cases from local resident with new smear positive pulmonary tuberculosis complicated by diabetes mellitus who hospitalized in our tuberculosis control center between January 1997 and June 2009.  Result The case with new sputum positive pulmonary tuberculosis complicated by diabetes mellitus had clinical characteristics as follows: more middle and old aged patients, extensive lesion, much mycobacteria in sputum, slow sputum negative conversion and poor lesion absorption. Conclusion The patients with new smear positive of pulmonary tuberculosis complicated by diabetes mellitusshow specific clinical characteristics. Strict control glycemia and reasonable antituberculous treatment should be taken into account.

Analysis on 16 delayed absorption pneumonia cases misdiagnosed as pulmonary tuberculosis

Liu Xin,Wu Wenqing

Chinese Journal of Antituberculosis. 2010, 32(9):  101-103. 

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Objective To investigate the causes for delayed absorption pneumonia patients misdiagnosed as pulmonary tuberculosis and to improve the clinical differential diagnosis ability on these two pulmonary diseases.  Methods Retrospective analysis of 16 cases with delayed absorption pneumonia who were misdiagnosed as pulmonary tuberculosis.  Results The clinical symptoms ofthese patients included10 caseswithfever, amongwhom 3 caseshad high grade fever, 4 cases had medial grade fever and 3 cases had low grade fever;2 cases with night sweat. All patientshadnegative acid fast bacteria; Of 16 cases 12cases showed that WBC were 4.0~10.0×10⁹／L, 7 cases were positive on TST result used PPD 5IU, 16 cases’ lesionlocated in the apical and rear segments of the upper lobes or the superior segments of the lower lobes, 2 cases had the history of pulmonary tuberculosis.  Conclusion The main causes of misdiagnosis are as follows:the clinical symptoms of delayed absorption pneumonia are atypical, Chest X-ray appearance and routine blood test Results are similar to that of pulmonary tuberculosis and the diagnostic value of PPD test is over-estimated.Comprehensive analysis of the clinical data and observing the focus dynamically after anti-inflammatory treatment should be important measures to avoid delayed absorption pneumonia misdiagnosed as pulmonary tuberculosis in clinical practice.

Evaluation of rRNA amplification assay for detection of Mycobacterium tuberculosis

Chinese Journal of Antituberculosis. 2010, 32(9):  104-108. 

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Objective To evaluate the clinical value of rRNA amplification assay in the detection ofMycobacterium tuberculosis .  Methods 551 sputum specimens from the patients with doubtful tuberculosis and health volunteers were detected using smear microscopy, L-J medium culture, rRNA amplification assay and real-time PCR. L-J culture used as control, the sensitivity, specificity, positive predictive value and negative predictive value of rRNA assay were analyzed. The accordance rate between rRNA assay and real-time PCR was also analyzed.  Results Compared with L-J culture, the sensitivity, specificity, positive predictive value and negative predictive value of rRNA assay were 98.5%, 95.0%，95.0% and 98.5%, respectively. Its sensitivity and specificity had significant difference between smear-positive and smear-negative specimens (P<0.01). Accordance rate between rRNA amplification assay and real-time PCR was 93.8%, which had significant difference between smear-positive and smear-negative specimens (P<0.05).  Conclusion rRNA amplification assay has a higher sensitivity and specitivity, can shorten the detection time. It would be a promising laboratory diagnosis method.

Evaluation of a method for the rapid culture and identification of mycobacterial species-TLA+PNB

Dai Guangming,Xia Hui,Ma Yifeng,Liu Guan,Li Yunxv,Shang Yuanyuan,Fu Yuhong,Zhao Yanlin

Chinese Journal of Antituberculosis. 2010, 32(9):  109-112. 

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Objective evaluate the clinical value of thin-layer agar (TLA+PNB) on the diagnosis of TB and identification of mycobacterial species.  Methods 211 samples including sputum and extra-pulmonary specimens from suspects with a clinical diagnosis of TB were decontaminated using NaOH/NALC, centrifuged, and then stained with Ziehl-Neelsen for the detection of acid-fast bacilli (AFB), cultured on L-J medium and TLA+PNB medium and identified by 16S rDNA sequencing. Sensitivity and specificity, growth detection time and contamination rate were calculated for both media.  Results Of AFB-positive samples, 77.4% were culture positive. Of AFB-negative samples, 8.2% were both L-J and TLA culture positive. The sensitivity and specificity of both L-J and TLA culture were 84.2% and 100%, respectively. 8 non-tuberculosis mycobacteria of 48 cuture-positive samples were detected by TLA+PNB, in which the sensitivity and specificity were 88.9% and 100%, respectively. Contamination rates were 4.7% for TLA and 1.2% for L-J. Median time of a positive culture was 10.6 days for TLA and 22.9 days for L-J (P<0.001).  Conclusions The TLA+PNB method is an inexpensive, rapid and reliable alternative for detectingM. tuberculosis .