Chinese Journal of Antituberculosis

Table of Content

20 January 2011, Volume 33 Issue 1

Analysis on the influential factors of completing tuberculosis treatment among patients who had transferred out of Gansu province

Li Xue,Zhang Lan,li Weibin,Xie Haibo,Zhang Hui,Jiang Shiwen

Chinese Journal of Antituberculosis. 2011, 33(1): 7-10.

Abstract ( 1363 )

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Objective To explore the influential factors of completing the treatment for tuberculosis (TB) patients who had transferred out in Gansu province.  Methods Selected 22 counties with high TB prevalence rate and with large amount of patients who had transferred out in Gansu province. The investigators were responsible for conducting the survey and filling out the querastionnaires. Results The treatment completion rate was significantly higher among the following groups than their counter parts: patients who had been given with the medications (OR = 13.281, 95% CI:5.557～31.739); patients who had informed information about going out to their physicians. (OR = 5.025, 95% CI:2.520～10.020); the patients who had spent ≥500 RMB for treatments (OR = 2.554, 95% CI:1.087～5.999); the patients who had received health education on TB before infection (OR = 2.200, 95% CI:1.112～4.352). Conclusion To locate patients who intended to shift at an early stage, we should be alert and pay more attention to strengthen the communication between physicians and patients, especially among the high risk groups. It is important to strengthen health education and to improve treatment completion rate when patients were initially diagnosed with TB. Prepare a certain amount of medications for the patients who insisted on shifting to ensure uninterrupted treatment.

Analysis of the current human resource situation in the nationwide tuberculosis control and treatment organizations

Xie Haibo,Zhang Hui,Li Xue,Wang Lixia,Jiang Shiwen

Chinese Journal of Antituberculosis. 2011, 33(1): 12-15.

Abstract ( 1747 )

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Objective To describe the basic human resource situation in the nationwide TB control and treatment organizations, and to provide witness for future improved human resource building. Methods All levels of the TB control and treatmentorganizations filled in the questionnaires in September to October in 2007, after the questionnaires aggregated, the provincial level organzationsreported the findings to the national center, finally the national center of TB control and prevention summarized and analyzed the data. Results Though the numberof TB professionals has improved in some degree, the staff of the TB control and treatment organizations reached the requirements remained few. There was a shortage ofstaff members with high education and high technical title, and staff who understand the clinical informaton of TB control and prevention. The age structure of staff from some organization need further improvement.

Effect analysis of Shandong provincial TB control project-role of community health facilities in TB control

Guo Xiaoyan,Li Fang,Zhang Xiulei,Wang Yu,Jin Jin

Chinese Journal of Antituberculosis. 2011, 33(1): 17-20.

Abstract ( 1517 )

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Objective To analyze the effect of Shandong provincial TB control project-role of community health facilities in TB control in order to explore working way of TB control in Communities . Methods Project quarterly reports, baseline data and questionnaires of TB patients from four project counties were collected and used for analysis. Results During the project implementation, reporting rate of pulmonary TB and TB suspects in these 4 counties reached 78.9%, referral rate was 67.7%, referral in place rate reached 84.1%, tracing rate was 100%, in place rate after tracing reached 93.1%. Meantime, Patients under the jurisdiction were supervised and managed according to the project requirement. Conclusions The project promoted the work of community health facilities in TB control, and provide theoretical basis for TB control in communities.

tuberculosis; pulmonary; registries; community health sevices; Shandong province;

Zhang Xiulei,Zhu Li,Zhang Hongmei,Guo Xiaoyan，Sun Xiaoying

Chinese Journal of Antituberculosis. 2011, 33(1): 21-24.

Abstract ( 1455 )

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Objective To understand the diagnosis and treatment condition of pulmonary tuberculosis (PTB) patients registered at urban TB dispensaries, in order to provide policy recommendations for quality improvement of TB services. Methods A total of 246 PTB patients registered in urban TB dispensaries of four prefectures were investigated by structured questionnaires. Results The average interval from onset of the disease to first visit to doctor was 12 days. The major reason for patients’ delay was that patients did not care for the symptoms. 67.5% of TB patients experienced diagnosis delay. In terms of diagnosis delay, there were statistically significant differences between groups with different marital status and choices of health facilities in their first medical visits. Conclusion We should conduct mass health education to improve TB awareness and reduce patient’s delay. In order to reduce the diagnosis delay, we should also encourage TB suspects to seek care at TB dispensaries, or general hospitals of district level and above, or special TB hospitals in their first medical visit after onset of disease.

Analysis of tuberculosis preventive therapy implementation among freshmen in universities of Tongzhou district in Beijing

Qi Guanghao,Ma Xiemin,Zhou Changshan,Li Changjiang,Liu Fei

Chinese Journal of Antituberculosis. 2011, 33(1): 25-27.

Abstract ( 1735 )

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Objective To investigate the implementation status of tuberculosis preventive therapy among freshmen in universities, and find the existing problems, and analyze the reasons. Methods All the freshmen in eight universities of Tongzhou District received Tuberculin test, among them, students with an induration of 15 mm or more, or with blister, pimple, double-loop, lymphatitis, necrosis are target population for preventive therapy. Patients were enrolled on a voluntary basis after health education. Statistics analysis was made to the participating situation of the preventive therapy, the regularity of medicine taken. Results The completion rate of TST was 76.9%. The signing rate of informed consent for preventive therapy was 79.0%. 15.5% agreed to enroll in preventive therapy. The liver function tests was normal for 95.9％ of participants during whole treatment course. The total regular treatment rate was 97.6%. Conclusion The TST completion rate among university freshmen was not high, the condition of preventive therapy participation was not satisfied, and the situation of liver function tests and regular treatment was good. In preventive therapy, we should strengthen leadership commitment, increase awareness and strengthen the monitoring and management of disease prevention.

Analysis of referral and tracing condition of pulmonary tuberculosis reported by non-TB institutions from internet-based infectious disease reporting system from 2005 to 2008 in Xinjiang

Xue Feng,Li Yuehua,Yipaer·aihaiti

Chinese Journal of Antituberculosis. 2011, 33(1): 28-31.

Abstract ( 1592 )

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Objective To analyze referral and tracing condition of pulmonary tuberculosis (PTB)reported by non-TB institutions from internet-based infectious disease reporting system from 2005 to 2008 in Xinjiang in order to explore the measures to improve case detection. Methods TB control monthly report of Xinjiang from 2005 to 2008 were collected and analyzed. Results The referral in place rate and tracing in place rate of patients reported by internet-based infectious disease reporting system were 32.5% and 54.1% respectively, and the overall in place rate was 63.4%. Among patients tracing in place, 69.2% were confirmed as pulmonary tuberculosis. The referral in place rate for smear positive, negative, and default were 41.9%, 26.0% and 34.3% respectively. PTB confirmation rate among tracing in place patients of smear positive, negative, and default patients reported by this reporting system were 96.0%, 80.8% and 53.8% respectively. Conclusion Non-TB institutions play an important role in TB case detection. In order to improve PTB case detection, we should establish standardized working mechanism in TB register, report and referral and improve smear checking rate. These will finally contribute to case detection improvement.

Analysis of Global Fund Project effect in treatment and management of pulmonary tuberculosis patients among floating population

Zhong Da，Zhang Yuhua，Fu Yanyong，Chen Shengyu，Qin Li，Zhang Zhi，Yang Xu

Chinese Journal of Antituberculosis. 2011, 33(1): 33-35.

Abstract ( 1459 )

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Objective To evaluate the effect of Global Fund Project in treatment and management of pulmonary tuberculosis (PTB) patients among floating population and provide relevant scientific evidence for tuberculosis control strategy development. Methods Treatment and management information of PTB patients of floating population before and after project implementation were collected and analyzed. Results Before and after project implementation, the system management rate, cure rate of new smear positive, cure rate of retreatment smear positive, treatment completion rate of smear negative increased from 63.6% to 84.7%, 64.0% to 89.4%, 56.3% to 78.9%, 64.6% to 82.9% respectively. Except retreatment cure rate, all rates are statistically improved. Conclusion The Global Fund Project play a positive role in tuberculosis case treatment and management, and lay a good foundation for tuberculosis control strategy development in floating population.

Investigation of latent Mycobacterium tuberculosisinfection in tuberculosis professionals and close contacts of TB patients

Zhang Zhongshun,Lou Hai,Xiao Heping

Chinese Journal of Antituberculosis. 2011, 33(1): 36-40.

Abstract ( 1707 )

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Objective To study latentMycobacterium tuberculosisinfection in TB professionals and those who in close contact with TB patients by γ-interferon secretory reaction. Methods All subjects were divided into three groups: Group 1 included 128 TB professionals (60 physicians and 68 nurses). Group 2 included 60 household close contacts of TB patients. Group 3 included 40 subjects without close contact with TB patients. T-SPOT.TB (Oxford Immunotec, Abingdon, UK) was used to assay the immune reactions of peripheral blood lymphocytes to two special secreted proteins ofMycobacterium tuberculosis : 6-kDa early secreted antigenic target (ESAT-6) and culture filtrate protein 10 (CFP-10). Results Positive rate in TB professionals, household close contacts and those who have no close contact with TB patients were 14.8% (19/128), 23.3% (14/60) and 5.0% (2/40) respectively. The positive rate of group 2 was significantly higher than that of group 3 (χ²=6.002, P=0.023). The positive rate of group 1 was higher than that of group 2 although the difference was not statistically significant. The positive rate of senior TB professionals who have worked for at least 3 years was 27.12% (16/59), this was significantly higher than that (5.0%, 2/40 ) of group 3［χ²=7.840,P=0.007;RR=5.42 (95%CI=1.32～22.31)］. Conclusion TB professionals and those who in close contact with TB patients are at higher risk of latentMycobacterium tuberculosisinfection and it has positive correlation with contact duration.

Detection of ofloxacin resistance in M.tuberculosisby phage-amplified biologically assay

Wang Qing,Xu Dongfang

Chinese Journal of Antituberculosis. 2011, 33(1): 43-46.

Abstract ( 1696 )

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Objective To develop a rapid method to detect Mycobacterium tuberculosis（MTB）resistance to ofloxacin by phage-amplified biologically (PhaB) assay, and to evaluate its clinical value. Methods Compared with absolute concentration method, 205 MTB clinical isolates were detected their resistance to ofloxacin. If the Results from these two Methods are inconsistent, the ofloxacin susceptibility of this strain would be was determined by the proportion method. Results As the Results from the absolute concentration method was considered as the golden standard, the sensitivity, specificity, positive and negative predictive value (PPV and NPV) as well as accuracy of PhaB assay for the ofloxacin susceptibility was 95.4%, 93.2%, 91.2%, 96.5% and 94.1%, respectively. The Results from 12 isolates were different between PhaB assay and the absolute concentration method, in which the Results from PhaB assay in 9 isolates were identical with that from the proportion method. Conclusions The Results of ofloxacin susceptibility from PhaB assay had higher concordance with that from the absolute concentration method. PhaB assay can be used for rapid screening of drug susceptibility in MTB.

Evaluation of loop-mediated isothermal amplification (LAMP) in rapid detection of Mycobacterium tuberculosis

Dai Guangming,Cao Yicheng,Chen Xun,Du Zhengping,Huang Shuhai,Pang Yu,Zhou Yang,Huang Hairong，Zhao Yanlin

Chinese Journal of Antituberculosis. 2011, 33(1): 47-51.

Abstract ( 1700 )

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Objective To evaluate the value of loop-mediated isothermal amplification (LAMP) in rapid detection of Mycobacterium tuberculosis . Methods A set of four LAMP primers were designed for recognizing six distinct regions on the target DNA (gyrB). The DNAs ofM. tuberculosisstrains from Beijing Chest Hospital were extracted,amplified at 65°C for 60 min, and their reaction Results were observed by simple naked eye. Results A total of 79 clinical isolates and standard strains were studied. The sensitivity and specificity of LAMP was 100% and 92%, respectively.  Conclusions LAMP is a rapid and reliable alternative method for diagnosingM. tuberculosisinfection.

The preliminary investigation in the isolation rate of drug-dependent Mycobacterium tuberculosisin Guangzhou

Wu Longzhang,Luo Chunming,Wu Xingyi，Pan Meiyu,Xu Yunyi

Chinese Journal of Antituberculosis. 2011, 33(1): 53-56.

Abstract ( 1570 )

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Objective To investigate the isolation rate of drug-dependent Mycobacterium tuberculosis in Guangzhou, and to provide scientific evidence for the clinical treatment. Methods 3 911 M. tuberculosisstrains isolated and identified were analyzed the dependence on 11 frequently-used drugs (including Rifampin R, Isoniazid H, Streptomycin S, Ethambutol E, Ciprofloxacin C, Levofloxacin Lfx, Amikacin Am, Prothionamide Pto, Moxifloxacin M, Clarithromycin Clr, Dipasic D) using L-J drug susceptibility test. Results Of 3 911 M. tuberculosisisolates, 192 strains isolated from 159 patients had dependence on 10 of 11 drugs, the isolation rate was 4.9% (192/3 911). Among these, the isolation rate of dependence on R was 2.7% (104/3 911), H was 2.4% ( 92/3 911 ), S was 1.0% (38/3 911), C was 0.4% (16/3 911), Lfx was 0.3% (12/3 911), Am was 0.3% ( 10/3 911 ), E was 0.2% (8/3 911), and Pto was 0.1% (5/3 911), both of Mfx and Clr were 0.1% (3/3 911), respectively. Dependence upon Dipasic was not observed. Of 159 patients, 25 were extensively drug-resistant TB (XDR-TB), and 110 were multiple drug-resistant TB (MDR-TB), accounting for 84.9% (135/159) cases of drug-dependent TB. Conclusions The drug-dependence ofM. tuberculosisin Guangzhou was primarily upon R and H, whereas dependence rate upon Mfx and Clr were the lowest. Furthermore, the majority of drug-dependent TB was MDR-TB or XDR-TB.

The clinical significance of sIL-2R、TNF-α、IFN-γ and IL-6 in the serum samples of patients with pulmonary tuberculosis

Li Hong,Tang Shenjie

Chinese Journal of Antituberculosis. 2011, 33(1): 57-60.

Abstract ( 2687 )

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Objective To explore the change and value of sIL-2R, TNF-α, IFN-γ and IL-6 in the serum samples of patients with pulmonary tuberculosis. Method The levels of sIL-2R, TNF-α, IFN-γ and IL-6 were measured using the sandwich ABC-ELISA method in 214 patients with pulmonary tuberculosis. Result The levels of sIL-2R in sera in each group were higher than normal, and increased with lesion scope enlarged, in which the levels of sIL-2R in 3-4 lung field group and 5-6 lung field group were significantly higher than those in 1-2 lung field group(P<0.01). The levels of sIL-2R in the smear-positive group were significantly higher than those in smear-negative group(P<0.01).The levels of TNF-α in sera in 1-2 lung field group and 3-4 lung field group were higher than normal, and decreased with lesion scope enlarged. The levels of TNF-α in 1-2 lung field group were higher than those in 5-6 lung field group, which were normal (P<0.01). The levels of TNF-α in non-cavity group were higher than those in cavity group(P<0.05).The levels of INF-γ in sera in each group were higher than normal, and in 5-6 lung field group were higher than those in 3-4 lung field group(P<0.05). The levels of INF-γ in the smear-positive group were higher than those in smear-negative group (P<0.05). Conclusion The levels of sIL-2R, TNF-α, IFN-γ and IL-6 in the serum samples of different patients with pulmonary tuberculosis were different．These cytokines may be play roles in the pathogenesis of tuberculosis.

Analysis of clinical and misdiagnosis of 11 cases of diffuse panbronchiolitis has been misdiagnosed as tuberculosis

Lv Kangyan; Liu Haoshan; Liu Sang; Mo Yuerong

Chinese Journal of Antituberculosis. 2011, 33(1): 61-65.

Abstract ( 3552 )

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