Table of Content

10 January 2008, Volume 30 Issue 1

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Knowledge and behavior about tuberculosis(TB) among village medical workers in Jiangsu province

Xu Weiguo¹,Chen Bin²,Chen Xiaoxiao²

. 2008, 30(1):  1-3. 

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Objective To investigate the knowledge and behavior about TB control among the village doctors in Jiangsu Province.Methods Questionnaire survey was conducted among 77 village doctors in 8 sample countries which were selected by random.Results Study showed 79.2% village doctors would consider TB when a patient coughed three weeks above.59.7% knew notify and cure in time for control tuberculosis was more effectively.54.5% knew the policy of free medcines,23.4% knew how long there were no infective if the patients treatmented regularly,while using DOTS was difficult for 60.4% village doctors.Conclusions Foundment knowledges of TB were well knew among the village doctors.However,there were still some shortcomings regarding transfer and supervise patients,.The village doctors should be further strengthen at training in order to advance their professional ability for TB control.

Network information technology used in the family supervision treatment of tuberculosis

Qiu Zhihong,Sun Dai,Zhang Sichao,et al

. 2008, 30(1):  4-6. 

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Objective To explore the function of national tuberculosis management information system to elevate the regular treatment rate and successful treatment rate.Methods To provide free diagnosis and treatment for pulmonary tuberculosis.And carry out the family supervision treatment of tuberculosis.Those patients’ information such as case notes,sputum examination,medicine taking logged into the tuberculosis management system by the staff of institute for tuberculosis control.The community physician supervised the treatment for the local tuberculosis patients according to the system information.Come the publicity to the patients who have delayed to attend the clinic for more than three days,urge them to attend the staff of institute for tuberculosis control.Results The regular treatment rate and successful treatment rate were both increasing 10%.Conclusions We can decrease the discontinuation rate, increase the regular treatment rate and the successful treatment rate by using the national tuberculosis management system.

Study on the reason of affecting the smear negative result at the end of 2^nd month of treatment of new smear positive pulmonary tuberculosis patients

Xian Cuiping,Chen Xiaohua,Xu Zhuowei,et al.

. 2008, 30(1):  7-10. 

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Objective To study on the reason of affecting the smear negative result at the end of 2^nd month of treatment of new smear positive pulmonary tuberculosis patients of tuberculosis control,so as to improve the treatment for the new smear positive pulmonary tuberculosis patients.Methods Based on the patient’s phlegm bacterium volume,focus scope,with or without cavities in lungs and whether have other complication(e.g diabetes and drug resistance situation,analysis the influence factors on the smear negative result at the end of 2^nd month of treatment on the new smear positive pulmonary tuberculosis patients. Results When phlegm bacterium volume are in the level of 3 times smear positive,2 times smear positive;one time smear positive and smear negative pei+,the clearance rate are 66.7%、81.2%、92.5% and 95.7% at the end of 2^nd month treatment respectively.Within 3 time smear positive,when phlegm bacterium volume of the specimen are in the level of 4+、3+、2+、1+,the clearance rate are 51.0%、60.5%、66.2% and 81.2% respectively.Clearance rate at the 2^nd month treatment of single drug resistance is 87.2%.Clearance rate at the 2^nd month treatment of two drugs resistance,three drugs resistance and four drugs resistance are 82.8%,74.3% and 70.6% respectively.Clearance rate at the 2^nd month treatment of multi drug resistance is 73.3%.When focus scope within 16 pulmonary field,the clearance rate are 93.6%,88.7%,77.9% 65.1%, 62.4% and 68% respectively.Those cases without cavities the clearance rate at the end of 2^nd month of the treatment can reach 87.6%.Single cavities cases the clearance rate can reach 77.4%.The multi cavities cases the clearance rate is only 47.6%.In the case of pulmonary,the clearance rate is 83.3% at the end of 2^nd month of the treatment,while pulmonary combined with diabetes the clearance rate is only 63.5%.We perform regression analysis on the above mentioned affecting factors,there is statistic meaning on the difference（smear negative and non-smear negative group） of variables of the patient’s phlegm bacterium volume,drug resistance situation,with or without cavities in lungs and whether have other complication（e.g diabetes）.The above mentioned 4 factors are independent reasons of affecting smear negative result at the end of 2^nd month.Conclusions Patient’s phlegm bacterium volume,drug resistance situation,with or without cavities in lungs and whether have other complication（e.g diabetes） are all the factors to affect the clearance result at the end of 2^nd month of treatment on the new smear positive pulmonary tuberculosis patients.It is also important to improve the register control on the new smear positive pulmonary tuberculosis patients,the health education need to be enhanced on the tuberculosis control,define the correct timing for the phlegm checking s also a important measure to improve the clearance rate at the end of 2^nd month of the treatment.

Hepatitis resulted from antituberculous drugs of 2H₃R₃E₃Z₃/4H₃R₃ and its impaction on the effect of antituberculosis

Li Shuangchu,He Bingsheng,Dai Xiuping,et al.

. 2008, 30(1):  11-14. 

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Objective To observe the occurrence of the hepatitis resulted from antituberculous drugs and it’s impaction on the effect of antituberculosis.Methods The initial treatment smear-positive cases with normal liver function were treated with 2H₃R₃E₃Z₃/4H₃R₃ and reexamined liver function one time every month.The cases with the raise of ALT during the course of antituberculosis were reexamined liver function one time every week,The effect was assessed after they had completed their antituberculosis treatment.Results 1.The occurrence of the hepatitis resulted from antituberculous drugs was 23.1%,and which of the cases with primary liver diseases was 66.3%;2.Among the cases whose ALT in the first reexamination was 50 U/L～100 U/L,and who had neither hepatitis symptoms nor the raise of bilirubin,the 51.2% of them belonged to temporary raise of ALT;3.73.2% of the hepatitis resulted from antituberculous drugs occurred during the first 2 months,and 26.8% of which occurred during the late 4 months;4.There was no cases died of the hepatitis resulted from antituberculous drugs,the average recovering time of all the hepatitis resulted from antituberculous drugs was 2.3 weeks,and which of the cases with primary liver diseases was 3.9 weeks,which of the cases without primary liver diseases was 1.8 weeks;5.The total cure rate of pulmonary tuberculosis was 94.6%,which of the cases without the hepatitis resulted from antituberculous drugs was 97.0%,which of the cases with the hepatitis resulted from antituberculous drugs was 86.6%,and which of the cases with primary liver diseases was 78.6%.Conclusions 1.The hepatitis resulted from antituberculous drugs is an important impacting factor on the treatment effect of pulmonary tuberculosis,especial on which of the cases with primary liver diseases,such as the patients with HBsAg（+）,and 2H₃R₃E₃Z₃/4H₃R₃ should not be widely used in the patients who have primary liver diseases;2、Among the cases whose ALT in the first reexamination is 50 U/L～100 U/L,and who have neither hepatitis symptoms nor the raise of bilirubin,the 51.2% of them belong to temporary raise of ALT,and need not stop taking antituberculous drugs,but close observation of symptoms and regular reexamination of liver function is necessary;3.The hepatitis resulted from antituberculous drugs may occur during the whole course of antituberculosis treatment,but mainly during the enhanced antituberculosis period,so the treatment of protecting liver and the surveillance of liver function should be enhanced during the enhanced antituberculosis period.

Epidemiological analysis of bacteriological positive pulmonary tuberculosis at Chinese Frontier Ports

Qu Jiangwen^1,2,Xu Yihua¹,Wei Sheng¹,et al

. 2008, 30(1):  15-18. 

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Objective Through epidemiological study of bacteriological positive pulmonary tuberculosis cases at Chinese frontier ports,we aim to master the spread conditions and determine important population to take derect measures of prevention and control for bacteriological positive pulmonary tuberculosis prevalence.Methods We analyze bacteriological positive pulmonary tuberculosis’ data from all Inspection and Quarantine authorities in China and use epidemiological study to describe the recorded data.Results The highest bacteriological positive pulmonary tuberculosis rate ports are Heilongjiang port(76.27/10000)、Guizhou port(26.32/10000)、Zhuhai port(15.29/10000)、Shanxi port(14.83/10000)、Anhui port(14.52/10000).The majority of bacteriological positive pulmonary tuberculosis cases outside border are from East Asia.Most of the bacteriological positive pulmonary tuberculosis cases are middle-young aged men.Entry-exit persons within the border that bacteriological positive pulmonary tuberculosis detection rate is higher are drivers,people who marry with foreigners,businessmen,sailers and entry-exit persons outside border are sailers,service workers,businessmen.People within the border bacteriological positive pulmonary tuberculosis detection rate(6.00/10000) is much higher than that of people outside borders(2.00/10000).Conclusions We need to strengthen the surveillance of the high risk population and educate the population about the potential spread and information related to bacteriological positive pulmonary tuberculosis,in order to effectively prevent the spreading of pulmonary tuberculosis through these frontier ports.

Study on the TOPSIS method for the comprehensive evaluation about tuberculosis control of all counties in Zhejiang province

Chen Songhua,Wang Xiaomeng

. 2008, 30(1):  19-22. 

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Objective To explore the indices and method for the comprehensive evaluation about tuberculosis control of all counties in Zhejiang province.Methods A comprehensive evaluation about tuberculosis countrol in 2005 using TOPSIS method.Results According to the TOPSIS method,get a comprehensive evaluation that the most excellent three counties were N62,N56,N68,while the worst three counties were N16,N71,N28,matching the Objective and actual work. Conclusions TOPSIS method is a relative accurate and practical method for comprehensive evaluation.It is more Objective than one index sign evaluation,deserve to proceed the study the application in tuberculosis control work.

Prevalent situation of prevention and therapy for tuberculosis and sustainable control strategies in Shanxi province

Guo Liujia¹,Xi Zhaoyan,Zhang Tianhua.

. 2008, 30(1):  23-25. 

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Objective To investigate the prevalent situation of prevention and therapy for TB in Shaanxi province,constitute sustainable control and development strategies for TB.Methods With the combination of the field investigation and analysis for TB,the strategies of control for TB were drafted and implemented. Results After the 4 years’ practices of government interventing,using new projects,enhaning management and implementing programs,the whole province coverage of rate of Directly Observed Treatment Course(DOTS) achieved 100%.With the government intervention,importing project,enhancement management and implementing program,the DOTS of Shaanxi province took the county,the district and the township as unit.There were 81122 activity pulmonary tuberculosis cases,37475 of 81122 cases were tubercle bacillus infected,while 25134 of 37475 cases were infected newly,so the rate of patients who were confirmed to be positive achieved and surpassed 70%.37475 patients accepted free therapy,whose phlegm examines of tuberculosis bacterium were positive.The rate of patients’ transformation from positive to negative achieved 87.8% though the therapy about two months,there were 20140 patients who were cured.The cure rate was 85.0%.Conclusions The basic strategies of putting the sustainable control development of tuberculosis into practice were implementing administrative guarantees,enhancing management of technical control,importing project and carrying out the funds safeguard.

Analysis on case and treatment outcome of smear positive pulmonary tuberculosis in Haidian district(1998—2006)

Yang Huiyin,Liu Yuqing

. 2008, 30(1):  26-29. 

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Objective To analyze case and treatment outcome of smear positive tuberculosis in haidian district in 1998—2006.Methods To find and register case of initial treatment and retreatment of smear-positive pulmonary tuberculosis from 1998 to 2006.Results Smear positive cases were 603 in 1998—2006.New registration rate of smear positive cases was raised from 2.19/100000 in 1998 to 3.56/100000 in 2006.Initial treatment of smear positive cases were 537.Retreatment of smear positive cases were 66.The rate of male and female was 2.0:1 in initial treatment.Ages were mostly 1535.Average cure rate of initial and retreatment were 85.1% and 75.8% respectively.Conclusions Government promises and carrying out seriously DOTS tactic are key of prevention and cure TB.They procured definite achievement in prevention and cure of TB.To find smear positive tuberculosis and ameliorate supervisory measure and heighten new registration rate and cure rate are key task in future work.

Analysis of first round EQA results for DST of MTB in Zhejiang province

Liu Zhengwei,He Haibo

. 2008, 30(1):  30-32. 

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Objective To organize the municipal TB reference labs in ZheJiang province to be proficiency test for drug susceptibility testing(DST) of MTB,and perfect the external quality assurance(EQA) standard of DST through analyze and evaluate the testing results.Methods We adopted the proportinal method for this proficiency testing of DST that recommended by WHO.Results 10 labs report their Results timely in whole 12 labs,and the general accordance rate about INH,RFP,SM,EMB was 92.0%,96.7%,83.3%,90.7%,respectively.Conclusions The general levels for DST in zhejiang province has reached the WHO’s requirement.But some labs must be strengthen their testing ability for DST.

Clinical value of TB-SA antibody in diagnosis of tuberculosis

Wang Haiying,Yu Chunbao,Wang Yan,et al.

. 2008, 30(1):  33-36. 

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Objective To evaluate the value of TB-SA(Tuberculosis-Specific Antigen) test in the diagnosis of tuberculosis.Methods 230 active tuberculosis patients(60 bacteriological-positive pulmonary patients,131 bacteriological-negative pulmonary patients,39 extra-pulmonary patients) and 96 non-tuberculosis respiratory system disease patients were recruited from May 2004 to November 2004 in Shandong Provincial Chest Hospital,and 41 healthy controls were from Shandong University,all specimens including sputum,pleural effussion,seroperitoneum, cerebrospinal fluid were submitted for Mycobacterium tuberculosis smear,culture,sera specimens from 367 cases were studied for TB-SA antibody by ELISA method.Results The total sensitivity of TB-SA test by ELISA serology method with sera from active tuberculosis patients was 67.8%,the sensitivities of subgroup of those with active pulmonary tuberculosis patients and extrapulmonary tuberculosis patients were 67.6% and 59.0%(P>0.05),respectively; the total specificity was 76.6%,the specificities of TB-SA test with sera from the no-tuberculosis respiratory system disease patients and healthy controls were 72.9% and 85.4%,respectively.Conclusions The TB-SA test was a kind of rapid,simple,relatively sensitive and specific method for diagnosis tuberculosis,especially in bacteriological-negative pulmonary tuberculosis,extra-pulmonary and childhood tuberculosis patients to aid in clinical decision making,which were hard to obtain specimens.

The research of the relationship between Km gene mutation and the drug-resistance of M.tuberculosis

Li Hongmin,Liang Jianqin,Wang Wei,et al.

. 2008, 30(1):  37-39. 

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Objective To study the relationship between Km gene mutation and the drug-resistant M.tuberculosis.Methods 127 M.tuberculosis strains isolated from clinical sputum specimens were analyzed by traditional drug susceptibility tests and PCR-SSCP to be compared with their kanamycin drug-resistance and Km gene mutation.Results The rate of drug susceptibility tests was 35.4%(45/127).The electrophoresis profiles of 16S rDNA PCR-SSCP indicated that the 127 M.tuberculosis strains were according to M.TB standard strain.12 of the 45 kanamycin drug-resistant strains(26.6%) displayed abnormal in PCR-SSCP profiles.Conclusions In some degree,the reason why a certain M.tuberculosis strains indicate resistance to some second-line kanamycin drugs is because of the Km gene mutation of them.

Feasibility study on rapid identification of Mycobacterium tuberculosis complex and non-tuberculosis mycobacterium using BACTEC MGIT 960 system

Chen Xiaorong¹,Zhang Xia1,Shi Xudong1,et al.

. 2008, 30(1):  40-42. 

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Objective A rapid method for identificating of M.tuberculosis complex(MTBC) and non-tuberculosis mycobacterium(NTM) were studied by adding ρ-Nitro benzoic Acid(PNB) into the Mycobacter Growth Indicator Tube(MGIT) in BACTEC MGIT 960 system.Methods Five strains were tested PNB inhibition concentration in vitro by MGIT.Results To compare with the method of L？wenstein-Jensen(L-J),a criterion of MGIT PNB 300 ug/ml was used to test the 111 clinical strains,the overall agreement rate was 90.09% compared with L-J.The average reporting time of PNB MIGT was 7.72 days,which was shorter and statistically significant difference in compared with the L-J method(P<0.001).Conclusions The PNB MGIT assay can be considered as a rapid,accurate and practical method for the identification of MTB and NTM.

Research on the evaluation of AFB-EQA models for diagnosis of tuberculosis

Yang Xinyu,Ding Beichuan,Wang Sumin

. 2008, 30(1):  43-46. 

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Objective To comprehend the purpose of current AFB-EQA mode deeply for improving the quality of the microscopy examination for TB control.Methods The datum of current EQA mode and original mode were compared,and analyzed the effects of the Results to improve the quality of AFB.Results The consistency positive rate from original mode was 97.1%(578/595),the consistency negative rate from original mode was 99.1%(1135/1145);from current EQA mode,they were 89.6%(225/251) for consistency positive rate and 98.7%(1067/1081) for consistency negative rate.Comparing with the datum of original EQA mode,more information were obtained from the datum of current AFB-EQA mode;current information can inflect truly the status of the operations for AFB microscopy daily;the evaluating reports of current AFB-EQA can be used for improving on the problems of AFB examinations.Conclusions The current AFB-EQA mode is feasible,the Results of EQA are important for the evaluations of AFB to improve quality of AFB operating.

CT diagnosis of adrenal tuberculosis

Xu Jinping,He Wei,Lv Yan,et al.

. 2008, 30(1):  47-49. 

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Objective To evaluate CT findings of adrenal tuberculosis and study its imaging manifestation.Methods CT scans in 21 cases with adrenal tuberculosis with retrospectively studied.All patients were diagnosed clinically.Results CT scans revealed two different morphological manifestations depending on disease phase:Enlarged adrenals including some low density areas with ring enhancement;Adrenal tuberculosis led to atrophy and calcification of adrenal gland.Conclusions When CT finds these manifestations of adrenal above,moreover,the tuberculosis is present in other organizations,diagnose of adrenal tuberculosis can be suggested.