Table of Content

10 April 2006, Volume 28 Issue 4

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Indicator system to evaluate the performance of case-detection in tuberculosis control

Zhu Liguo¹,Wang Hua,Yu Jingjin,et al.

. 2006, 28(4):  195-198. 

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Objective To establish and evaluate an indicator system in evaluating of case detection in tuberculosis control. Method Focus-group discussion,brainstorming and intent investigation was conducted. Results Ten indicators and four key indicators in evaluating of case detection in tuberculosis control were developed. Conclusion The system provide evidence to check and evaluate the performance of case-detection in tuberculosis control.

The situation and reason analysis of tuberculosis prevention and control in China

Lu Yaoliang¹,Zhu Liguo,Luo Li,et al.

. 2006, 28(4):  199-202. 

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Objective To understand the progress and existing problems in tuberculosis prevention and control. Method To analysis by intent investigation. Results Tuberculosis prevention and control has not met the request both in quality and quantity,and the main reasons are short of funding,human resource,and equipment and less of collaboration between TB dispensary and relevant sectors. Conclusion The tuberculosis prevention and control will be benefit by distributing health resource equally,and establishing and improving the tuberculosis prevention and control network.

The research on laboratory sputum examination in Urumqi in Xinjiang

Liu Hong,Wang Xuejun,Ma Li.

. 2006, 28(4):  203-205. 

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Objective To explore an effective way to improve smear positive tuberculosis(TB) case-detection rate through strengthening laboratory sputum examination in health care facilites. Methods According to various firsthand information of TB control in Urumqi,combine with the data from epidemiological random survey for tuberculosis,the performance of laboratory sputum examination and TB case-finding were analysed. Results Since TB control was conducted in Urumqi from 1996 to 2004,the registration rate of smear positive TB increased from 21.17/100000 to 26.53/100000,the detection rate of sputum smear positive,the sputum examination rate of suspect and extermal quality control have reached targets. Conclusion Laboratory sputum examination should be strengthened in health care facility and the capacity of lab technicians should be enhanced.Active case finding and exploring new diagnosis of Mycobacterium tuberculosis are the important ways how to improve case-detection at early stage.

Survey of awareness of tuberculosis knowledge among general population in Heilongjiang province

Xie Yanguang,Fang Hongxia,Wang Hongyan,et al.

. 2006, 28(4):  206-208. 

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Objective To understand the level of awarness of tuberculosis(TB) knowledge among general population in Heilongjiang province,to evaluate the impact of TB health promotion in Heilongjiang province,to(identify) and solve the existing problems. Methods Multilevel stratified random sampling method was used in sampling in 13 cities in Heilongjiang province and information collected from questionnaire were summarized and analyzed. Results The general awareness in Heilongjiang province was 75.3%.Among 12 546 persons,(10 316) persons(82.2%) had answered half of the questions correctly.The awareness of the knowledge on TB control and prevention,control and prevention policy and correct behavior trend were 80.4%,54.7% and 80.44% respectively.The numbers of persons who had answered half of the questions correctly were 10 942(87.2%),4 699(37.4%),10 689(85.2%),respectively.The level of awareness of TB knowledge was affected by residency(whether urban or rural),local economic development,level of education,occupation,whether having tuberculosis,whether accepting health education on TB in the past. Conclusion Health promotion had positive impact in Heilongjiang province,but there is still potential space for further improvement.Health education should be strengthened in rural area and focused on the certain groups such as farmers,foresters,salesclerks,service workers and the students.

Explore the causes of prior irregular treatment among re-treatment pulmonary TB cases in TB Control Project Areas

Wang Xuejing,Wu Guiying,Duan Mu Hongjin,et al.

. 2006, 28(4):  209-211. 

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Objective To explore the causes of prior irregular treatment among the re-treatment pulmonary tuberculosis(TB) cases. Method Face to face interview was conducted to the re-treatment TB patients with the prior irregular treatment by using the designed questionnaire. Result The first main cause of prior irregular treatment among the re-treatment TB patients was to stop treatment when they felt better,and the second was economic barrier. Conclusion In order to increase the compliance of the patients to the treatment,reduce the occurrence of re-treatment and drug resistant cases,the most effective measure is DOTS,the second is to provide free treatment to TB patients and reduce their economic burden,and the third is to strengthen the health education to TB patients and improve their correct awareness on TB knowledge,especially on TB treatment.

Rapid identification of mycobacterium species by amplification of rpoB gene and reverse dot blot hybridization assay

Fan Bo,Wang Wei,Li Guoli,et al.

. 2006, 28(4):  212-215. 

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Objective To establish a rapid,sensitive and specific method for identification of mycobacterium species through rpoB gene. Method Based on the sequence of rpoB gene,the standard strains of 24 Mycobacteria and 8 nonmycobacteria,37 clinical isolates of mycobacteria were detected by PCRreverse dot blot hybridization assay. Results 360 bp DNA fragments were amplified from all mycobacterial strains tested and were not found in all nonmycobacterial strains besides Hemolytic streptococcus and Corynebacterium pseudodiphtheriticum. 1 pg of M.tuberculosis DNA could be detected by PCR assay.Among 21 oligonucleotide probes,probe-M,fortuitum cross-hybridized with M.marinum,the other probes were specific.The Results of clinical isolates identified by this assay were in agreement with those obtained by conventional methods. Conclusion RpoB-based PCR-reverse dot blot hybridization assay might become a rapid,effective method for identification of mycobacterium species.

Study on promoter structure of HLA susceptive gene DRB1*040101-44 of Pulmonary Tuberculosis Patients in Guangdong Province in China

Xuli,Yang Yingzhou,Tan Weiguo,et al.

. 2006, 28(4):  216-220. 

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Objective To investigate the possible role of HLA in incidence of pulmonary tuberculosis patients in Guangdong in China,we study the promoter structure of HLA susceptive gene DRB1*040101-44. Methods The promoter sequence of HLA susceptive gene DRBl*040101-44 was searched in nucleotide database in NCBI(http://ncbi.nlm.nih.gov/),and according to the conservational nucleotide sequence specific primers was designed to amplify the promoter structure of HLA susceptive gene DRBl*040101-44 by PCR,then the production was reclaimed for PCR direct sequencing;finally the promoter sequences of HLA susceptive gene DRBl*040101-44 in pulmonary tuberculosis patients was compared with normal people and with those sequence published in NCBI. Results The group of pulmonary tuberculosis patients had the same promoter sequences of HLA susceptive gene DRBl*040101-44 as control group.But it was different with those published in nucleotide database in network,and had 6 point mutations in Y component box: T in position-166 was replaced by A,C in-150 by G,T in-137 by G,C in-121 by G,T in-98 by C,A in-73 by G.There were no mutations in nucleotide sites from position-93 to-88 in TATA box,from position-130 to-125 in CAAT box and from position-189 to-179 in X box. Conclusion The promoter structure of HLA susceptive gene DRBl*040101-44 had polymorphism,its nucleotide mutation happened in Y-box,but the polymorphism had no association with development of pulmonary tuberculosis in Guangdong in China.

Clone,expression in E.coli and efficiency measurement of recombinant CFP10ESAT6 fusion proteins from Mycobacterium turberculosis

Du Weixin,Chen Baowen,Shen Xiaobing,et al.

. 2006, 28(4):  221-224. 

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Objective The recombinant CFP10-ESAT6 fusion protein coding by the genes located in RD1 regions of genome of Mycobacterium tuberculosis was expressed in E.coli,and its skin reactions were detected inguinea pigs. Methods A genomic DNA of Mycobacterium tuberculosis H37Rv strain was used as template,amplified the cfp10-esat6 fusion gene by Overlap PCR.PCR production was cloned into pET-30a plasmid.The recombinant E.coli was induced by IPTG.The supernatant liquid of centrifugal ultrasonic bacteria was purified through anion column.Skin reactions of fusion protein were tested in guinea pigs infected with M.tuberculosis. Results The fusion proteins was expressed as soluble state in E.coli.The content of recombinant CFP10-ESAT6 fusion proteins was more than 30% of total proteins,and more than 95% purity was acquired through anion column.The fusion proteins could induce DTH in guinea pigs infected with M.tuberculosis and 2.5 μg/ml recombinant proteins induced the same DTH as PPD（50 IU/ml）. Conclusion The recombinant CFP10-ESAT6 fusion proteins is hopeful to become new skin test reagent in the differential diagnosis of tuberculosis.

The analysis of the impact of tuberculosis control for new smear-positive pulmonary tuberculosis for 17 year in Shijingshan District in Beijing

Han Qi

. 2006, 28(4):  225-226. 

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Objective To evaluate the outcomes of new smear positive pulmonary tuberculosis patients under extensively directly observed treatment. Methods To summarize and analyze the data of 750 new smear positive pulmonary tuberculosis patients about their chemotherapy regimen,the management administration,sputum smear examination and the treatment outcome. Result During 1985—1989,the traditional 12-month regimen was used,83.7% of patients received DOT,and the cure rate was 84.3% according to cohort analysis.6-month regimen of HRZS was recommended since 1990,more than 95.7% of patients received DOTS,and the cure rate was above 93.2%. Conclusion In urban area,bringing the tuberculosis control into the primary health care,and implementing extensively directly observed treatment were the most effective measures for tuberculosis control.

The investigation of sustainable development of TB control project in Dongguan

Yi Lailong,Peng Jianmei,Hu Chunmei,et al.

. 2006, 28(4):  227-230. 

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Objective To evaluate the effect of TB control project in Dongguan for 13 years and to investigate the sustainable development of TB control. Methods The quarterly reports and some other relevant materials from 1992 to 2004 were collected and analyzed. Results Over the past 13 years,35 487 TB suspects were examined,and among of them 5 614 smear-positive TB patients were detected.The notification rate of smear-positive TB was 29.54/100 000 and the notification rate of new smear-positive TB was 25.06/100 000.The cure rate reached 97.9% among new smear-positive TB,and 84.6% among retreated smear-positive TB. Conclusion Conducting TB control project in Dongguan has made great progress during the last 13 years.It has proved that implementing effective project is feasible.The experience is very useful for sustainable development of TB control.

The study of current tuberculosis infection status among the temporary resident students in the simple school in Baoshan District

Cao ming Yang Zhuo Ming,et al.

. 2006, 28(4):  231-234. 

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Objective To investigate the current tuberculosis(TB) infection status among the temporary resident students in the simple school in Baoshan District,and to provide scientific evidence for policy makers to develop policies and measures to control and reduce the incidence of pulmonary TB among this special population. Methods 5 037 students from 4 simple schools in this district were investigated through cluster sampling on age,sex,registered permanent resident,the duration of staying in Shanghai,the proportion of BCG inoculation,vaccinated scar,the TB contact history,the test of Human-PPD(purified protein derivative),chest X-ray,the test of tubercle bacillus in sputum. Results The proportion of child BCG inoculation was 65.3%,the proportion of students with scar was 55.1% and the proportion of positive TB contact history was 2.8%, PPD test with negative result was 71.6%,and with positive result was 28.4%,(advanced positive 6.5%,chest X-ray abnormity 1.1%,3 cases should be followed up clinically and 1 case had been diagnosed as pulmonary TB. Conclusions The TB infection control among temporary resident students in simple school in Baoshan District should be reinforced.

Analysis of the tuberculosis control project in Nanning city

Zhao Yaling¹,Deng Qijun,Ge Lihui,et al.

. 2006, 28(4):  235-237. 

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Objective To analyze the effect of tuberculosis(TB) project jointly conducted by disease control department and infectious disease hospital in Nanning city. Method The data of TB in Nanning from 2002 to 2004 were analyzed. Result With the implementation of the TB control project,the registeration rate of smear positive TB was increased from 15.60/100 000 in 2002 to 39.65/100 000 in 2004 and the cure rate of new smear positive TB was increased from 40.6% in 2002 to 94.5% in 2003. Conclusion The administration mode of TB control project in Nanning was successful.

Clinical observation on the clinical efficacy and safety of the regimen of ’Pasiniazid Rifapentine Amikacin and Levofloxcin’ for lesions of the liver caused by tuberculosis

Lin Zhilai,Shi Zhenhui,Weng Heng,et al.

. 2006, 28(4):  238-240. 

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Objective To observe the clinical efficacy and safety of the treatment regimen of’Pasiniazid, Rifapentine, Amikacin and Levofloxcin’ for lesions of the liver caused by tuberculosis. Methods By random group-matching,100 cases with lesions of the liver caused by tuberculosis were divided into the treatment group(50 cases) and control group(50 cases).The chemotherapy regimen adopted: the treatment group used Pasiniazid(D),Rifapentine(L),Amikacin(K) and Levofloxcin(V) while the control group used Isoniazid(H), Rifampicin(R), Amikacin(K), and Pyrazinamide(Z).The course of treatment was 9 months for both groups. Results Ninty-six cases completed the treatment with 49 cases in the treatment group and 47 cases in the control group.In the treatment group,the sputum negative conversion rate by the end of the 9^th month was 95.0% in smear and 96.4% in culture;while in the control group,the rates were 94.4% and 95.7% respectively.At the end of the treatment,X-rays evidently improved the assimilation of focuses up to 98.0% in the treatment group and 97.9% in the control group;the ratios of cavity closure reached respectively 61.5% and 57.1%;there was no significantdifference in the treatment outcome in the two groups(P＞0.05).The re-checking in 2 years showed that the positive conversion rate was 3.7% in treatment group and 4.5% in control group with no significant different between the two groups.The lesions of the liver was 32.0% in the treatment group and 58.0% in the control group with significant difference in the two groups(P＜0.01). Conclusion The regimen of ’DLKV’ scheme is effective and reliable to cure lesions of the liver caused by tuberculosis and it is easy to expand the application of this regimen in the clinical practice.

A clinical trial of Mycobaeterium Vaccae vaccine combining chemotherapy in treating new pulmonary tuberculosis

Li Hong,Tangshenjie.

. 2006, 28(4):  241-243. 

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Objective To study the efficacy and adverse reaction of Mycobacterium Vaccae vaccine in treating new smear positive tuberculosis(TB). Method 109 new smear positive pulmonary TB patients were randomly allocated into treatment group which received 2 M.Vaccae vaccine +HRZE(S)/4 M.Vaccae vaccine +HR (58cases)and control group which received 2HRZE(S)/4HR(51 cases). Result The sputum negative conversion rate at the second week,the first and second month were 44.8% 62.0%,89.7% in the treatment group and 25.5%,41.2%,76% in the control group respectively;at the second month chest radiography showed the resolution of pulmonary lesions in the treatment group and the control group were 37.9% and 19.6% respectively;with cavity closure rate of 65.5% in the treatment group and 38.7% in the control group;at the 2~(nd) week,the clinical symptoms such as cough,fever,fatigue disappeared at the level of 48.3%,71.4%,59.3% in the treatment group and of 25.5%,50.0%,40.0% in the control group(P＜0.05)respectively;there were no drug adverse reaction in the treatment group;there were no significant difference on the sputum positive conversion rates at the 6^th,12^th and 24^th month after treatment between the treatment group and the control(P＞0.05). Conclusion M.Vaccae vaccine combining chemotherapy shortens the time of sputum negative conversion,the resolution of pulmonary lesions and the improvement of clinic symptoms.The drug adverse reaction is slight.It is a fairly good immune drug for TB treatment and is worth to be recommended.

Observation of treatment outcome of Rifapentine on 80 bacteria positive tuberculosis cases resistant to Rifampin

Zhaolili,Mahaizhan,et al.

. 2006, 28(4):  244-246. 

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Objective To observe and evaluate the drug susceptibility of Rifapentine on Rifampin resistant tuberculous(TB) bacterium and its treatment outcome on pulmonary TB with Rifampin resistance. Methods Eighty cases of pulmonary TB with Rifampin resistance were randomly divided into group A and group B.Different treatment regimens as DEZThT and DEZThP were applied in group A(40 cases) and group B(40 cases) for 12 months respectively.The sputum negative conversion,the absorption of lung foci,and side effects or poor clinical response of patients were observed. Result The sputum negative conversion rates were 55.0% in group A and 28.2% in group B after twelve months treatment respectively with significant difference((P＜ 0.05).Furthermore,the absorption rates of lung foci determined by X-ray were 57.5% in group A and 33.3% in group B with significant difference((P＜ 0.05). Conclusion Our Results demonst rate that Rifapentine is still effective in the treatment of Rifampin resistant pulmonary TB in clinical practice.

Analysis on factors influencing the treatment outcome of tuberculosis patients.

Liu Fengren¹,Ye Linxiang,LiangXiangsheng,et al.

. 2006, 28(4):  247-249. 

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Objective To analyze the factors influencing on the treatment outcome of pulmonary tuberculosis(TB) patients and to provide evidence for TB prevention and control. Methods The data of 4 747 cases in Lianyuan Disease Control and Prevention Station from 1993 to 2001 were collected to analyze the factors influencing the treatment outcome of TB patients by using Chi square test and unconditional Logistic regression analysis. Results Single factor analysis showed that the factors related with the treatment outcome included age,sex,relevant clinical symptoms,combining other kinds of TB,delaying to visit doctors,intaking medicines before the treatment,cavity,non-supervised treatment during the whole treatment course,sputum positive after the treatment for 2 month and treatment without streptomycin for new smear-positive patients.Unconditional Logistic Regression analysis indicated that favorable factors influencing treatment outcome of pulmonary TB patients included fatigue and sputum positive result at the initiation of treatment, while the unfavorable factors influencing treatment outcome of pulmonary TB patients included symptoms and signs in the beginning of the treatment such as fever,cavity in the lung, non-supervised treatment during the whole treatment course and thenon-compliance which resulted in sputum positive after 2,3,5 months of treatment. Conclusion It is of great significance for improving TB patients’ prognosis by reducing patients’ delay to visit doctor through health education, increasing the directly supervised treatment during the whole treatment course to increase patients compliance of correct medication.

The impact analysis of World Bank China TB Control Project in Xinyi,Guangdong Province

Su feng,Gu liya,Ye qing.

. 2006, 28(4):  250-252. 

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Objective To evaluate the impact of World Bank China TB Control Project in Xinyi City. Methods The case detection and treatment of pulmonary tuberculosis patients were analyzed according to the tuberculosis report in Xinyi City. Results World Bank China TB Control Project in Xinyi City was launched in November 1994. By December 31,2001,19 403 TB patients or suspects received medical consultation,3 130 active TB patients were detected among whom 2 955 were smear positive TB with 2 645 new smear positive TB and 310 retreatment smear positive TB.The average cure rate in new smear positive TB was 97.2% with an incremental trend from 87.5% to 98.7% in the seven years. Conclusion Satisfactory effect has been achieved by World Bank China TB Control Project in Xinyi City.

Analysis of the result of survey on the incidence of pulmonary tuberculosis in a prison in Shenzhen

Zhao Meigui¹,Xu Dongying,Huang Changhua,et al.

. 2006, 28(4):  253-255. 

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Objective To investigate the incidence of pulmonary Tuberculosis in a prison. Methods (4 228) prisoners in a prison in Shenzhen was investigated.The micro chest X-ray was used to screen the patients,and for those with shadow suggesting TB in lung,X-ray and 3-time sputum smear were conducted. Result 92 cases had abnormal shadow in the lung.By consultation,34 cases(37.0%) were diagnosed as steady focus and 50 cases(54.3%) as active focus(6 cases were diagnosed as new smear positive pulmonary Tuberculosis),8 cases were diagnosed as infectious TB.44 cases were sputum smear negative TB.,among whom 11 cases(25%)had history of pulmonary Tuberculosis before being enrolled into the prison;all the 6 new smear positive cases had symptoms and 17(38.6%) out of the 44 smear negative cases had symptom.Their active focus,clinical symptom and final diagnosis mostly happened in the two periods: from two to six month and six to twelve month after prisoners enrolled into prison. Conclusion Prevalence of pulmonary tuberculosis among prisoners was markedly higher than the community,their symptom were atypical and diagnosis of pulmonary tuberculosis was often delayed.