Table of Content

10 January 2013, Volume 35 Issue 1

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Enhance the basic research and its combination with the prevention and control of tuberculosis

XIA Hui，ZHAO Yan-lin

Chinese Journal of Antituberculosis. 2013, 35(1):  6-7. 

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Study on the correlation between the gene polymorphisms of transforming growth factor beta-1 with tuberculosis in the Han population in Shenzhen

SONG Ying-jian，WANG Zheng，ZHANG Guo-liang，LI Wei，ZHANG Ming-xia，CHEN Xin-chun，YANG Lin

Chinese Journal of Antituberculosis. 2013, 35(1):  8-12. 

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Objective  To explore the single nucleotide polymorphisms（SNP）of rs4803455 from TGFβ1 gene in the Han population in Shenzhen, and study the correlation between its gene polymorphisms and different clinical manifestations of tuberculosis (TB).   Methods  The allele genotypes of TGFβ1（rs4803455）in 373 TB patients (TB group) and 350 healthy controls (control group) were detected by using the real-time fluorescent PCR method based on TaqMan probe technology and performed stratified analyses. Then we observed the difference of allele frequency between in pulmonary TB patients (pulmonary TB group) and in the patients with tuberculous pleurisy (tuberculous pleurisy group), all of which were confirmed by bacteriological and pathological examination.    Results The frequencies of allele C/A in the genetic locus rs4803455 were as follow: allele A and allele C in TB group were 31.8%（237/746）and 68.2%（509/746）respectively, and in control group were 40.6%（284/700）and 59.4%（416/700）respectively. There were statistical differences between two groups (P=0.000,  χ²=12.139，OR=1.466, 95% CI=1.182-1.819). There were not significant differences between the population aged ≤25 years of two groups (P=0.094,  χ²=2.807, OR=1.381, 95% CI=0.946-2.015): allele A and allele C in TB group with 121 cases were 33.5%（81/242）and 66.5%（161/242）respectively, and in control group with 111 people were 41.0%（91/222）and 59.0%（131/222）respectively. There were significant differences between the population aged >25 years of two groups (P=0.002,  χ²=9.511,  OR=1.511, 95% CI=1.162-1.965): allele A and allele C in TB group with 252 cases were 31.0%（156/504）and 69.0%（348/504）, and in control group with 239 people were 40.4%（193/478） and 59.6%（285/478）allele A and allele C in pulmonary TB group with 111 cases were 32.4%（72/222） and 67.6%（150/222）respectively, in tuberculous pleurisy group with 57 cases were 21.1%（24/114） and 78.9%（90/114）respectively, and in control group with 350 people were 40.6%（284/700）and 59.4%（416/700）respectively,there were significant differences between pulmonary TB group or tuberculous pleurisy group and control group (P<0.05; OR value were 1.422, 2.560; 95%CI were 1.034-1.957, 1.592-4.116).The frequency of allele C in tuberculous pleurisy group  (78.9%, 90/114) was higher than that in pulmonary TB group（67.6%, 150/222）.   Conclusion  The gene polymorphisms of TGFβ1 (rs4803455) may be associated with TB, especially tuberculous pleurisy. Allele C may be a risk factor for prediction of TB in particular tuberculous pleurisy, and its prediction in the age of >25 years had greater possibility.

Study on Mycobacteria tuberculosis and rifampin resistance detection of Xpert Mtb/RIF test

ZHANG Zhi-guo, OU Xi-chao, SUN Qian, DU Chun-ying, GAO Tie-jie, ZHAO Yan-lin

Chinese Journal of Antituberculosis. 2013, 35(1):  13-16. 

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Objective  To evaluate the performance of Xpert Mtb/RIF test on detecting tuberculosis and rifampin resistance for patients.   Methods  Recruited 588 initial diagnosis patients, selected sputum samples to do smear, solid culture, traditional proportion method drug susceptibility test and Xpert Mtb/RIF test. Analyze the sensitivity and specificity of Xpert Mtb/RIF method in detecting tuberculosis and refampin resistance.  Results  According to the solid culture result, the sensitivity and specificity of Xpert Mtb/RIF test in detecting tuberculosis are 95.0% (345/363) and 89.6% (147/164). According to the conventional drug susceptibility test result, the sensitivity and specificity in detecting rifampin resistance are 89.1% (41/46) and 96.3% (289/300) respectively.  Conclusion  The Xpert Mtb/RIF test has very high sensitivity and specificity. It has very good application prospects in rapidly detection tuberculosis and rifampin resistance.

Genotyping of Mycobacterium tuberculosis clinical strains isolated Anhui province with variable number tandem repeats

WANG Qing, DONG Hai-yan, BAO Xun-di, ZHAO Xiu-qin, XU Dong-fang, WAN Kang-lin

Chinese Journal of Antituberculosis. 2013, 35(1):  17-21. 

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Objective  To investigate the genotype distribution of Mycobacterium tuberculosis clinical isolates from Anhui province with the multiple-locus variable number tandem repeats analysis (MLVA).  Methods  391 M. tuberculosis clinical isolates randomly selected from Anhui province were cultured in Lowenstein-lensen medium. The bacteria were collected, and then their genome DNAs were extracted. The polymorphism of 15 VNTR locus in the DNA samples was analyzed by PCR respectively. The clustering of genotype was analyzed with the software BioNumerics(Version 5.0). Chi-square test was used for statistical analysis.  Results  The clustering analyses of genotype showed that 391 strains were categorized into 4 gene clusters (genogroup Ⅰ, Ⅱ, Ⅲ and Ⅳ), in which 3.32%（13/391）was belong to genogroup Ⅰ,  3.07%（12/391）was genogroup Ⅱ, 89.00%（348/391） was genogroup Ⅲ, and 4.60%（18/391）was genogroup Ⅳ. The 391 strains were typed to 183 distinct MIRU patterns. 149 isolates were unique, 242 strains were grouped into 34 diferent MIRU clusters, in which the largest cluster was genotype 424343357333544 and included 64 strains．There were obvious polymorphisms of VNTRs in these strains,Mtub21 and MIRU26 were highly discriminative (h=0.591 and 0.527, respectively)， ETR-B, ETR-C, ETR-D and MIRU23 were poorly discriminative (h=0.125, 0.08, 0.124 and 0.137, respectively)．Distribution of genotypes was not significantly associated with the resistance to four drugs (the values of χ² were 0.22, 0.00, 0.01, 0.07 respectively，P>0.05).  Conclusion  M. tuberculosis clinical strains from Anhui province had obvious VNTR polymorphisms. There were at least 4 clusters of VNTR genotypes, and cluster type Ⅲ was predominant. The surveillance on this type of M. tuberculosis needs to be strengthened.

Analysis on bacteriology examination results of epidemiological sampling survey for tuberculosis sites of Henan province in 2010

LI Hui, MA Xiao-guang, SHI Jie, YAN Guo-rui, YANG Hong-yi, ZHAO Yu-ling

Chinese Journal of Antituberculosis. 2013, 35(1):  22-26. 

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Objective  To investigate the epidemiological characteristics of Mycobacterium tuberculosis in Henan province. Methods  According to the inclusion criteria defined by the Guideline for the Fifth National Epidemiological Sampling Survey for Tuberculosis, 36 sites were selected in Henan to represent the tuberculosis prevalence in the province, which included 18 prefectures and 36 counties, 2877 cases with suspected pulmonary tuberculosis symptoms and/or abnormal chest were detected among 49 091 people by chest X-ray examination. Sputum specimens were collected from 2877 cases for smear, culture, strain identification and drug susceptibility test to first and second-line anti-tuberculosis drugs, including INH, RFP, EMB, S, PAS, Km, Ofx, Am and Cm. Results  35 smear-positive cases were detected among 2877 cases, and the smear-positive rate was 1.22%. 45 isolated strains of Mycobacterium tuberculosis from 2875 samples were acquired including 41 Beijing genotype strains(91.11%) and 4 non- Beijing genotype strains, and the culture positive rate was 1.57%(45/2875). The rates of drug resistance and multidrug resistance among pulmonary tuberculosis cases were 28.89%(13/45) and 6.67%(3/45). Conclusion  The Mycobacterium tuberculosis Beijing genotype is dominant in Henan province. Henan province is still a high burden area of drug resistant tuberculosis and needs more effective strategy and measures for tuberculosis control.

The analysis of the granules formed in mycobacterial BACTEC^TM MGIT960-negative culture

ZHAO Li-ping, YU Xia, JIANG Guang-lu, MA Yi-feng, DONG Ling-ling, HUANG Hai-rong

Chinese Journal of Antituberculosis. 2013, 35(1):  27-31. 

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Objective  To investigate the properties and the forming reasons of granules in the BACTEC^TM MGIT960-negative culture from Mycobacterium growth indicator tube (MGIT). Methods  The granules were collected from 31 BACTEC^TM MGIT960-negative culture tubes, and then performed acid-fast bacilli (AFB) examination, BACTEC^TM-MGIT960 culture and Lowenstein-Jensen (LJ) medium culture, respectively. The positive cultures were performed species identification and drug susceptibility tests. M. tuberculosis strain H37Rv (ATCC strain 27294) and 8 clinical isolates acquired from the granules subculture were selected for the inoculation tests. The 8 strains included 2 M. tuberculosis complex (MTC) strains, 3 M. xenopi strains and 3 M. intracellulare strains. The isolates were adjusted to the McFarland no. 1 turbidity standard, which were diluted to 10^-5, 10^-6, 10^-7, 10^-8 suspensions. An aliquot of each preparation was inoculated into the MGIT vials in duplicate. Results  Of 31 granules from BACTEC^TM MGIT960-negative culture tubes, 29 were subculture positive by either MGIT 960 or/and LJ medium, in which 24 granules were AFB smear positive, and 18, 4 and 7 isolates were identified as MTC, M. intracellulare and M. xenopi, respectively. A limited amount of 8 clinical isolates and H37Rv strain were inoculated, granule formation was observed in the MGIT-negative culture inoculated respectively with 10^-6 (granule in 4/6 tube), 10^-7(granule in 5/6 tube), 10^-8 (granule in 6/6 tube) of M. xenopi strains after incubation for 6 weeks. Conclusion  The granules in BACTEC^TM MGIT960-negative culture tubes are more likely to be live mycobacteria. The granule formation in the MGIT960 may be correlated with a low bacterial load in the tested specimens, might also be a species-specific feature of M. xenopi and M. intracellulare.

Mycobacterium tuberculosis subunit vaccine AEC/BC-C02 induced long term antigen-specific cellular immune response in mice

LU Jin-biao, YANG Lei, FU Li-li，CHEN Bao-wen, DU Wei-xin，WANG Guo-zhi, XU Miao

Chinese Journal of Antituberculosis. 2013, 35(1):  32-36. 

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Objective To evaluate dynamically cellular immune response of Mycobacterium tuberculosis subunit vaccine AEC/BC-C02 in mice. Methods Forty-eight female BALB/c mice (6-8 weeks old) were randomly divided into two groups. One group was immunized intramuscularly 3 times with AEC/BC-C02 at an interval of 10 days, and the other with PBS as the control. At 1, 2, 4 and 8 weeks after the last vaccination, spleen lymphocytes were isolated (6 mice per group) to measure the frequency of antigen-specific IFN-γ secreting T cell by ELISPOT. Meanwhile, antigen-specific IFN-γ level was detected by ELISA at 2, 4 and 8 weeks, and lymphoproliferation response was measured by cell counting kit-8 assay at 4 and 8 weeks.   Results (1) At 1, 2, 4 and 8 weeks after the last vaccination, the spot forming cells (SFC) of Ag85B-specific IFN-γ in vaccine group were respectively 168.8±103.5, 205.2±51.0, 206.8±65.3 and 160.0±67.9, and significantly higher than that in PBS group (8.9±6.0, t=3.779, P<0.01; 16.1±18.8, t=8.525, P<0.01; 9.3±4.9, t=7.424, P<0.01 and 7.7±6.6, t=5.473, P<0.01, respectively). ESAT6/CFP10 (EC)-specific IFN-γ SFC in vaccine group were respectively 45.1±18.6, 75.6±39.3, 86.2±50.4 and 54.3±26.3, and significantly higher than that in PBS group(4.5±3.5, t=5.258, P<0.01; 11.7±10.5, t=3.850, P<0.01; 3.8±5.8, t=3.977, P<0.01 and 5.2±4.3, t=4.521, P<0.01, respectively). (2) At 2, 4 and 8 weeks after the last vaccination, IFN-γ release induced by Ag85B peptide pool in vaccine group were (1.27±0.13)ng/ml, (1.76±0.55)ng/ml and (1.44±0.44)ng/ml, respectively, and that induced by EC peptide pool were (0.81±0.33)ng/ml, (0.81±0.69)ng/ml and (0.54±0.29)ng/ml, respectively. The difference between them was statistically significant (t=3.008, P<0.05; t=2.631, P<0.05 and t=10.02, P<0.01, respectively). (3) At 4 and 8 weeks after the last vaccination, stimulation indexes (SI) of spleen lymphocytes induced by Ag85B peptide pool were respectively 1.756±0.339 and 1.936±0.287 in vaccine group and signi-ficantly higher than PBS group (1.287±0.0581, t=3.030, P<0.05 and 1.382±0.114, t=4.387, P<0.01, respectively). SI of spleen lymphocytes induced by EC peptide pool in vaccine group were respectively 1.599±0.154 and 1.581±0.156 and significantly higher than PBS group (1.380±0.126, t=2.540, P<0.05 and 1.314±0.170, t=2.844, P<0.05, respectively).  Conclusion Mycobacterium tuberculosis subunit vaccine could induce long term and stable antigen-specific memory T cells in mice, which provided the basis for the late-stage study of its protective immunity against Mycobacterium tuberculosis.

Analysis on drug resistance and cross resistance of Mycobacterium tuberculosis isolated from clinical samples to four injectable antituberculous drugs

CHANG Shan, FU Yu-hong, LI Qi, BU Jian-ling, HUANG Hai-rong, MA Yu, CHEN Xiao-you

Chinese Journal of Antituberculosis. 2013, 35(1):  37-40. 

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Objective  To investigate the drug resistance and the cross resistance of Mycobacterium tuberculosis isolated from clinical samples to streptomycin (S), kanamycin (Km), amikacin (Am) and capreomycin (Cm) and to provide scientific evidences for clinical treatment of drug resistance tuberculosis. Methods  A retrospective study was adopted to analyze the results of drug susceptibility testing(DST) with absolute concentration method of 4247 isolates from patients with tuberculosis in Beijing Chest Hospital from Jan. 2004 to Dec. 2010. Mathed Chi-square test and partition of chi-square were applied for the overall drug resistant rate analysis, while chi-square test was applied to compare the cross resistance to 4 injectable antituberculous drugs. Results  The drug resistant rates to the four drugs were 45.11%(S, 1916/4247), 17.93%(Km, 718/4005), 19.02%(Am,792/4164) and 9.44%(Cm, 401/4247) among 4247 resistant isolates respectively. The differences were statistically significant by matched χ² test and partitions of χ² method. The values of χ² were 1349.34 (Cm/S), 281.54 (Cm/Am) and 193.16 (Cm/Km) (P<0.007 14) respectively. For the drug resistant rates of S/Am and S/Km, the values of χ² were 821.10 (S/Am) and 869.28 (S/Km) (P<0.007 14) respectively. The value of χ² was 13.98 (Am/Km) (P<0.007 14). The drug resistant rates sequencing from up to down were S, Am, Km and Cm. The drug resistant rates to S among the other 3 drug-resistance isolates were 82.59%(Km resistant isolates, 593/718), 77.78%(Am resistant isolates, 616/792) and 76.81%(Cm resistant isolates, 308/401) respectively. The values of χ² were 502.959, 453.911 and 626.654 (P<0.05). The drug resistant rates to Km among the other 3 drug-resistance isolates were 33.13%(S resistant isolates, 593/1790), 83.31%(Am resistant isolates, 634/761) and 67.89%(Cm resistant isolates, 260/383) respectively. The values of χ² were 502.959, 12.079 and 100.536 (P<0.05). The drug resistant rates to Am among the other 3 drug-resistance isolates were 32.78%(S resistant isolates, 616/1879), 89.55%(Km resistant isolates, 634/708) and 77.95%(Cm resistant isolates, 304/390) respectively. The values of χ² were 453.911, 12.079 and 163.761 (P<0.05). The drug resistant rates to Cm among the other three drug resistance isolates were 16.08%(S resistant isolates, 308/1916), 36.21%(Km resistant isolates, 260/718) and 38.38%(Am resistant isolates, 304/792) respectively. The values of χ² were 626.654, 100.536 and 163.761(P<0.05). Conclusion  The drug resistant rates sequencing from up to down of four injectable antituberculous drugs are streptomycin, amikacin, kanamycin and capreomycin. There are cross resistances among these four drugs with different levels. Streptomycin is unidirectional resistant to the other three drugs. Kanamycin and amikacin are almost full cross-resistant. Capreomycin is the candidate drug when the other three drugs are resistant.

The social impacts of MDR-TB on patients compared to non-MDR-TB in Henan province

SUN Yan-ni, WANG Guo-jie, ZHEN Xin-an, LIU Zhan-feng, Harley David, Hall Gillian, Vally Hassan, Sleigh Adrian

Chinese Journal of Antituberculosis. 2013, 35(1):  41-47. 

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Objective  To investigate the social impacts of MDR-TB and compare to non-MDR-TB in Henan province in 2010 to provide scientific evidence for developing comprehensive TB control strategies. Methods  Participants were randomly selected by using Excel generated random digits table from an anti-TB drug resistance surveillance survey dataset collected by the Institute for Tuberculosis Control and Prevention, Henan Centre for Disease Control and Prevention in 2001, supported by the World Health Organization. Face to face interviews were carried out using a questionnaire to collect information on the social impacts among MDR-TB and non-MDR-TB patients. Bivariate analysis was performed for data analysis. Altogether 234 TB cases were interviewed. Among the interviewed cases, 86 were MDR-TB cases and 148 were non-MDR-TB cases based on their anti-TB drug resistance status. T-test was applied in continuous variables and Chi square test was used for categorical variables for comparison. Results  Compared to non-MDR-TB (52.4%, 77/148), a greater proportion of MDR-TB patients (70.9%, 61/86) reported pessimism (χ²=8.58, P=0.01). More MDR-TB patients (9.3%, 8/86) continued working outside when they were ill with TB compared to non MDR-TB patients (2.0%, 3/148) and the difference was statistically significant (χ²=6.43, P=0.01). However, after TB recovery, less MDR-TB patients (8.8%, 7/80) were able to work outside compared to non-MDR-TB patients (24.0%, 35/146), and the difference between the two groups was statistically significant (χ²=7.92, P<0.01). Compared to non-MDR-TB patients (18.9%, 28/148), more MDR-TB patients (34.9%, 30/86) maintained their smoking habit after they became ill with TB (χ²=7.44, P<0.01). A substantially greater proportion of MDR-TB patients reported future plans changed because of the disease compared to non-MDR-TB patients (45.8%,33/72 vs 23.9%,27/113,  χ²=11.67, P<0.01). Conclusion  The findings from this study suggest that social support to TB patients, especially MDR-TB patients is an important factor to be concerned when designing a comprehensive TB program.

Feasibility of carrying out tuberculosis health education activities on the train

CHEN Qiu-lan,YU Lan, ZHOU Lin, CHEN Ming-ting, CHANG Chun

Chinese Journal of Antituberculosis. 2013, 35(1):  48-53. 

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Objective  To explore the feasibility of carrying out tuberculosis(TB) health education activities and determine the effective way of educating passengers on the train, and then provide recommendations on designing large-scale TB health education activities on the train. Methods  A small-scale TB publicity was carried out through posters and broadcast on 4 trains with the duration of 3 months. During the publicity，207 passengers were inquired about the exposure of the publicity and knowledge, attitude related to TB along with the preferred channel to obtain TB knowledge on the rain by a uniform questionnaire, who were in one hard-seat compartment and one hard-sleeper compartment, randomly selected in one of the four trains according to the random number table  (207 questionnaires were returned among the 211 issued and all the 207 questionnaires were valid). Twenty passengers and 12 train conductors were interviewed about the willingness and suggestion on publicity about TB on the train. Results  64.0%（121/189）of the passengers either exposed to the broadcast or the posters. The general awareness rate of key TB massage among the train passengers was 52.4%(525/1002) with the average score of （2.48±1.21）(full score is 5). 41.9%(83/198) of the passengers selected showing more concern when their neighbors got TB. The top four preferred channel for the passengers were broadcast, television, posters, and pamphlets with selecting rates respectively 64.3%(133/207), 36.7%(76/207), 30.0%(62/207) and 24.6%(51/207). The passengers were divided into four groups to compare the possibility of obtaining high score (≥3) of TB knowledge according to the exposure of broadcast and poster: those exposed to both poster and broadcast (group 1), those exposed to broadcast only (group 2), those exposed to poster only (group 3),and those exposed to neither poster nor broadcast (group 4). The results of logistic regression analysis show that compared to group 4,group 1 and 2 were more likely to have high scores with possibility of 2.167 times（β=0.773；Wald χ²=4.369；P=0.037；OR=2.167,95%CI=1.049-4.475）and 3.374 times （β=1.216；Wald χ²=5.177；P=0.023；OR=3.374,95%CI=1.184-9.618）respectively,while the group 3 shows no difference（β=0.066；Wald χ²=0.023；P=0.88；OR=1.068,95%CI=0.454-2.512）.Based on the result, broadcast was more effective than poster in publicity on the train. Among the interviewees, 18 passengers were willing to learn TB knowledge and all the 12 conductors were willing to offer the help; while 17 passengers and 10 conductors regarded broadcast as the most effective way to convey TB messages to them when on board a train. Conclusion  It is feasible to carry out health education activities about TB knowledge on the train; broadcast should be given the priority when concerning the ways of publicity about TB on the train, however, entertaining programs related to TB message and increased playback frequency is a must to improve its effectiveness of publicity.

Analysis on impacting factors on the failures in referring suspected TB patients reported and referred in Kashi Prefecture of Xinjiang Uygur autonomous region

LIU Fang-mei, GU Xiao-ming, YANG Jin-ming, LIU Nian-qiang, Yipaer, Mayixiati, WU Wei-dong

Chinese Journal of Antituberculosis. 2013, 35(1):  54-59. 

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Objective  To explore the causes and influencing factors on TB patients and suspected patients who had been referred, but did not arrive at TB control institute with the implementation of medical-prevention cooperation, and to provide evidence for overall arrival rate improvement and appropriate policies and measures development. Methods  In the period May to July 2010, a questionnaire survey of suspected TB patients, including 60 arrived and 60 non-arrived patients, was conducted with standard investigation plan in Kashi city and Yingjisha county. The questionnaire was developed by National Center for TB Control and Prevention (NCTB), China CDC according to the investigation plan. The trained investigators interviewed 120 TB patients or suspected TB patients, and each questionnaire was checked by staff from CDC at autonomous region. Description, univariate analysis and multivariate analysis were used. Results  Univariate analysis showed: by self-administered medication, 18 cases thought they could be cured, 39 didn’t think so in arrival group, while the numbers in non-arrival group were 22 and 26 respectively (OR=1.223, 95%CI=0.700-2.138, Wald χ²=8.40, P=0.015). 48 cases and 37 cases were informed the national free policy on TB in arrival and non-arrival group respectively (OR=2.486, 95%CI=1.096-5.641, Wald χ²=4.88, P=0.027). Multivariate logistic regression analysis revealed that the patients who thought they could be cured by self-administered medication (β=-1.871, Wald χ²=7.069, P=0.008, OR=0.154, 95%CI=0.039-0.612) and those who were informed by the referring doctors of national free policy on TB (β=0.886, Wald χ²=4.000, P=0.045, OR=2.424, 95%CI=1.018-5.774) were influencing factors on arriving at TB dispensaries referred by non-TB control institutions. Conclusion  The health care workers should conduct TB health education activities patiently and carefully to avoid misunderstanding of TB, in order to improve referral arrival rate of TB patients in Kashi Prefecture.

The national awareness survey on key TB messages in 2010

YU Lan, Lv Qing, XIA Yin-yin, HUANG Fei, CHEN Qiu-lan, CHEN Ming-ting, ZHANG Hui

Chinese Journal of Antituberculosis. 2013, 35(1):  60-64. 

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Objective  To learn and evaluate the awareness level of TB knowledge in 2010 to guide future health promotion and health education on TB control nationwide. Methods  The multi-stage stratified clustered equal ratio random sampling method was applied to select 176 survey sites nationwide including 77 urban sites and 99 rural sites. All 252 981 subjects who are 15 years old and above at the survey sites were interviewed face-to-face with the same questionnaire designed by the expert group of the National Awareness Survey (There are 5 questions in the questionnaire corresponding to the 5 key TB messages).  Results  The general awareness rate of all 5 key messages is 57.0%（720 912/1 264 905）. The awareness rate of the first key message, pulmonary TB is a harmful chronic respiratory infectious disease, is 68.0%（171 961/252 981）；the rate of the second key message, coughing with sputum for more than 2 weeks is highly suspicious of TB, is 74.4%（188 252/252 981）；the rate of the third key message, TB suspects should go to the county TB dispensary for examination and treatment, is 61.5%(155 611/252 981）；the rate of the fourth key message, TB examination and treatment at county TB dispensary is free of charge, is 30.7%(77 757/252 981）；and the rate of the fifth key message, most pulmonary TB patients will be cured with standard treatment, is 50.3%(127 331/252 981）. Out of the 5 key messages, the awareness of the message of free-charge service is the lowest（χ²=121 924.1, P＜0.001).  Conclusion  The awareness of key TB messages need to be further analyzed at all levels to plan and implement localized TB control health promotion and health education activities in the future.

The evaluation of implementation effect of tuberculosis control program in Fujian province during 2001—2010

LIN Shu-fang, CHEN Qiu-yang, ZHENG Jin-feng, WEI Shu-zhen, DAI Zhi-song, LIN Yong-ming

Chinese Journal of Antituberculosis. 2013, 35(1):  65-69. 

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Objective  To evaluate the implementation effect and the achievement of the overall objectives and working targets of tuberculosis control program in Fujian province during 2001—2010, and analyze the difficulties and problems existed in the implementation process and provide reference for sustainable development of provincial TB control work.  Methods  We collected the data from program evaluation forms and TB special reporting system of all levels including 9 cities and 86 counties between 2001 and 2010. Excel 2007 and SPSS 15.0 was used for analysis.  Results   (1) Fujian initiated DOTS strategy in 2002, and the coverage rate reached 100.0% in 2004. (2) A total of 220 351 cases of active pulmonary tuberculosis were detected in the whole province during 2001—2010, in which 110 343 were new smear positive cases with the registration rate of 32.0 per 100 000; 92 440 cases of new cases were cured with the average cure rate of 90.7%. The average referral arrival rate was 40.5%(60 336/148 944) during 2005—2010, the rate of arrival after tracing increased from 47.0%(4350/22 922) to 91.0%(12 325/24 799), the overall arrival rate increased from 63.1%(1447/22 922) to 93.6%(23 203/24 799). (3) Compared with 2001, in 2009 the number of TB control staff increased by 39.1%, a 118.4% increase in staff with undergraduate or above background, the number of staff with senior titles increased by 69.4%.(4) 742 202 healthy people were avoided of TB infection and 74 220 new cases of TB were avoided of development, 5.056 million Yuan of medical costs was reduced and 15.4 billion of social economic loss was saved.  Conclusion  During the ten years of implementation of TB control program, the TB control in Fujian had made remarkable achievements.

Application of Health Belief Model in tuberculosis area

FANG Hong-xia, QIN Yu-bao, WANG Xu, XIE Hai-bo, SUN Yan-bo, LI Fa-bin, YAN Xing-lu, HONG Feng, HE Xiao-xin, CHANG Chun, ZHAN Si-yan

Chinese Journal of Antituberculosis. 2013, 35(1):  70-76. 

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The Health Belief Model（HBM）is a theoretical model that was generated in 1950，which uses social psychology method to explain the health-related behaviors. It contributes to helping people produce health promotion behavior and abandon health-risky behavior and to forecast the health behavior. At present, HBM had been widely used in many areas include tuberculosis. In tuberculosis area abroad, HBM had been applied in case finding (screening and diagnose), treatment, prevention and health education and so on, among which, patient’s diagnosis was more applied. In addition, its theoretical model was also improved in the actual continuously application. HBM had been applied in treatment (adherence and care) in China.

Research progress on burden of disease of tuberculosis

BAI Li-qiong，XIAO Shui-yuan, ZHANG Yi-rui, JIN Shui-gao, CHENG Shi-min

Chinese Journal of Antituberculosis. 2013, 35(1):  77-80. 

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With the changing and developing of China’s tuberculosis control situation, the concept and evaluation method of burden of disease of tuberculosis need to be updated accordingly. This article reviewed the recent international and domestic researches on burden of disease of tuberculosis, the methods and results were discussed and their advantages and disadvantages were described as a reference for developing tuberculosis control policy.