Table of Content

10 July 2014, Volume 36 Issue 7

Previous Issue    Next Issue

Issues in selection of treatment regimen for multidrug-resistant tuberculosis

TANG Shen-jie, LIU Yi-dian, ZHANG Zhan-jun, XIAO He-ping, WAN Li-ya

Chinese Journal of Antituberculosis. 2014, 36(7):  521-524.  doi:10.3969/j.issn.1000-6621.2014.07.001

Abstract ( 4549 )   PDF (993KB) ( 571 )   Save

References | Related Articles | Metrics

The following topics relate to the treatment of multidrug-resistant tuberculosis (MDR-TB) were discussed in this paper: the essential principles for the design of treatment regimens, selection of the anti-tuberculosis drugs, frequency and dosage of the use of anti-tuberculosis drugs, duration of the treatment regimens, the recommended treatment regimens and the adjustment of treatment.

Evaluation of fluorescent microscopic with light-emitting diodes in detecting Mycobacterium tuberculosis in laboratories based basic-level

SONG Yuan-yuan, JIANG Ming-xia, GUO Zhan-qing, XIA Hui, ZHAO Yan-lin

Chinese Journal of Antituberculosis. 2014, 36(7):  525-529.  doi:10.3969/j.issn.1000-6621.2014.07.002

Abstract ( 1542 )   PDF (979KB) ( 329 )   Save

References | Related Articles | Metrics

Objective  To evaluate the application effects of fluorescent microscopes with light-emitting diodes (LED-FM) in detecting Mycobacterium tuberculosis (Mtb) in sputum samples in laboratories based basic-level. Methods  One thousand seven hundred and thirty-eight sputum samples were collected from 592 pulmonary tuberculosis (TB) suspects who were detected by seven county TB dispensaries in Xining city of Qinghai province from July 2011 to September 2011. Two smears were prepared for each sputum specimen and then stained by Ziehl-Neelsen and auramine O respectively. The smear specimens stained by Ziehl-Neelsen were read by using conventional light microscope (CLM) while the specimens stained by auramine O were read by using LED-FM, and the results were recorded. Culture on solid Lowenstein-Jensen (L-J) media was also performed for all collected sputum samples and the culture result was used as a gold standard for comparison of smear-positive rate tested by two different types of microscopes; the veracity of diagnosis and diagnosis time by using the two methods were also compared.  Results  The smear-positive rate was 14.90% (259/1738) by using LED-FM, which was 1.15% higher than that of 13.75% (239/1738) by using CLM (Z=5.88, P<0.05). With L-J culture as the gold standard, the sensitivity, specificity and the area under the curve (AUC) of CLM in detecting TB patients were 79.60% (199/250; 95%CI＝74.60%-84.60%), 97.31% (1446/1486; 95%CI＝96.49%-98.13%) and 0.8878 (95%CI＝0.8623-0.9133); the sensitivity, specificity and AUC of LED-FM were 84.80% (212/250; 95%CI=80.30%-89.25%), 96.84% (1439/1486; 95%CI＝95.95%-97.73%) and 0.9118 (95%CI＝0.8890-0.9347). The reading time by LED-FM and CLM was (144.19±62.173) s and (185.600±79.271) s respectively; the difference of the reading time was significant (t=15.32, P<0.01).  Conclusion  If LED-FM is used for TB diagnosis, the smear-positive rate of sputum samples can be increased significantly. Compared with CLM, LED-FM has higher sensitive and similar specificity in detecting TB patients. So it is concluded that the application of LED-FM has higher value in detection of pulmonary TB, and it can also shorten the reading time of sputum smear slides.

The implementation effect of smoking control project in newly diagnosed tuberculosis patients and analysis of influencing factors

LI Xiang, KAN Xiao-hong, ZHANG Xiu-jun, WANG Jing-hong, YANG Jian-an, LI Zhi-li, CHEN Wen-hua

Chinese Journal of Antituberculosis. 2014, 36(7):  530-536.  doi:10.3969/j.issn.1000-6621.2014.07.003

Abstract ( 1951 )   PDF (816KB) ( 333 )   Save

References | Related Articles | Metrics

Objective  To describe the result of smoking control project on patients at tuberculosis outpatient department in Huaiyuan county of Anhui province and analyze the factors affecting the effect.   Methods  From August 2008 to March 2009, smoking cessation advice was repeatedly given to 302 new pulmonary tuberculosis patients with smoking habits registered at tuberculosis outpatient department in Huaiyuan county. Follow-ups examination were conducted at the second month, the fifth month, the sixth month and the twelfth month, during which motivation scores and confidence scores (measured on a scale of 0 to 10 according to the strength of the patients’ willingness) of patients who volunteered for smoking cessation were recorded. A project management system at county, township and village levels was established in order that the whole quitting processing of the patients could be supervised and recorded. Follow-up results were described，the changes of motivation scores and confidence scores were observed and the factors affecting motivation and confidence scores were studied. Measurement data were compared with nonparametric tests, with a significance level of 0.01.  Results The quit rate at the ending of treatment was 27.9%(83/297). At the sixth month after treatment completion, it was 18.0%(53/295). At the beginning of treatment and the 4 times of follow-ups, motivation scores(the median score was 7.5, 5.0, 3.0, 1.0 and 1.0, respectively; χ²=405.524，P<0.01) and confidence scores(the median score was 7.0, 5.0, 3.0, 1.0 and 1.0, respectively; χ²=390.893，P<0.01) of the patients showed a downward trend. A negative correlation was found between the amount of cigarette smoked per day and the initial motivation score(r=－0.127, P<0.05), and it was also found between the amount of cigarette smoked per day and the initial confidence score(r=－0.141,P<0.05), between smoking time and the initial motivation score(r=－0.119,P<0.05), and between smoking time and the initial confidence score(r=－0.146,P<0.05).  Conclusion Health education offered by doctors in outpatient department could help improve the quit rate of patients. The amount of cigarette smoked per day and smoking time has negative effect on motivation and confidence of quitting behavior.

Pulmonary tuberculosis internet-reporting analysis in 8 different type of TB designated hospitals

HUANG Fei, DU Xin, LIU Xiao-qiu, XIA Yin-yin, QU Yan, WANG Li-xia, ZHANG Hui

Chinese Journal of Antituberculosis. 2014, 36(7):  537-541.  doi:10.3969/j.issn.1000-6621.2014.07.004

Abstract ( 2166 )   PDF (836KB) ( 386 )   Save

References | Related Articles | Metrics

Objective  To evaluate pulmonary TB internet-reporting in specific and general TB designated hospital.  Methods We selected the prefecture hospitals in Zhenjiang, Yicang and Hanzhong, then select 3 county hospitals in the 3 cities by stratified sampling based on GDP per capita, exclude hospital designated less than 1 year. Three specific hospitals and 5 general hospitals were finally surveyed to examine outpatient and hospitalization departments’ work log in the 4th quarter to find out and record all diagnosed pulmonary TB cases (659 cases totally), and then check these records with the infectious disease internet reporting system to analyze the internet-reporting situation; Excel 2007 was used to establish database and conduct statistics, Chi-square test was used to compare the difference with P<0.05 as statistically significant difference. Results The overall internet-reporting rate of these surveyed hospitals is 89.4%(589/659), and the rate for specific and general hospital is 91.4%(374/409) and 86.0%(215/250) respectively with significant difference(χ²=4.84, P<0.05); the reporting rate of TB department, non-TB department and hospitalization department in specific hospital is 45.5%（170/374）, 19.3%（72/374） and 35.3%（132/374）respectively, while the rate in general hospital is 50.7%（109/215）, 29.8%（64/215）and 19.5%（42/215）respectively, and there is significant difference for the rate of different departments between specific and general hospital(χ²=18.81, P<0.01) and the case underreporting mainly happened in outpatient department, which accounted for 61.4% (43/70). Conclusion The internet-reporting for pulmonary TB in specific and general designated hospitals is going well, but the reporting situation of specific hospital is better than that of general hospital.

Results analysis of TB screening among university students using BCG-PPD and TB-PPD

MENG Wei-li, LUO Ping, HU Jing-kun, SUN Zhao, LI Hui-ying, LIAN He-yu

Chinese Journal of Antituberculosis. 2014, 36(7):  542-546.  doi:10.3969/j.issn.1000-6621.2014.07.005

Abstract ( 4515 )   PDF (986KB) ( 686 )   Save

References | Related Articles | Metrics

Objective  To compare the tuberculosis (TB) screening results among university students by using purified protein derivative of BCG (BCG-PPD) and purified protein derivative of tuberculin (TB-PPD) skin-test.  Methods  The TB screening (PPD skin-test) results obtained from 2821 students in 3 universities, which located in Xicheng district of Beijing, from 2012 to 2013 were retrospectively analyzed. The students were divided into two groups according to the different PPD reagents used: BCG-PPD group consisting of 1386 students who received BCG-PPD skin-test and TB-PPD group consisting of 1435 students who received TB-PPD skin-test. The test result was read at 72 hours and the maximum transverse diameter of the induration was measured. Chest X-ray was performed to the students with strong-positive. SPSS 11.5 software was applied for statistical analysis. Rank sum test was used for comparison of diameter of induration in two groups. Chi-square test was used for comparison of TB screening results and frequency distribution of PPD results in two groups. When the theoretical value was less than 1, Fisher’s exact test was used. The correlation between BCG scar and PPD positive result was analyzed using logistic regression, P<0.05 was considered as statistically significant.  Results The median diameter of induration in BCG-PPD group (6 mm) was larger than that in TB-PPD group (0 mm); and the difference was statistically significant (Z=－10.034, P<0.05) between the two groups. The positive rate of BCG-PPD group (54.8%, 759/1386) was significantly higher than that of the TB-PPD group (32.7%, 469/1435) (χ²=139.818, P<0.05); the strong-positive rate of BCG-PPD group (6.6%, 92/1386) was significantly higher than that of the TB-PPD group (3.4%, 49/1435) (χ²=15.425, P<0.05); the adverse reaction rate of the BCG-PPD group (1.9%, 27/1386) was significantly higher than that of the TB-PPD group (0.4%, 6/1435) (χ²=14.274, P<0.05). BCG scar was associated with the PPD positive result; the students with BCG scar were more likely to have PPD positive results (OR=2.046, 95％CI=1.630-2.569, P<0.05).  Conclusion In TB screening among the university students, the strong positive rates and the abnormal reaction rates of TB-PPD and BCG-PPD skin test were dif-ferences. Further research is needed to be conducted.

Application of grey model in analysis and prediction of tuberculosis  mortality of China

LI Tao, CHENG Shi-ming, CHEN Wei, XIA Yin-yin, CHEN Qiu-lan, DU Xin

Chinese Journal of Antituberculosis. 2014, 36(7):  547-551.  doi:10.3969/j.issn.1000-6621.2014.07.006

Abstract ( 1538 )   PDF (783KB) ( 339 )   Save

References | Related Articles | Metrics

Objective This study aims to analyze the trend of mortality of tuberculosis of China in recent years and make predictions, to provide reference data for making rational and effective TB control strategies. Methods The mortality from 2005 to 2012 based on national disease surveillance points are respectively 6.58/100 000, 5.14/100 000, 4.65/100 000, 4.15/100 000, 4.05/100 000, 3.87/100 000, 3.39/100 000, and 2.29/100 000. The national DSP system was adjusted in 2005, which nowadays covers 161 sites in 31 provinces (Hong Kong, Macau, Taiwan not included), including 64 urban sites, 97 rural sites. About 6% of national population, 81.53 million residents are covered by this system and ICD-10 standard is used as classification of cause of death. The mortality based on WHO global tuberculosis report 2012 are 19.00, 13.00, 8.70, 5.70 and 3.80 in every 100 000 population in every 5 years from 1990 to 2010. GM (1,1) grey models are established based on these data by using MATLAB V7.0, then we could get the prediction formulas and predict future TB mortality data after fitting test. Results Via prediction formulas, based on two data resources, the predicted TB mortality of 2015, 2020, 2025 are 2.44/100 000, 1.62/100 000, 1.07/100 000, and 2.55/100 000, 1.71/100 000, 1.14/100 000. Meanwhile, the corresponding predicted results of mortality are 2.27/100 000, 1.40/100 000, 0.86/100 000, and 2.54/100 000, 1.70/100 000, 1.14/100 000, through time series model. Conclusion The GM (1,1) model has showed good effect in simulating historic TB mortality data, and the predicted results indicate that the TB mortality of China will continue to decline in the condition of unchanged external environment and impact factors, and expected to reach the millennium development goals of U.N. in time.

Analysis of bi-directional screening for Mycobacterium tuberculosis and human immunodeficiency virus infection in 2011—2013 in Hefei city

CAO Hong，ZHANG Huan

Chinese Journal of Antituberculosis. 2014, 36(7):  552-555.  doi:10.3969/j.issn.1000-6621.2014.07.007

Abstract ( 1248 )   PDF (775KB) ( 370 )   Save

References | Related Articles | Metrics

Objective  To describe the status of the bi-directional screening model for Mycobacterium tuberculosis(Mtb) and human immunodeficiency virus(HIV)/AIDS infection in Hefei city, and to provide the scientific evidence for prevention and control of tuberculosis(TB) and HIV co-infection.  Methods  One thousand four hundred and twenty-two HIV/AIDS patients were screened for Mtb in 2011—2013 in Hefei, and 5772 newly registered TB patients were screened for the HIV antibody. All statistical analyses were performed using SPSS 21.0 statistical software, and Chi-square test was used for categorical variables, 0.05 was set as the criteria of statistical significance.  Results  During 2011—2013, the TB screening rates among HIV/AIDS patients were 92.62%(276/298), 99.57%(458/460) and 98.29%(688/700) respectively, with significant increasing trend (χ²_trend=18.57, P<0.001). During 2011—2013, the HIV screening rate of registered TB patients were 40.17%(1701/4234), 38.20%(1632/4272) and 53.49%（2439/4560） respectively, which showed the significant increasing trend as well (χ²_trend=162.83, P<0.001). The HIV antibody screening rate in new TB control network areas was 60.99%(2029/3327), which was significantly higher than other areas（33.25%，410/1233）(χ²=1083.62, P<0.001).  Conclusion  The bi-directional screening for Mtb and HIV is the main route to detect Mtb/HIV co-infection patients, accordingly，actively carrying out the screening work has important implications for improving the detection rate of co-infection, effective control of Mtb/HIV co-infection, improving the quality of life and mortality of co-infected patients.

Parotid gland tuberculosis：a case report and literature review

WANG Peng, ZHANG Zhong-shun, YANG Yan, CHEN Gang, XIAO He-ping

Chinese Journal of Antituberculosis. 2014, 36(7):  556-564.  doi:10.3969/j.issn.1000-6621.2014.07.008

Abstract ( 1512 )   PDF (1504KB) ( 286 )   Save

References | Related Articles | Metrics

Objective To improve the understanding and early diagnostic ability for parotid gland tuberculosis.  Methods The clinical characteristics based on the clinical data of a 57-year-old female patient confirmed by pathologic histology in Shanghai Pulmonary Hospital in 2012 and the literature of 34 cases with parotid gland tuberculosis from domestic and “PubMed” database from 2005 to 2013 were retrospectively analyzed. Results Among 35 parotid gland tuberculosis cases. There were 22 males and 13 females. The left and right parotid gland tuberculosis were 16 cases respectively, and the bilateral were 3 cases. The main symptoms were progressive，painless swelling of parotid gland. In additional, fever, dental caries, toothache, difficulty in opening mouth was seldom(2/35) and few patients was suffered from tuberculous symptoms like as night sweat, fatigue, weight loss and anorexia(34/35). Fine needle aspiration cytology was the great help in diagnosis. There were 18 cases performed by fine needle aspiration cytology and 10 cases with the cytological results. Twenty-seven cases got satisfactory efficacy due to regular treatment and 1 case didn’t due to irregular treatment.  Conclusion Parotid gland tuberculosis can get satisfactory efficacy with regular treatment. It should be kept in mind while dealing with parotid swellings patients.

Investigation on the service satisfaction of tuberculosis patients of floating population in China global fund TB program area

WANG Jia,LI Tao,ZHANG Li-jie, HE Min,JIANG Shi-wen

Chinese Journal of Antituberculosis. 2014, 36(7):  565-569.  doi:10.3969/j.issn.1000-6621.2014.07.009

Abstract ( 1453 )   PDF (781KB) ( 282 )   Save

References | Related Articles | Metrics

Objective  To investigate on the service satisfaction of tuberculosis patients of migrant population, to provide the basis for further improvement of the medical service of the floating population.  Methods Thirty one counties in 12 provinces were selected as study sites which were selected by simple random sampling in the China Global Fund Program area. A questionnaire was adopted in the survey, the total questionnaire were 614,and 607 valid questionnaires were received. The response rate was 98.9%（607/614）.  Results The overall satisfaction rate of patient for tuberculosis medical service was 77.9%（473/607）.Satisfaction levels from highest to lowest are: reception service for health care staff (88.6%,538/607), doctors described knowledge of tuberculosis (84.0%,510/607), treatment processes (82.4%,500/607). The lowest are the free policy and the required cost of diagnosis and treatment which were 60.5%（367/607）.The satisfaction level varied by age and type of sputum. In terms of satisfaction level with health education, the smear positive patient had higher satisfaction(86.6%,207/239) than smear negative patients(79.6%,293/368）,and the difference was statistically significant(χ²=4.878, P=0.02). In terms of satisfaction level with subsidies, 67.8%（145/214）of smear positive patient were feel satisfied, which is higher than smear negative patients (57.8%,190/329）, The difference was statistically significant(χ²=5.174，P=0.023). In terms of satisfaction level with treatment process, the patient elder than 50 years old had higher level of satisfaction (92.0%,81/88) than the patients younger than 30 years old （78.2%，204/261）and 30-50 years old （83.3%，215/258）. The difference was statistically significant (χ²=9.023, P=0.011).  Conclusion At present the overall satisfaction of pulmonary tuberculosis patients in floating population on tuberculosis treatment services is good. But still need to improve the treatment process, expand the free policy, reduce the cost in treatment services and further improve the patient satisfaction.

Analysis of adverse drug reactions in 91 multidrug-resistant tuberculosis patients

SU Wei, RUAN Yun-zhou, ZHAO Jin,CHENG Jun,ZHANG Can-you,WANG Li-xia, LI Ren-zhong

Chinese Journal of Antituberculosis. 2014, 36(7):  570-575.  doi:10.3969/j.issn.1000-6621.2014.07.010

Abstract ( 1961 )   PDF (792KB) ( 368 )   Save

References | Related Articles | Metrics

Objective To analyze the adverse drug reactions(ADR) of the standardized treatment of multidrug-resistant tuberculosis(MDR-TB)，and to evaluate the impact on treatment. Methods  We designed the questionnaire of MDR-TB ADR through expert consultation, and retrospectively investigated MDR-TB patients’ medical records with standardized ADR questionnaire in He’nan Puyang city, Heilongjiang Daqing city, Zhejiang Quzhou city and Tianjin municipality. A total of 91 MDR-TB patients confirmed during March 1, 2010 to February 29, 2012 were enrolled in the analysis.  Results 89.0%(81/91) of 91 MDR-TB patients had adverse reactions(ADR). The most common ADR was gastrointestinal reaction which accounted for 35.4%(52/147), followed with hepatotoxicity，which accounted for 17.7%(26/147). After the ADR treatment, 55.1%(81/147) of patients maintained the original treatment regimen, 32.7%(48/147) patients changed or stopped ADR-induced drugs，only 7.5%(11/147) cases stopped MDR-TB treatment for ADR. The highest percentage of changed or stopped drug is amino acid (PAS), which accounted for 37.5%(18/48), the least percentage is kanamycin injections (Km), which accounted for 6.3%(3/48).  Conclusion ADR is common during the treatment course of MDR-TB, but the vast majority of ADR do not need to be dealt with. Attention should be paid to monitoring and management of ADR, drugs should not be stopped easily or even stopping treatment.

Detection rates and drug sensitivities of Pseudomonas aeruginosa and Acinetobacter  baumannii in tuberculosis patients

PAN Mei-yu, WU Long-zhang, SU Bi-yi

Chinese Journal of Antituberculosis. 2014, 36(7):  576-578.  doi:10.3969/j.issn.1000-6621.2014.07.011

Abstract ( 1414 )   PDF (814KB) ( 296 )   Save

References | Related Articles | Metrics

Objective  To understand the detection rates and the drug sensitivities of Pseudomonas aeruginosa and Acinetobacter baumannii in tuberculosis (TB) patients, to provide the basis for rational use of antibiotics and control of nosocomial infection. Methods  According to the National clinical laboratory operating procedures, 6493 specimens (including 5059 sputa, 878 fiberoptic bronchoscopy lavage fluid (FBLF), and 556 thoracic or abdominal cavity effusion, wound secretions, blood etc.) were collected from clinical laboratory in the Guangzhou Chest Hospital from January in 2011 to August in 2013,and then the bacteria were identified and performed the drug sensitivity test by PHOENIX-100 automatic microorganism analyzer.   Results There were 3612 strains isolated from 6493 specimens, including 985 (27.27%) Pseudomonas aeruginosa and 324 (8.97%) Acinetobacter baumannii. Of 985 Pseudomonas aeruginosa isolates, 100.00% were sensitive to polymyxin, 94.52%（931/985）were sensitive to tobramycin, 99.39% (979/985) were resistance to ampicillin/Shubatan, and cefazolin. 100.00%（324/324）Acinetobacter baumannii isolates were highly sensitive to polymyxin, and different degrees of resistance to other antibiotics.  Conclusion Pseudomonas aeruginosa and Acinetobacter baumannii clinical isolates were resistance to various antibiotics. Should be reasonable to select antibiotics according to the drug sensitivity test results, to avoid drug-resistant strains.

Clinical analysis on 42 cases with bronchioloalveolar carcinoma misdiagnosised as pulmonary tuberculosis

LIAN Juan-wen

Chinese Journal of Antituberculosis. 2014, 36(7):  579-583.  doi:10.3969/j.issn.1000-6621.2014.07.012

Abstract ( 1448 )   PDF (967KB) ( 316 )   Save

References | Related Articles | Metrics

Objective  To study the clinical characteristic, the causes of misdiagnosis, diagnosis and treatment experience of bronchioloalveolar carcinoma. Methods From 2009 January to 2012 January, 203 cases who were initially misdiagnosed as pulmonary tuberculosis were diagnosed finally with other lung diseases among 22047 cases diagnosed with pulmonary tuberculosis in Xi’an Tuberculosis and Thoracic Tumor Hospital. Forty-two cases were confirmed as bronchioloalveolar carcinoma among 203 cases. A retrospective clinicopathologic analysis was conducted on these 42 patients. Results The typical clinical manifestations of bronchioloalveolar carcinoma were cough and expectoration, shortness of breath, chest pain and stuffinees. All patients were divided into 3 categorie accor-ding to imaging finding. Solitary nodular type 33 cases, pneumonia type 4 cases and diffuse nodular type 5 cases. Forty-two patients with bronchioloalveolar carcinoma were misdiagnosed as pulmonary tuberculosis, of which 23 were misdiagnosed as infiltrative pulmonary tuberculosis, pulmonary tuberculoma in 11 cases, 5 cases of subacute blood disseminated pulmonary tuberculosis and 3 cases of pulmonary tuberculosis complicated with serous cavity effusion. Symptoms were repeated and imaging were unimproved after anti-tuberculosis therapy. All cased were diagnosed finally with bronchioloalveolar carcinoma by pathological examination.  Conclusion The clinical symptom and imaging manifestations of bronchioloalveolar carcinoma have its low specificity which is easily misdiagnosed as pulmonary tuberculosis. It should be comprehensive analysis to enhance the rate of early diagnosis.

Analysis of arrival situation of suspected pulmonary tuberculosis patients reported by non-tuberculosis control institutions from 2009 to 2012 of Nanshan district, Shenzhen

ZHONG Tao, DING Yi, WANG Jian, GUO Xu-jun, HUANG Yao, WU Guo-hua, HUANG Jin-cheng, HUANG Ying-dong

Chinese Journal of Antituberculosis. 2014, 36(7):  584-587.  doi:10.3969/j.issn.1000-6621.2014.07.013

Abstract ( 1496 )   PDF (774KB) ( 260 )   Save

References | Related Articles | Metrics

Objective  To analyze the arrival situation of the suspected pulmonary tuberculosis patients reported by non-tuberculosis control institutions of Nanshan district, and explore the methods to improve the arrival rate. Methods  Data of arrival situation on referral-report and arrival of 10520 suspected pulmonary tuberculosis patients reported by non-tuberculosis institutions from January 2009 to December 2012 of Nanshan district were collected and analyzed with Chi-square trend test. The difference of P<0.05 was considered statistically significant.  Results The referral arrival rate were respectively 55.76%（1709/3065）,50.90%（1470/2888）,49.21%（1149/2335）and 50.45%（1126/2232）, the tracking arrival rate were respectively 57.11%（699/1224）,49.29%（521/1057）,56.39%（375/665） and 63.79%（303/475）, and the overall arrival rate were respectively 82.87%（2540/3065）,81.44%（2352/2888）,87.58%（2045/2335）and 92.29%（2060/2232）of suspected pulmonary tuberculosis patients reported by non-tuberculosis control institutions from 2009 to 2012 of Nanshan district. The referral arrival rate showed a declining trend（χ²_trend=17.89, P<0.001）, while the tracking arrival rate and overall arrival rate had an increasing trend (respectivelyχ²_trend=4.04, P<0.05 andχ²_trend=113.31, P<0.001).  Conclusion By taking the comprehensive interventions, and standardizing the referral and tracking procedure of the suspected pulmonary tuberculosis patients, the overall arrival rate showed an increasing trend from January 2009 to December 2012 in Nanshan district.

Factors affecting referral and tracing of pulmonary tuberculosis cases reported by Dongfang Hospital Affiliated to Beijing University of Chinese Medicine

LI An-de,WANG Xiao-cai,CHEN Yan-li,LI Jing-yu, WANG Ling-pu, HUANG Xiang-an

Chinese Journal of Antituberculosis. 2014, 36(7):  588-591.  doi:10.3969/j.issn.1000-6621.2014.07.014

Abstract ( 1712 )   PDF (771KB) ( 274 )   Save

References | Related Articles | Metrics

Objective  To understand referral in place situation of pulmonary tuberculosis patient in Dongfang Hospital Affiliated to Beijing University of Chinese Medicine. Methods By the mean of telephone follow-up, we investigated referral,tracking situation of 156 cases with pulmonary tuberculosis reported by Dongfang Hospital from January 2011 to December 2013. Taking referral in place rate as analysis indicator, we collected the information including ages， gender, health insurance, awareness of free treatment policy, income stablility, concern for social prejudice，seeking care delay, the referral department. SPSS 15.0 statistical software is used for collation and statistical analysis, χ² tests were applied to analysis, and statistical significance is on the basis of P<0.05. Results Among 156 cases with tuberculosis,106 cases were treated in tuberculosis dispensaries,while 29 cases in Chest Hospital, 6 cases went back to their hometowns, 15 cases were lost for follow-up. Ninety-six cases were referred and the arrival rate of the referred cases was 61.54％(96/156);60 were tracked and the arrival rate of the tracked cases was 75.00％ (45/60). The overall in place rate was 90.38% （141/156）; Inpatient referral in place rate was significantly higher than outpatients (90.00%（27/30）vs 54.76%(69/126))(χ²=12.712，P＜0.01); There are significant differences between referral rate in place of different gender, whether have health insurance, have or no stable income, know or unknown free policy, whether referral departments is respiratory department or not (referral in place rate 94.85% (92/97) vs 83.05% (49/59),98.09% (103/105) vs 74.51% (38/51), 97.37% (111/114) vs 71.43% (30/42), 96.21% (127/132) vs 58.33% (14/24), 98.70% (76/77) vs 82.28% (65/79 respectively); χ²=5.87,19.34,20.87,29.31,12.10 respectively; P＜0.05，＜0.01，＜0.01，＜0.01，＜0.01 respectively). Conclusion  The general referral in place rate of pulmonary tuberculosis cases reported by Dongfang Hospital is generally high; different gender, whether have health insurance, whether have stable income, whether known of free policy, whether referral from respiratory department are the important factors affecting the referral in place rate.