Email Alert | RSS

Chinese Journal of Antituberculosis ›› 2018, Vol. 40 ›› Issue (6): 583-588.doi: 10.3969/j.issn.1000-6621.2018.06.007

• Original Articles • Previous Articles     Next Articles

Exploration of the application of new diagnostic techniques for tuberculosis in Liuzhou and Kashi Region

Yun-zhou RUAN,Ren-zhong LI(),Wei SU,Yan-lin ZHAO,Li-xia WANG,Xu WEI,Yi-yao LIU,Qi-zhi. LIAO   

  1. Chinese Center for Diseases Control and Prevention, National Center for Tuberculosis Control and Prevention, Beijing 102206, China
  • Received:2018-03-08 Online:2018-06-20 Published:2018-07-24

Abstract: Objective

To explore the application of light-emitting diode fluorescence (LED) microscope and linear probe resistance detection in China frontier minority areas.

Methods

A typical survey was conducted. Liuzhou of Guangxi Zhuang Autonomous Region and Kashi of Xinjiang Uygur Autonomous Region were selected as two research sites. The subjects were all tuberculosis (TB) suspects who first visited the local TB prevention and treatment centers from January 1, 2013 to December 31, 2016. There were 14337 suspected pulmonary TB cases in Liuzhou and 32022 in Kashi before the application of new diagnostic techniques (2013), while after the application of new diagnostic techniques for 3 years (2014-2016), the average annual number of suspected cases in Liuzhou and Kashi was 12796 and 36649, respectively. The measures of new diagnostic techniques were based on the LED microscopes equipped at the county level centers to diagnose spear positive cases and active cases through examination of sputum specimens of suspects, and the linear probe resistance detection equipment and reagents in the city level centers for detection of resistance to first-line anti-TB drugs (rifampicin and isoniazid) through examination of sputum spear positive specimens. The data before the application of new diagnostic techniques were retrospectively collected, and the data after the application of new diagnostic techniques were prospectively collected. The changes in the sputum examination rate of TB suspects and the screening rate of drug resistant in high-risk populations were compared before and after the application of new diagnostic techniques.

Results

The sputum examination rate of TB suspects was increased from 54.15% (7763/14337) to 64.25% (8221/12796) in Liuzhou and 65.36% (20930/32022) to 74.34% (27246/36649) in Kashi after the application of new diagnostic techniques, respectively; the differences were statistically significant (χ 2=285.00, P<0.001 and χ 2=658.00, P<0.001). Among them, the proportion of sputum examination with LED microscope was increased from 0.00% to 79.36% (6524/8221) and 92.88% (25307/27246), showing significant differences (Fisher exact test, Ps<0.001). The screening rate of drug resistant in high-risk populations was increased from 0.00% to 94.61% (158/167) and 74.96% (494/659) in the two cities, respectively; the differences were statistically significant (Fisher exact test, Ps<0.001). The proportion detected by linear probes was increased from 0.00% to 80.38% (127/158) and 52.83% (261/494). The proportion of rifampicin resistance (multidrug resistance included) diagnosed by linear probes was increased from 0.00% to 81.82% (9/11) and 53.06% (26/49).

Conclusion

The new diagnostic technologies for TB helps the frontier minority areas achieve the TB prevention and control goals. They are feasible but still require long-term support.

Key words: Tuberculosis, pulmonary, Tuberculosis, multidrug-resistant, Minority groups, Poverty areas, Molecular probe techniques, Microscopy, fluorescence