Table of Content

20 July 2010, Volume 32 Issue 7

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impact of collaboration between general hospital and TB dispensary on increasing pulmonary TB case

HUANG Fei, WANG Li-Xia, CHENG Shi-Ming, JIANG Shi-Wen, LIU Xiao-Qiu

Chinese Journal of Antituberculosis. 2010, 32(7):  8-12. 

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Objective To evaluate the impact of collaboration between general hospital and TB dispensary on improvement of pulmonary tuberculosis case finding. Methods To analyze the TB case/suspect referral and tracing forms reported by general hospitals via internet-based infectious disease reporting system and determine the overall condition of reporting, referral and tracing of internet-reported tuberculosis case/suspect and evaluate the contribution of collaboration between general hospital and TB dispensary to case detection of National TB Program. Results (1) TB cases reported by general hospital via internet-based reporting system are increasing year by year, from 36.1/100000 in 2004 to 74.6/100000 in 2008; (2) The overall arrival rate is increasing annually, from 60.8% in 2004 to 83.1% in 2008; (3) The case finding contribution of general hospital to NTP is increasing by year, from 25.7% in 2004 to 40.6% in 2008 for active pulmonary TB case, and from 22.6% in 2004 to 34.8% in 2008 for smear positive pulmonary TB case. Conclusion s The collaboration between general hospital and TB dispensary has a remarkable effect on increasing case finding, and it is one of important components in NTP.

The role and effect of strengthened intervention in Referring and Tracing of suspected TB patients

LI Jian-Wei, ZHONG Qiu, HUANG Gui-Qing, JIANG Li, CHEN Liang

Chinese Journal of Antituberculosis. 2010, 32(7):  13-16. 

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Objective To evaluate the role and effect of strengthened intervention in referring and tracing of suspected TB patients reported by hospital. Methods The strengthened interventions such as standardizing the referring and tracing procedure were taken. Referred rate, referred-arrival rate and overall arrival rate were compared between the intervention year and the previous year. Results The referred rate, the referred-arrival rate, the tracing-arrival rate and the overall-arrival rate were 86.8%、41.3%、72.2% and 83.7% respectively in the intervention year, significantly higher than the level of the previous year(P<0.05). In the intervention year, 99 suspects didn’t go to TB dispensary after referral, among which 80 were not reported by local hospital, accounting for 80.8%. Working outside the local county and wrong telephone number and address are the main reasons for suspected not attending the TB dispensary for diagnosis. Conclusion Taking the comprehensive strengthened interventions and focusing on every step in suspects referring and tracing are essential in improving suspected patients’ arrival.

Treatment outcome analysis of new smear positive pulmonary tuberculosis patients detected from 1994 to 2006 in Tibet

Chiliedunzhu,Pingcuozhuoma

Chinese Journal of Antituberculosis. 2010, 32(7):  17-19. 

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Objective To analyze and evaluate treatment outcome of new smear positive pulmonary tuberculosis patients in Tibet. Methods Treatment record of new smear positive pulmonary tuberculosis patients in 7 prefectures and 74 counties from 1994 to 2006 were searched, and treatment outcome was analyzed. ResultFrom 1994 to 2006, cure rate was 33.3%, 49.6%, 48.0%, 44.2%, 67.1%, 71.2%, 82.3%, 74.1%，82.5%，80.5%, 76.5%, 75.3% and 81.3% respectively. DOTS coverage was 0 in 1994, 5.30% in 1995, and 100% in 2005. Conclusion In these 13 years, most of new smear positive patients could receive good treatment outcome, however, it is still far from 85% of national cure rate requirement. This reflects the importance of patient management.

Analysis of resources and work status of sputum checking centers of township hospitals in Gansu Province

Mu Taojun,Si Hongyan,Li Qing,Ma Ling

Chinese Journal of Antituberculosis. 2010, 32(7):  20-22. 

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Objective To understand the resources and present work status of sputum checking centers of township hospitals of Gansu, and provide reference for future work.  Methods Basic situation of 535 sputum checking centers of township hospitals in Gansu and their work status from 2005 to 2008 were analyzed.  Results Sixty-six point five percent of these centers still carry out checking work. Only 3.0% has full-time smear staff. From 2005 to 2008, a total of 80899 cases of tuberculosis suspects received smear check, and 4065 cases were found as smear positive. Detection rate of smear positive is 5.0%. There are 254 pieces of false positive and 3017 of false negative slides. The consistency rate of positive Results is significantly lower than national standard. Conclusion s Township sputum checking centers plays a limited role in finding smear positive patients. The experimental condition and biological safety is poor, and work is imbalance between different centers. Therefore, there is a need to implement feasible measures based on local conditions, and integrate the limited resources to improve laboratory conditions and further regulate the work of these centers.

Treatment status of 223 cases of retreatment smear positive pulmonary tuberculosis

Wang Jing,Luo Ping,Hong feng,Li Bo,Han Yu

Chinese Journal of Antituberculosis. 2010, 32(7):  23-26. 

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Objective To understand the treatment status and the effect of retreatment smear positive pulmonary tuberculosis in Beijing.  Methods Local retreatment smear positive cases registered during 2006—2007 were selected. Analysis was made in terms of age, place for initial treatment, treatment institution, initial management mode, drug susceptibility test (DST) before retreatment and the complication, treatment outcome of the cases with standardized chemotherapy regimen and non-standard regimen. Results Results Among the total 223 cases, middle-aged patients account for 65.5%. 54 cases did DST before retreatment, 25 were drug resistant, the drug resistant rate was 46.3%(25/54), multi-drug resistant rate was 13.0%(7/54). 170 cases adopted standardized regimen, accounting for 76.2%, For them, average cure rate was 75.9% and the cure rate for patients failing in initial treatment was 50%. 53 cases adopted non-standard regimen, accounting for 23.8%. Reasons for non-standard regimen were explained as drug resistance, adverse drug reaction, or accompanied by complications.  Conclusion s In order to improve the cure rate of the retreatment cases, DST for the first and the second line drugs should be done for patients failing in initial treatment based on the standardized chemotherapy regimen. For patients who could not fit for standard regimen, individualized regimen should be developed based on the result of the DST and patient’s situation.

Analysis on susceptible factors in patients with pulmonary tuberculosis complicated by fungal infection

Wang Changsheng,Yang Jinsun,Dou Guolei

Chinese Journal of Antituberculosis. 2010, 32(7):  27-30. 

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Objective To study the susceptible factors in patients with pulmonary tuberculosis complicated by fungal infection. Methods The clinical data of 522 patients with pulmonary tuberculosis, in which 54 cases were complicated by fungal infection (observation group), while 468 cases were not complicated by fungal infection (control group), were collected and analyzed retrospectively from July 2008 to July 2009. Results The involved factors of pulmonary tuberculosis complicated by fungal infection were correlated with sex, age, body mass index, clinical types, with or without the long-term use of antibiotics and glucocorticoids, diabetes mellitus and sputum smear-negative by acid-fast stain. There were significant differences in these factors between the observation group and the control group (P＜0.05). Through the analysis with the non-conditional logistic regression, 4 risk factors for the pulmonary tuberculosis patients were screened out, they were elderly, the long-term use of antibiotics or glucocorticoids, diabetes mellitus. Conclusion s The patients with elderly, the long-term use of antibiotics or glucocorticoids, diabetes mellitus need to be raised vigilance and need to be taken appropriate preventive control measures.

Analysis of CT imaging in pulmonary tuberculosis with diabetes

Huang Hua,Cai Xiongmao,Lu Puxuan,Yu Weiye,Deng Qunyi,Li Guobao,Deng Yingying,Ye Ruxin,Gong Xiaolong

Chinese Journal of Antituberculosis. 2010, 32(7):  33-36. 

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Objective To study the imaging characteristics of pulmonary tuberculosis in patients with diabetes mellitus.  Mehtods75 patients with pulmonary tuberculosis complicated with diabetes mellitus were collected as a study group, and 75 patients with pulmonary tuberculosis only were considered a control group. All patients were performed chest CT scan. The findings were compared between the two groups. Results Lesion locations were not different with statistics in two groups. Lesions in the study group distributed more one lobe than that of the control group with statistical difference. The frequency of cavity,mass and infiltration were more higer in the study group with statistically singificant difference. Conclusion s The extent of lesions is extensive in imaging of pulmonary tuberculosis patients with diabetes mellitus,cavity, mass and infiltration shown in CT imaging are very common.

Serodiagnostic value of recombinant Mtb81 protein from M.tuberculosis for tuberculosis

Yang Yourong,Wu Xueqiong,Zhang Junxian,Liang Yan,Zhang Cuiying,Dong Mei,Chen Hongbing,He Jufang

Chinese Journal of Antituberculosis. 2010, 32(7):  38-41. 

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Objective To evaluate the value of recombinant Mtb81 (rMTB81) protein from M.tuberculosis on the serodiagnosis of tuberculosis (TB), and to develop more effective diagnostic reagents for TB. Methods The rMTB81 protein was expressed and purified by metal chelation chromatography. The antibody IgG against M.tuberculosis rMtb81 antigen in 402 human sera were detected by ELISA. Results The rMTB81 protein existed in inclusion bodies of E. coli, and amounted to 30% of total bacterial proteins. Its molecular weigh...