Table of Content

10 April 2008, Volume 30 Issue 4

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The incidence of the adverse reactions of the first-line anti-tuberculosis drugs in Beijing and its influence on the chemotherapy

Wang Jing,Tu Dehua,Li Bo,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  271-274. 

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Objective To find out the occurring of the adverse reactions of the first-line anti-tuberculosis drugs in Beijing and its influence on the chemotherapy. Methods All pulmonary tuberculosis patients who come from five districts include the urban area,the suburbs and the outer suburbs were treated with the first-line standard regimen from July 2006 to January 2007.And the prospective study was used to observe their abnormal clinical reaction,the liver and the kidney function and the blood routine during the chemotherapy.The evaluation on the abnormal which were related,make "affirmation" and "in all probability" as the side effects. Results The patients who occurred side effects from this group of anti-TB drugs were 188,which accounted for 34.9%.Among these patients,the mild were 78,accounted for 14.5%,the moderate were 106,accounted for 19.3%,and the serious were 6,accounted for 1.11%.78 patients were resulted in modification or discontinuation of therapy,which accounted for 14.5%. Conclusions The incidence of the first-line anti-tuberculosis drugs which used in the standard regimen in Beijing is relatively high,influencing on the chemotherapy at a certain extent.We should pay more attention to the hepatotoxicity,which is more significant during all the side effects.We should also perfect the definition of the hepatotoxicity and the principle of disposal.

Analysis of the adverse drug reactions of anti-tuberculosis drugs in 702 cases

Xie Li,Gao Weiwei,Bu Jianling,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  275-278. 

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Objective To analyze the anti-tuberculosis adverse drug reactions(ADRs) occurred in hospital patients in special tubercular hospital. Methods Retrospectively studied the incidence rate of anti-tubercular adverse drug reactions through admission document,medical orders,laboratory examination and diagnostic examination offered by tuberculosis specialists. Results Of 1222 patients,702 cases experienced 25 types of ADRs.287 cases experienced more than one types of ADRs.The total number of the ADRs was 1097.Treatment regimens were required modification in 332 of 1222 patients(27.17%) because of severe adverse reactions.Hyperuricemia was the most common ADRs.Among 1079 ADRs,409 were hyperuricemia(37.28%).96% ADRs occurred in 60 days. Conclusion The ADRs should be taken into consideration.It is important to reinforce the training to the doctors and to intensify the propagandizer to the patients.Individual treatment should be adapted to every patient. Closer monitored during the process of treatment in order to modify the dosage and the regimen.The anti-tuberculosis ADRs reporting system in hospital should be improved.

Clinical analysis of 62 cases with myeloid form tubercular meningitis in adult

Han Lijun,Yan Shiming,Guo Ziyuan,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  279-282. 

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Objective To discuss the clinical feature and treatment method of myeloid form tubercular meningitis（TBM） in adult. Methods To retrospectively analyze the 62 cases myeloid form tubercular meningitis in adult from 1999 to 2004. Results The percentage of myeloid form tubercular meningitis to tubercular meningitis in corresponding period patients was 13.9%.Main clinical manifestation were paraplegia,urination disorder and dysporia,disturbance of sensation result of conduction tract besides fever and meninges irritation symptom.Cerebrospinal fluid（CSF） circulation circuit was obstructed at various degree and CSF routine and biochemistry was not fully corresponding with albuminocytologic dissociation phenomenon and ADA activity rises obviously,cytology presents mix cell changed,but the percentage of neutrophil was relatively low,the average rate was 17.7%.Urination disorder and dysporia resumed earlier than paraplegia and the cure rate was 61.3%,case-fatality rate was 3.2%,the sequela rate was 35.5%,the recuring rate was 1.6%. Conclusion The cure rate of myeloid form tubercular meningitis is low and the sequela rate is high.Early discovery and effective treatment can prevent partly myeloid form tubercular meningitis.Anti-tubercular therapeutic schedule with mainly H,R,S（E）,Z combined through 18～24 months apply to myeloid form tubercular meningitis,and feasible dose dexamethasone and long-period releasing cerebrospinal fluid combined with intrathecal injection can raise the cure rate of myeloid form tubercular meningitis.

Comparing analysis between chest X-ray film and CT scan in the diagnosis of smear negative pulmonary tuberculosis

Lu Xiwei¹,Wu Jianlin,Liu Jinghua,et al

Chinese Journal of Antituberculosis. 2008, 30(4):  283-287. 

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Objective To explore the value of CT in diagnosis of secondary smear negative pulmonary tuberculosis compared with chest X-ray film. Methods 118 smear negative pulmonary tuberculosis suspects were detected by chest X-ray film and CT scan,which included 76 cases of pulmonary tuberculosis and 42 cases of non-pulmonary tuberculosis.X-ray findings and CT manifestations were double-blindedly analyzed according to Receiver Operating Characteristic(ROC) curve. Results Calculated in the diagnostic threshold,the sensitivity,specificity,accuracy,positive prediction value and negative prediction value of X-ray findings were respectively 81.6%,61.9%,74.6%,76.3% and 69.2%,and those of CT findings were 93.4%,88.1%,91.5%,92.2% and 89.8%.Areas under the ROC curve(Az=0.958±0.043) of CT findings were significantly higher those of chest X-ray findings(Az=0.758±0.102) and chest X-ray findings with PPD,TB-AB tests(Az=0.833±0.071,P<0.01). Conclusion Chest CT scan plays the important role in diagnosis and differentiate diagnosis of smear negative pulmonary tuberculosis suspects.

Contrast research of NovoRapid 30 and Novolin 30R in treating T2DM complicated with pulmonary tuberculosis

Jin Zhoude,Yu Guancheng,Zhang Zhiyong,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  287-290. 

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Objective To compare NovoRapid 30 with Novolin 30R in curative effect and security in treating type 2 diabetes mellitus complicated with pulmonary tuberculosis. Method The contrast observation was conducted randomly and openly for 12 weeks,60 patients of T₂DM complicated with pulmonary tuberculosis were divided into two groups.One group was treated by NovoRapid 30 and the other by Novolin 30R.All of them used in the way of hypodermic injection before breakfast and dinner,the blood sugar for 7 times a day was measured and HbA_lC and low blood sugar response and other side effects were also observed.In addition to this,sputum conversion and chest X-ray were observed. Result The level of blood sugar of using NovoRapid 30 after three meals was lower obviously than that of Novolin 30R(P<0.05),the rate of low blood sugar of NovoRapid 30 was lower than that of Novolin 30R,and the rate of serious low blood sugar of NovoRapid 30 was 55% of Novolin 30R,HbA_lC,amount of of the use of insulin and other side effects of the two groups have no statistically significant difference.The rate of sputum conversion rate of NovoRapid 30 was 90.4%,and that of Novolin 30R was 75%.There was statistically significant difference between the two groups(P<0.05).The number of the cases with absorption of chest X-ray of NovoRapid 30 was 19 and that of Novolin 30R was 18.There was no statistically significant difference between them. Conclusion The effect of NovoRapid 30 in controlling blood sugar after breakfast and dinner is more satisfied than that of Novolin 30R.The rate of low blood sugar is lower,and the rate of sputum conversion is higher.Thus,to select NovoRapid 30 to treat T₂DM complicated with pulmonary tuberculosis is better than Novolin 30R.

Clinical analysis of 67 cases with pulmonary tuberculosis in infant

Zhang Hailin,Huang Limi

Chinese Journal of Antituberculosis. 2008, 30(4):  291-294. 

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Objective To analyze the clinical features of pulmonary tuberculosis in infant. Methods Retrospective analysis of the clinical features of 67 cases with pulmonary tuberculosis in infant,including BCG vaccine,contact history with tuberculosis,clinical manifestation,laboratory examination,chest imaging and PPD test was conducted. Results Twenty cases(29.9%) were found with no BCG vaccine. Thirty-one cases(46.3%) had contact history with tuberculosis and 26 cases(38.8%) were temporary resident children.Fifty-one cases(76.1%) were found with fever,59(88.1%) with respiratory symptom,and 15(22.4%) with nerve system symptom.Fourteen cases(20.9%) were found with negative PPD test,50(74.6%) with elevatory CRP,45(67.1%) with elevatory ESR,45(67.2%) with leucocytosis.Chest x-ray was performed in 67 cases,while 16 cases(23.9%) showed increased bronchovascular shadows.CT examination was performed in 58 cases and 2 cases were normal.Finally,40 cases(59.7%) were diagnosed with primary pulmonary tuberculosis,14(20.9%) with hematogenous pulmonary tuberculosis,5(7.5%) with secondary pulmonary tuberculosis and 8(11.9%) with tuberculous pleurisy. Conclusion Pulmonary tuberculosis in infant has a certain clinical characteristics and clinical physician should attach weight to the early diagnosis.Prevention and cure with pulmonary tuberculosis in recurrent population should be strengthened and BCG vaccination in temporary resident children should be extended.

Clinical study of a scoring model for smear negative active pulmonary tuberculosis

Zhang Qing,Xiao Heping

Chinese Journal of Antituberculosis. 2008, 30(4):  295-298. 

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Objective To develop a diagnostic scoring model of smear negative active pulmonary tuberculosis(TB). Methods A hospita1-based case-control study was undertaken among a cohort comprised of 119 smear negative active pulmonary TB patients and 79 patients with other respiratory diseases who were hospitalized between Jun,2005 and Dec,2006.All patients were recorded with their symptoms and laboratory examinations.Risk factors and symptoms described in the documents were compared between these two groups.Significant and borderline risk factors and symptoms were selected to undergo multivariate logistic regression.A high risk scoring model was constructed according to the weighted numerical scores of every variable. Results The average score was significantly higher for the smear negative active pulmonary TB patients than for the control patients(mean 21.3±3.0vs15.3±3.4,P<0.01).With a cut-off value of 19 points,the sensitivity and specificity of the scoring model were 84.9%(101/119) and 81.0%(64/79),respectively. Conclusion The diagnostic scoring model provides a simple and feasible way to detect earlier smear negative active pulmonary TB patients in hospitals at all levels,especially for hospitals at low level without sputum culture facility.This screening strategy needs to be demonstrated furtherly.

The treatment of modified anterior focus debridement for the lower lumbar tuberculosis

Meng Chaozhong,Dang Li,Ren Fengqiang,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  299-300. 

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Objective To evaluate the curative effect of modified anterior focus debridement for the treatment of lower lumbar tuberculosis. Method Eight lower lumbar tuberculosis cases from April 2005 were analyzed retrospectively among whom 3 were male and 5 were female,and the age was ranged from 26 to 57 years with a mean of 35 years.For the focus of tuberculosis,1 was involved in L₃～L₄,4 were involved in L₄～L₅,1 was involved in L₅～S₁,1 was involved in L₃～L₅,and 1 was involved in L₄～S₁.All cases received modified anterior focus debridement,bone fusion and internal fixation along with strict anti-tuberculosis chemotherapy.The improvement of symptoms and neurological function,angles reduced by the surgeries and bone fusion during follow-up were observed. Result No recurrence was found in the follow-up period extending from 6 months to 24 months with an average of 14 months.4cases were observed for up 12 months,4cases acquired primary healing,the systematic and local symptoms were released postoperatively,and no internal loosing of the fixation was found.According to the standard of Bridwell,there were 2 cases in Bridwell class I and 2 cases in class Ⅱ. Conclusion The treatment of lower lumbar tuberculosis through modified anterior focus debridement has many advantages which include fully revealing,complete lesion resection,and less injury.

Primary analysis on the effect of implementing the pilot of the Manual of Standard Operating Procedures for Tuberculosis Drug Administration

Qin Yubao,Fang Hongxia,Xie Yanguang,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  301-303. 

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Objective To analyze the effect of implementing the Manual of Standard Operating Procedures for Tuberculosis Drug Administration(SOP Manual) in 27 pilot counties. Methods To contrast the lack percent of drugs,the usable time of stock drugs,the stock percent before implementing the SOP Manual(first quarter in 2007) and after(fourth quarter in 2007)in 27 pilot counties. Results The lack percent of drugs and the stock percent were the same before and after implementing the SOP Manual.The number of the counties,in which the usable time of HRZE,HR,water used in injection and injector were in 1～5 months logical useable time,were 19(67.9%),18(64.3%),16(57.1%) and 17(60.7%)before implementing the SOP Manual,and were increased to 23(85.2%),21(77.8%),21(77.8%) and 20(74.1%)after implementing the SOP Manual. Conclusions After half a year,the usable time of drugs are more reasonable in pilot counties implementing the SOP Manual,but there are some problems in the stock control in a few pilot counties.When the SOP Manual is generalized in the future,the training and the supervision should be strengthened to improve the drug management level roundly.

Relationship of drug resistance retreated smear-positive tuberculosis and chemotherapy history

Miao Ziping,Zheng Jinlei,Liu Zhengwei,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  304-307. 

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Objective To understand the chemotherapy history and the antituberculosis drug resistance among the retreated smear-positive tuberculosis patients in Zhejiang,and to provide evidence for estimating applicability of standard chemical therapy regiment for retreated smear-positive tuberculosis patients. Methods According to the Guidelines for Surveillance of Drug Resistance in Tuberculosis of WHO/IUATLD,30 counties were randomly selected with population proportionate cluster sampling method.Proportion method was used for drug sensitivity test.The data of the drug resistant surveillance and the clinical information questionnaire recording treatment history of all retreated smear positive pulmonary tuberculosis cases enrolled were analyzed. Results The rate of drug resistance and multi-drug resistance was 52.9% and 29.7% respectively,the order of drug resistance rate arranged from high level to low level was H(38.1%),R(34.8%),S(29.7%),E(13.5%).Any drug resistance rate and multi-drug resistance(MDR) rate in the finished treatment course cases were 77.3% and 52.3% respectively,which was the highest among all cases,and the second highest rate was that in the first time treatment cases with the drug resistant rate and MDR rate were 45.1% and 23.2%. The trends of any drug resistant rate and MDR rate increased with the increasing of treatment period and drug variety. Conclusion Drug resistance rate varies in different types of the first time retreated pulmonary tuberculosis patients due to the history of drug use,which indicates that the current standard retreatment regimen is probably ineffective for some patients.It is suggested that chemical therapy regiment for retreated smear-positive tuberculosis patients should be various.

The report of WHO drug resistance surveillance on tuberculosis,Xinjiang

Jia Wei,Zhang Wei,Wu Weidong,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  307-310. 

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Objectives To evaluate the magnitude and pattern of drug resistant tuberculosis in Xinjiang,and to assess TB control performance in the region. Methods Thirty clusters were randomly selected with cluster sampling method.According to case enroll criteria,all the new smear positive cases and retreated smear positive cases during the survey period were involved and their sputum were collected for culture. Results Drug susceptibility testing against INH,RFP,SM and EMB were performed in 1083 cases.The overall drug resistance,drug resistance among new cases and retreated smear positive cases were 26.4%,25.9% and 30.7%,and the multi-drug resistance rate was 4.6%. Conclusions The prevalence of drug resistant tuberculosis is rather high in Xinjiang,and the quality of TB control performance need to be strengthened.

Analysis on anti-tuberculosis efficiancy and cell mediated immunity for HIV-1 infected patients with pulmonary tuberculosis disease

Liu Fengren1,Tang Heng,Yin Jiguo,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  311-315. 

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Objective To understand the immunological characteristics and chemotherapy effect of HIV infected patients with tuberculosis. Methods Cross-sectional study was performed to compare the lymphocyte subsets of 12 HIV infected patients with tuberculosis,24 HIV infected patients with latent M.tuberculosis infection,74 patients infected HIV only,56 active pulmonary tuberculosis without HIV infection and 36 normal controls,and data of full blood count,adverse reactions,convert of sputum test and lung pathological changes in HIV-infected patients with tuberculosis disease were prospectively collected to analyse their chemotherapy effect after 6 month therapy. Results(a) Compare to normal controls,both HIV infection and M.tuberculosis infection can result in a decrease of lymphocyte subset count among these patients(P<0.05).(b) Immunology changes correlated with HIV infection predominated among patients co-infected with HIV and M.tuberculosis,and their lymphcyte count decreased similarly whether their tuberculosis disease occurred or not.(c) Anti-tuberculosis therapy was good in HIV-infected patients with tuberculosis.There was no significant difference regarding occurrences of adverse reactions,convert of sputum test and changes of represents of chest radiography between HIV-infected patients with tuberculosis disease and patients with tuberculosis only(P>0.05). Conclusion Cell-mediated immunity of HIV-infected patients with tuberculosis mainly correlates with their HIV infection,and effective anti-tuberculosis therapy can enhance their cellular immune function and control their tuberculosis disease well.

Study on human resource quantity for TB prevention and control in China

Xu Huan1,Liu Yi,Liu Xin

Chinese Journal of Antituberculosis. 2008, 30(4):  316-319. 

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Objective To provide evidence for policy making,and to explore human resource research for institute of tuberculosis(TB) prevention and control. Methods Three sources of data,namely the investigation in 6 provinces on TB institute human resource development conducted in 2006,the mid-term evaluation for national TB program conducted in 2005,and the national investigation on TB training needs conducted in 2005 were used. Results During 2001—2005,there was a persistent and slow increase of permanent staff from 19375 to 24056 in nationwide institutes for TB prevention and control,average annual increase rate was 5.6%;however,proportions of institute which could not meet the national recommended standard of staff number in provincial,prefecture and county level were 64.5%,70.6% and 40.1%,respectively;proportions of institute which could not meet staff number required by its own demand in relevant each level were 76%,67% and 63% respectively.In recent five years,institutional outflow rate of staffs was grown up firstly followed by decreasing,and inflow rate was persistent increasing,furthermore,44.0% of inflow was by competitive hiring procedure,and 43.3% was by non-competitive procedure,45.5% of outflow was by passive way,35.5% by active way. Conclusion It is necessary to understand the changing model of human resource quantity for TB prevention and control in China,and develop the human resource development plan in tactical perspective.

Analysis on the factors affected the results of 962 retreatment smear-positive pulmonary tuberculosis cases

Yin Jianjun,Zhong Qiu,Jiang Li,et al

Chinese Journal of Antituberculosis. 2008, 30(4):  320-322. 

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Objective To explore the factors related to the Results of retreatment smear-positive pulmonary tuberculosis cases and establish predictive model. Methods Retrospectively analyze the chemotheraputic Results of 962 retreatment smear-positive pulmonary tuberculosis cases through Logistic Regression Analysis. Results The model can be established based on the five factors which affect the Results significantly(P<0.05): the result of sputum smear test after two months of treatment,hemoptysis or bloody sputum,chemotherapy regimens,category of patient,extent of disease on radiograph. Conclusion The predictive model will be helpful to detect the potential failure cases more timely and provide new idea for MDR-TB control.

Analysis on the factors related to the non-arrival of the traced patients reported by general hospital through the Internet based TB reporting system

Gao Cuinan,Xu Zuowei,Li Xiaoyan,et al

Chinese Journal of Antituberculosis. 2008, 30(4):  323-325. 

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Objective To explore the factors related to the non-arrival of the traced patients reported by general hospital through the Internet based TB reporting system. Methods The factors of the 99(the total number of pulmonary tuberculosis cases reported were 380) cases who reported by general hospital through the Internet based TB reporting system and were failed to be traced by TB institution from Jan.2006 to Mar.2007 were analyzed. Results Of 380 cases with pulmonary tuberculosis in Yuexiu district,there were 281 cases who arrived after tracing.The arrival rate was 74.0% and the non-arrival rate was 26.0%.Of the 99 cases who did not arrive after tracing,30(7.9%) cases returned hometown,24(6.3%) cases could not be found,17(4.5%) cases were left with false address,5(1.3%) cases died,4(1.3%) cases were because of moving home and refusing to TB institution for medical help respectively,15(3.9%) cases were because of other reason. Conclusion There are multiple factors related to the non-arrival of the traced patients reported by general hospital through the Internet based TB reporting system,among which returning hometown,patients could not be found and false address were the main factors accounting for the 72% of the total non-arrival.

Investigation on Nourishment Status in Hospitalized Adult Tuberculosis Patients

Lv Jing,Sui Xiangqian,Xu Ying,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  325-328. 

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Objective To understand the nourishment condition of hospitalized adult tuberculosis patients. Methods 585 hospitalized adult tuberculosis cases were selected by random sampling.Among them,357 were male,228 were female;387 cases were with single type tuberculosis,and 198 cases were with 2 types of tuberculosis or above.Control group had 312 cases of healthy person.The height,weight,index of body weight%（IBW%）,body mass index（BMI）,triceps brachii skin fold（TSF）, upper arm muscle circumference（AMC）,serum albumin（ALB）,serum prealbumin（PA）, serum transferri（TF）,creatinine-height index（CHI）,and total number of lymphocyte（TLC） were measured in these cases.The measured data were compared between the tuberculosis group and the control group,different type of tuberculosis,and different age groups The data were analyzed by t test and F test. Results The IBW%,BMI,TSF,ALB,TF,PA,CHI and TLC in cases with tuberculosis were much lower than that in control group（P<0.05）.The IBW%,BMI and TSF in cases with type Ⅲ tuberculosis were much lower than those in type Ⅱ tuberculosis（P<0.05）.The IBW%,BMI,TSF,AMC,ALB,CHI and TLC in cases with 2 types of tuberculosis or above were much lower than that in single type tuberculosis（P<0.05）.There were no obvious different between the different age groups（1844y,4559y,≥60y）. Conclusions The tuberculosis is the nutrition relativity disease.Many data about nourishment condition in tuberculosis cases were much lower than those in the control group.Compared with cases with Ⅱ type tuberculosis and single type tuberculosis,the conditions of malnutrition in Ⅲ type tuberculosis and were with 2 types of tuberculosis or above were more severe.

Evaluating the effect of the external quality assurance of the tuberculosis sputum smear blind rechecking in Tai Zhou City

Bao Wenjuri¹ , Liu Zhengwei；

Chinese Journal of Antituberculosis. 2008, 30(4):  329-331. 

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Objective To evaluate the quality of tuberculosis (TB) sputum smear and sputumexamination in TB lab in Tai Zhou City, and to improve the quality of the sputum examination.Method According to the Handbook of Quality Assurance of Sputum Examination, Chinese Tu-berculosis Prevention and Control Plan, the field evaluation and blind rechecking of TB lab werecarried out. Result Rechecking coincidence rate was 98.6%, positive coincidence rate was96. 1 %, negative coincidence rate was 99. 1 % , coincidence rate of general hospital was 98. 9% , andcoincidence rate of TB dispensary was 98. 1 %. Sputum smear quality index included the coincidencerates of sputum cell, size, thickness, dyeing and shedding, which were 89. 5%, 69. 5%, 72. 9%,91. 5% and 97. 4% respectively. For the field evaluation, the pre-job training for the TB lab techni-cians in TB dispensary was stable, the room for TB lab, the equipment and the maintain of the spu-tum smears in TB dispensary were better than the lab in general hospitals. Conclusion Blind re-checking of EQA and field evaluation are effective Methods to identify the problems and rectify theexisting mistakes.

The investigation report of the situation about sputum smear spots at township level in Gansu province

Si Hongyan,Mu Taojun,Li Qing，et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  332-335. 

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Objective To investigate the situation of the tuberculosis sputum smear spots in the township hospitals established from 2005 to the first half year of 2007,to offer the basis of the development of the next-step plan and to standardize the work of the criterion work of sputum smear spots. Methods The basic situation of the sputum smear spots in Gansu province and the situation from 2005 to first half year of 2007 were investigated,and the problems in the sputum smear spots were analyzed. Results There were 535 sputum smear spots at township level in Gansu Province.The staff of laboratory were all part-time worker.The munberof the sputum smear were 18416,17798,and 9242 cases/shares respectively from 2005 to first half year of 2007.1 001936 and 395 smear positive TB cases were reported respectively.Nevertheless,there were 20～33% sputum smear spots have never been started,and there were 20%～24% among the spots which have found over 50 cases every year.The smear positive rate of TB patients examined was 4.3%～5.4% on average and under the county level. Conclusion Although it has contributed to the case finding in Gansu province,it still has some problems such as no professional examination staff,poor laboratory situation,unbalanced the activities of TB laboratory.Thus,the capacity building of TB control laboratory should be greatly improved on the base of the actual situation.

Investigation on the nutritional status and nutritional therapy in 398 patients with pulmonary tuberculosis

Xu Yingling

Chinese Journal of Antituberculosis. 2008, 30(4):  335-337. 

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Objective To evaluate the nutritional status of the patients with pulmonary tuberculosis and discuss the effect of nutritional support in the treatment of tuberculosis. Methods A total of 398 subjects with pulmonary tuberculosis were randomly allocated into two groups(the nutritional support group and the general treatment group).Conventional therapy was same in two groups,and the general treatment group ate freely while the nutritional support group was provided with additional high-protein enteral nutrition formulations. Results Body mass index,triceps,skinfold thickness,albumin and total lymphocyte count increased significantly in the nutritional support group and were higher than those of the normal treatment group,and the conversion rate of sputum culture in the nutritional support group was significantly higher than that of the normal treatment group(P<0.05). Conclusion The intake of dietary nutrition was inadequate and the high proportion of the malnutrition was high in patients with pulmonary tuberculosis.The nutritional support therapy has great effect in alleviating the clinical symptoms and reducing hospitalization duration..

Rapid detection of drug susceptibility testing in Mycobacterium tuberculosis by nitrate reductase assay

Gao Tiejie,Zhang Zhiguo,Du Chunying,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  338-341. 

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Objective To evaluate the value of nitrate reductase assay(NRA) for drug susceptibility testing of Mycobacterium tuberculosis. Method Four hundries and ninety-two Mycobacterium tuberculosis strains and 30 standard strains were determined the resistances to isoniazid,rifampin,streptomycin,and ethambutol with absolute concentration method and NRA. Results Absolute concentration method as control,NRA and absolute concentration method in accordance basically(than 95%),NRA susceptibility was more than 90% and specificity than 95%.Compare with absolute thickness law,the sensitivities of NRA for the detection of isoniazid,rifampin,streptomycin,and ethambutol resistances were 91.6%,96.5%,92.2%,90.7%,respectively.The specificities of NRA were 96.0%,98.2%,97.3%,97.3%,respectively.The accordance rates of these two Methods were 95.0%,97.9%,96.2%,96.7%,respectively. Conclusions NRA is a simple,rapid and low-cost drug susceptibility testing of Mycobacterium tuberculosis.

The survey on the awareness rate about tuberculosis control policy among general public and TB suspects in Henan province

Jiang Jianguo,Zhang Yanqiu

Chinese Journal of Antituberculosis. 2008, 30(4):  341-343. 

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Objective To understand the awareness rate about tuberculosis(TB) control policy in Henan. Method By non-probability aim sampling,the target population were divided into two groups including the resident group and the TB suspect group.Questionnaire was used in the survey. Result 637 residents,220 TB suspects were surveyed.The awareness rate of TB patients about the free treatment policy was less than 50% and the awareness rate of the residents was under 30%.The awareness rate of the "less than 20 yeas old group" was the highest.There was no difference between different genders of TB suspects and residents in the awareness rate about tuberculosis control policy.The awareness rate of the residents who have a better economic level was higher. Conclusion It is important to strengthen the public health education about the free treatment policy of TB.When the clinician provides health care service to TB patient,he should inform the knowledge to the patient.We should do more public health education to the people in the poverty area.

Analysis on sputum examination for tuberculosis suspects in general hospital in 30 counties in Hubei province

Zhou Liping,Xiong Changfu,Zhangxiaofeng,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  344-347. 

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Objective To analyze the status of health consultation of tuberculosis(TB) suspects in different conditions,and to explore the Methods to improve the consultative rate of TB patients. Methods In 30 counties which implemented FIDELIS(Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) project,the suspected are transferred to county level TB dispensaries or township/ general hospital smear microscopy spots by having trained village-doctor referred,and compared with the self-referred suspected patients.The active pulmonary tuberculosis will receive 8 yuan communication allowance,and the medical practitioner will receive 24 yuan reward who has successfully referred 1 smear positive patient. Result 43464 TB suspects were enrolled in 30 county dispensaries where the FIDELIS project has been implemented from Nov.2004 to Oct.2005.The consultative rate of TB suspects was 0.6‰,and the consultative rate of self referred TB patients was 1.2‰.In 2003,the consultative rate of referred by medical practitioner and self referred were 0.2‰ and 1.2‰,respectively,and the total in the 30 units was 1.4‰.Compared with the rate before the project implementation,the consultative rate TB suspects has increased 28.5%.In poverty and non-poverty counties,the consultative rate were 1.7‰ and 1.8‰,and among them,the rates of referred by medical practitioner and self referred were 0.9‰,0.8‰,and 0.6‰,1.3‰,respectively.In plain,mountainous and hill counties,their consultative rates were the same,1.8‰,and among them,the rates of referred by medical practitioner were 0.5‰,1.0‰ and 0.6‰,respectively. Conclusion Recommending the suspected patients to TB dispensary referred by medical practitioners,it is effective to increase the rates of consultative and case-finding,especially in poverty and mountainous areas where they lack of medical supports and information.

Analysis of survey of the World Bank Loaned/DFID granted TBcontrol program in Changchun

Li Xiaokun,Yang Guangxu,Yuan Li,et al.

Chinese Journal of Antituberculosis. 2008, 30(4):  348-351. 

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Objective To evaluate the implementation of World Bank Loaned/DFID granted TB control program. Methods The routine supervision data and some relevant materials in 10 districts countries of Changchun municipality from 2003 to 2006 were collected,summarized and analyzed. Results Over the past four years,11533 smear-positive TB cases were found.The notification rate of smear-positive TB was increased by 57.9% from 30.80/100000 to 48.64/100000,new smear-positive TB also increased by 149.2% from 16.68/100000 to 41.57/100000.The cure rate of new smear-positive TB reached 91.5% and retreatment smear-positive TB reached 84.0%.The number of retreatment smear-positive TB decreased year after year.The lose rate of smear-positive patient reduced.The lose rate of 2006 was lower than the rate for the three years before the implementation of the TB preject.The lose rate of new smear-positive TB reduced from 5.6% to 0.6%,the lose rate of retreatment smear-positive from 30.1% to 0.9%. Conclusion World Bank Loaned TB control preject in Changchun has made a great progress in the past four years.This requires much more effort in the coming several year to control the spread of TB and assure the program goals to be fully realized.