Table of Content

10 September 2026, Volume 48 Issue 9

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Special Topic

Application and prospect of ultrasound-mediated transdermal drug delivery in adjuvant treatment of tuberculosis

Zhong Leping, Qin Shibing, Sha Wei, Deng Guofang, Lin Minggui

Chinese Journal of Antituberculosis. 2026, 48(9):  1245-1249.  doi:10.19982/j.issn.1000-6621.20260284

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Ultrasound-mediated transdermal drug delivery is a new drug treatment method, which has the advantages of precision, non-invasiveness, safety, local high concentration, and is an important new idea and new measure for tuberculosis treatment. This article systematically elaborated the mechanism and principle of ultrasound-mediated transdermal drug delivery, the indications and contraindications of various tuberculosis treatments, the evaluation and preparation before treatment, the operation process of treatment, the selection of therapeutic drugs, the prevention and treatment of complications, and the management after treatment. The aim is to provide clinical medical staff with operational practice guidance, help to improve the safety and standardization of this technology in the application of adjuvant treatment of tuberculosis, and show the future development prospects of this technology in the adjuvant treatment of tuberculosis.

Interpretation of Standards

Interpretation of the World Health Organization’s Target Product Profiles for Tuberculosis Screening Test Products

Huang Huan, Wang Xiaomin, Song Zhe, Li Xuelin, Ding Feng, Wang Jin, Zeng Jianfeng, Wu Haiwu, Zhong Xinguang, Lu Shuihua

Chinese Journal of Antituberculosis. 2026, 48(9):  1250-1258.  doi:10.19982/j.issn.1000-6621.20260285

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Global tuberculosis (TB) prevention and control has long relied on the passive case finding model, where patients seek medical attention only after symptom onset. This pattern leaves approximately 20%-40% of TB cases undetected each year, and the persistent diagnostic gap has emerged as a major obstacle to achieving the strategic targets of the WHO End TB Strategy. To scale up screening coverage and strengthen active case finding capacity, there is an urgent need to develop screening test products applicable to large-scale community settings and high-risk populations. In 2025, the World Health Organization (WHO) issued its first Target Product Profiles for Tuberculosis Screening Test Products dedicated to screening scenarios. The document systematically defines the minimum and optimal requirements for screening test products across multiple dimensions, including intended use, diagnostic performance, pricing strategy, and operational attributes. The core update of this guidance is the proposal of three categories of screening test products adapted to distinct scenarios, informed by mathematical modelling: single-step screening assays with both high sensitivity and high specificity, high-sensitivity two-step screening assays, and high-specificity single-step screening assays. These profiles establish clear performance benchmarks and application roadmaps for the research and development of innovative screening technologies. As the first strategic guidance document exclusively focused on TB screening test products, it provides not only a normative framework for product development, but also decision-making reference for stakeholders including national TB control programs, funding agencies, and screening test manufacturers. It is expected to accelerate the translation and deployment of innovative diagnostic tests, and advance the optimization and widespread adoption of active TB screening strategies.

Interpretation of the Group Standard Specifications for the Construction of Tuberculosis Preventive Treatment Clinics in Primary Medical Institutions

Ren Feilin, Jin Meihua, Tong Zhaowei, Zheng Pingming

Chinese Journal of Antituberculosis. 2026, 48(9):  1259-1265.  doi:10.19982/j.issn.1000-6621.20260015

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Specifications for the Construction of Tuberculosis Preventive Treatment Clinics in Primary Medical Institutions (T/CHATA—052—2025) is a group standard issued by the Chinese Antituberculosis Association on September 25, 2025, and took effect on the same day. This standard mainly covers the construction conditions for tuberculosis preventive treatment clinics in primary medical and health institutions. It clarifies the norms regarding the clinics’ service targets, service contents and construction effect evaluation, providing a reference for primary medical and health institutions to deliver tuberculosis preventive treatment services. To facilitate the grassroots staff in accurately understanding and standardizing the application of this standard, this paper elaborates on its compilation background, main contents, formulation basis and application. It thereby provides technical guidance for the standardized construction and operation of the tuberculosis preventive treatment clinics at the grassroots level.

Original Articles

Analysis of clinical characteristics and factors influencing outcomes in elderly patients with drug-susceptible pulmonary tuberculosis

Bai Yan, Chen Yu, Gao Xusheng, Liang Jianqin, Zeng Yi, Wang Yun, Fan Lin

Chinese Journal of Antituberculosis. 2026, 48(9):  1266-1276.  doi:10.19982/j.issn.1000-6621.20260078

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Objective: To investigate clinical characteristics and identify clinical determinants of treatment outcomes in elderly patients with drug-susceptible pulmonary tuberculosis (DS-PTB), with the aim of providing evidence to improve prognosis. Methods: A national multicenter retrospective cohort study was conducted, enrolling 2349 elderly DS-PTB patients aged ≥60 years admitted to five hospitals between January 1, 2020 and January 31, 2025. Clinical information throughout the entire treatment course and treatment outcome data were collected. Multivariate logistic regression models were employed to analyze clinical factors influencing treatment outcomes in these patients. Results: The successful treatment rate among the 2349 patients was 69.26% (1627/2349), comprising a cure rate of 40.95% (962/2349) and a treatment completion rate of 28.31% (665/2349). Treatment failure in 26.39% (620/2349), lost to follow-up in 3.36% (79/2349), and death in 0.98% (23/2349). Multivariate logistic regression analysis showed that retreatment (OR=1.352, 95%CI:1.037-1.764), malnutrition (OR=2.657, 95%CI: 1.588-4.444), involvement of three or more lung fields (OR=1.776, 95%CI:1.425-2.213), pulmonary cavitation (OR=1.436, 95%CI:1.173-1.757), and adverse drug reactions (OR=4.005, 95%CI:3.284-4.884) were identified as risk factors for unfavorable treatment outcomes in elderly patients with DS-PTB. Prolonged treatment duration (OR=0.937, 95%CI:0.913-0.962) and use of the 9H-Rpt-E-Lfx regimen (OR=0.649, 95%CI:0.498-0.846) emerged as protective factors associated with favorable treatment outcomes. Conclusion: Elderly DS-PTB patients showed a lower successful treatment rate. In clinical practice, priority attention should be given to patients with retreatment, malnutrition, extensive lesions with cavitation, and poor drug tolerance, and early intervention targeting these factors is helpful to improve prognosis in this population.

Study on the association between gut microbiota and drug-induced liver injury in patients with drug-resistant pulmonary tuberculosis

Li Cheng, Wu Chunli, Xia Fan, Yu Wenduo, Liu Zhenguo, Yi Hengzhong, Wen Xinmin, Tang Zhigang, Huang Sheng, Li Yao, Chen Mengshi, Rong Pengfei

Chinese Journal of Antituberculosis. 2026, 48(9):  1277-1289.  doi:10.19982/j.issn.1000-6621.20260282

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Objective: To compare the differences in gut microbiota and their functional pathways between drug-resistant pulmonary tuberculosis (DR-PTB) patients with and without drug-induced liver injury (DILI), so as to identify gut microbiota and functional pathways associated with the development of DILI. Methods: A nested case-control design was adopted with Hunan Chest Hospital as the research site. Newly admitted inpatients diagnosed with DR-PTB were prospectively enrolled starting from September 8, 2021, to establish a follow-up cohort of DR-PTB patients. All cohort participants were followed up, and liver function tests were performed to monitor the occurrence of DILI during anti-tuberculosis treatment. By November 4, 2022, all patients diagnosed with DILI in the cohort were assigned to the DILI group (68 cases). Using a 1∶1 matching strategy, DR-PTB patients with normal liver function were selected as the control group (68 cases), matched by gender, age (±3 years), duration of anti-drug-resistant TB treatment (±1 month), and sample collection time (±1 month). Metagenomic sequencing was applied to extract DNA information from fecal samples. Software including R was used to analyze gut microbial alpha diversity, beta diversity, differential species, differential functional pathways, and correlations between differential species and differential functions across the two groups. Results: No statistically significant differences were observed in gut microbial alpha diversity and beta diversity between the DILI group and the control group (P>0.05). After adjusting for confounders such as age, eight bacterial species showed significant intergroup differences. Four species were enriched in the DILI group: Dorea longicatena (P=0.007), Prevotella sp. CAG:386 (P=0.012), Prevotella stercorea (P=0.013), and Prevotellamassilia timonensis (P=0.043). The other four species were enriched in the control group: Clostridium sp. CAG:7 (P=0.020), Eubacterium sp. CAG:38 (P=0.002), Faecalibacterium sp. CAG:82 (P=0.047), and Klebsiella michiganensis (P<0.001). At KEGG level 3, pyruvate metabolism (P=0.010), butanoate metabolism (P=0.034), valine, leucine and isoleucine degradation (P=0.009), ethoxylate and dicarboxylate metabolism (P=0.041), and cationic antimicrobial peptide (CAMP) resistance (P=0.031) were enriched in the control group. Starch and sucrose metabolism (P=0.027) and fructose and mannose metabolism (P=0.005) were enriched in the DILI group. The abundances of seven differential functional pathways were positively correlated with the abundance of Klebsiella michiganensis (P<0.05). The pathway of valine, leucine and isoleucine degradation was negatively correlated with the abundances of the other seven differential species including Eubacterium sp. CAG:38 and Faecalibacterium sp. CAG:82 (P<0.05). Ethoxylate and dicarboxylate metabolism was negatively correlated with the abundances of Prevotella stercorea, Prevotellamassilia timonensis and Clostridium sp. CAG:7 (P<0.001). Pyruvate metabolism was negatively correlated with the abundances of Prevotella stercorea and Prevotellamassilia timonensis (P<0.001). Butanoate metabolism was negatively correlated with the abundance of Prevotella stercorea (P<0.001). Conclusion: Differences in gut microbial composition already exist prior to DILI onset between DR-PTB patients who subsequently develop DILI and those who do not. Abnormal functions related to starch, sucrose, fructose, mannose, pyruvate and butanoate metabolism, as well as impaired valine, leucine and isoleucine degradation, may be associated with DILI occurrence in patients with drug-resistant pulmonary tuberculosis.

Construction and clinical evaluation of an early diagnostic model for Mycobacterium intracellulare pulmonary disease

Xu Chaoyan, Wei Jiaojiao, Li Shanshan, Yao Lin, Li Ling, Gao Mengqiu

Chinese Journal of Antituberculosis. 2026, 48(9):  1290-1299.  doi:10.19982/j.issn.1000-6621.20260226

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Objective: To develop machine learning-based diagnostic models for efficient differential diagnosis between early Mycobacterium intracellulare pulmonary disease and pulmonary tuberculosis. Methods: A total of 335 patients, including 135 cases of Mycobacterium intracellulare pulmonary disease and 200 cases of pulmonary tuberculosis admitted to Beijing Chest Hospital, Capital Medical University from January 1, 2021 to December 31, 2023, were retrospectively enrolled as the training cohort. Sociodemographic characteristics, baseline clinical parameters, and immunological indicators were collected. Univariate logistic regression was used for preliminary feature screening, followed by combined feature selection using weighted aggregated SHapley Additive exPlanations (SHAP)-based recursive feature elimination and Least Absolute Shrinkage and Selection Operator (LASSO) regression to identify core discriminative indicators, based on which multiple machine learning differential diagnosis models were constructed. An independent external validation cohort comprising 83 patients (35 with Mycobacterium intracellulare pulmonary disease and 48 with pulmonary tuberculosis) from the Fifth People’s Hospital of Suzhou, admitted from January 1, 2024 to December 31, 2024, was used to evaluate model generalizability. Results: Univariate analysis initially identified 11 clinical and immunological indicators with statistically significant intergroup differences. After dual feature screening, five core differential indicators were finally identified, namely age, pulmonary infection, diabetes mellitus, bronchiectasis, and body mass index (BMI). Among five machine learning models constructed based on these core indicators (Random Forest, Light Gradient Boosting Machine, Extreme Gradient Boosting, Extremely Randomized Trees, and Adaptive Boosting), the Random Forest model achieved the best diagnostic performance, with an area under the receiver operating characteristic curve (AUC) of 0.946 in the training cohort. In the independent external validation cohort, the model achieved an AUC of 0.830, with a sensitivity of 71.4% (25/35) and specificity of 75.0% (36/48), demonstrating stable discrimination between the two diseases. SHAP analysis enabled individualized interpretation of model predictions, and the model exhibited satisfactory overall interpretability and clinical stability. Conclusion: The Random Forest model constructed using routine clinical indicators can effectively differentiate early Mycobacterium intracellulare pulmonary disease from pulmonary tuberculosis, providing a reference for rapid auxiliary differential diagnosis in clinical practice.

Retrospective analysis of 21 cases of advanced knee tuberculosis treated with one-stage radical debridement and total knee arthroplasty

Ma Liang, Ilyar Batyr, Gu Fuding, Tang Wei, Zhou Wenzheng, Dilixiati Abulizi, Mierzhati Aisha, Qin Wei

Chinese Journal of Antituberculosis. 2026, 48(9):  1300-1306.  doi:10.19982/j.issn.1000-6621.20260314

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Objective: To investigate the clinical efficacy of one-stage radical debridement combined with total knee arthroplasty (TKA) on the basis of standard anti-tuberculosis treatment for advanced knee tuberculosis. Methods: A retrospective analysis was performed on the clinical data of 21 patients with advanced knee tuberculosis admitted to The Sixth People’s Hospital of Xinjiang Uygur Autonomous Region from January to December 2014. All patients received one-stage radical debridement combined with TKA and anti-tuberculosis chemotherapy. Perioperative laboratory indicators including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were collected. Pain and functional outcomes, including Hospital for Special Surgery (HSS) knee score, knee range of motion (ROM), and visual analogue scale (VAS) score, were documented before surgery and at the last follow-up. Prosthesis stability and postoperative complications were also recorded. Changes in CRP, ESR levels, HSS score, ROM and VAS score were compared between preoperative and postoperative status to evaluate the improvement of knee pain and function. Results: All patients underwent uneventful surgery with primary wound healing. The mean operative time was (100.5±12.3) min, the mean postoperative hospital stay was (11.5±2.2) d, and the mean duration of postoperative anti-tuberculosis chemotherapy was (14.0±2.6) months. All patients were followed up for 6 to 36 months, with a median follow-up of 24 (24, 36) months. At the last follow-up, the median (interquartile range, IQR) CRP was 5.4 (4.1, 6.8) mg/L and ESR was 14 (12, 17) mm/1 h, which were significantly lower than the preoperative levels (median (IQR) CRP: 15.8 (11.5, 20.3) mg/L; median (IQR) ESR: 45 (31, 67) mm/1 h), with statistically significant differences (χ²=91.575 and 86.941, respectively; both P<0.001). During follow-up, 1 patient (4.8%) developed wound breakdown due to early self-discontinuation of medication, and achieved full recovery after adjustment of the anti-tuberculosis regimen and debridement. At the last follow-up, all remaining patients had well-positioned prostheses, with no complications such as prosthesis loosening or periprosthetic fracture. Preoperatively, the mean HSS score was 39.0±7.0, the median (IQR) ROM was 60 (45, 75)°, and the mean VAS score was 6.7±0.9. At the last follow-up, the mean HSS score reached 81.3±6.8, the median (IQR) ROM was 100 (95, 110)°, and the mean VAS score was 2.1±0.7. Knee pain and function were significantly improved, with all differences statistically significant (t=51.421, P<0.01; Wilcoxon signed-rank test, P<0.01; t=24.500, P<0.01). Conclusion: For advanced knee tuberculosis, on the premise of strictly selecting indications, implementing standardized perioperative anti-tuberculosis treatment and performing thorough intraoperative debridement, one-stage TKA can effectively control infection, relieve pain and reconstruct knee function with a low recurrence rate. It is a feasible therapeutic strategy.

Analysis of the incidence of anemia and related risk factors in 878 AIDS patients with tuberculosis

Zhang Aihua, Xu Meng, Yang Yuying, Su Shuang, Song Lei, Ma Dandan, Wei Suxia, Cheng Junwei, Fu Chaohong

Chinese Journal of Antituberculosis. 2026, 48(9):  1307-1314.  doi:10.19982/j.issn.1000-6621.20260093

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Objective: To analyze the incidence and influencing factors of anemia in AIDS patients with tuberculosis in Henan Province. Methods: The clinical data of 878 patients with AIDS complicated by tuberculosis who were hospitalized in Henan Provincial Infectious Disease Hospital from January 2021 to November 2025 were retrospectively collected. The incidence of anemia and its influencing factors were analyzed. Results: The incidence of anemia among the 878 AIDS patients with tuberculosis in Henan Province was 61.39% (539/878). The results of multivariate logistic analysis showed that patients with extrapulmonary tuberculosis (OR=0.640, 95%CI: 0.432-0.947), antituberculosis treatment course of 6-24 months (OR=0.605, 95%CI: 0.428-0.855), or a CD4⁺ T-cell count >200 cells/μl (201-349 cells/μl: OR=0.320, 95%CI: 0.216-0.474; 350-499 cells/μl: OR=0.159, 95%CI: 0.094-0.272; ≥500 cells/μl: OR=0.051, 95%CI: 0.021-0.122) had a lower risk of anemia. Conclusion: The proportion of anemia in AIDS patients with tuberculosis in Henan Province is high. It is necessary to focus on patients with pulmonary tuberculosis, antituberculosis treatment course <6 months, and CD4⁺ T cell count ≤200/μl, so as to formulate and implement scientific and reasonable intervention measures to reduce the incidence of anemia risk.

Global, regional, and national burdens of tuberculosis attributable to smoking from 1990 to 2021

Xue Yunlian, Li Sijie, Jiang Xue, Liu Guihao, Wu Huizhong, Wang Tingting, Zhou Zhanqi, Ji Lianrong, Wang Jiawen, Wu Xinghua, Wu Yue, Zhou Lin

Chinese Journal of Antituberculosis. 2026, 48(9):  1315-1323.  doi:10.19982/j.issn.1000-6621.20250519

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Objective: To comprehensively assess the smoking-related tuberculosis burden from 1990 to 2021 and explore potential improvement room. Methods: Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed mortality and disability-adjusted life years (DALYs) attributable to smoking-related tuberculosis, stratified by age, sex, and socio-economic development level. Decomposition analysis was applied to identify key drivers of burden changes, while frontier analysis was used to visualize the potential for burden reduction at various levels of development. Results: From 1990 to 2021, the global age-standardized mortality rate of tuberculosis attributable to smoking decreased from 14.17 per 100000 population to 3.84 per 100000 population, and the age-standardized DALYs decreased from 483.39 per 100000 population to 136.43 per 100000 population, with estimated annual percentage changes (EAPC) of -4.33% and -4.21%, respectively. The smoking-related tuberculosis burden declined across all examined age groups aged 30-89 years, with the largest decrease in the mortality rate observed in the 65-69 year age group (EAPC: -4.57%) and the largest decrease in the DALY rate observed in the 60-64 year age group (EAPC: -4.48%). Among 204 countries and territories, the smoking-related tuberculosis burden generally showed a downward trend; only Lesotho and Zimbabwe showed increasing trends in age-standardized disability-adjusted life years rate (ASDR), whereas the remaining 202 countries and territories showed decreasing trends. In 2021, the age-standardized mortality rate (ASMR) and ASDR in low-socio-demographic index (SDI) regions were 9.80 per 100000 population and 320.81 per 100000 population, respectively, higher than those in high-SDI regions, which were 0.21 per 100000 population and 7.08 per 100000 population, suggesting an overall negative association between SDI and the smoking-related tuberculosis burden. Decomposition analysis showed that the declines in global deaths and DALYs were mainly driven by epidemiological changes, with contribution rates of 250.49% and 239.43%, respectively. Frontier analysis indicated that the smoking-related tuberculosis burden varied substantially across countries at the same SDI level; Lesotho, Kiribati, and Zimbabwe had relatively large ASDR effective differences of 3428.92, 2018.03, and 1425.11, respectively. Conclusion: The global burden of tuberculosis attributable to smoking showed a clear downward trend from 1990 to 2021, yet notable regional disparities persist, especially in low-SDI regions where the burden remains disproportionately high. Strengthening proactive and targeted tobacco control strategies is essential to further reduce smoking-related tuberculosis burden.

The current status and influencing factors of preoperative anxiety in patients with cervical lymph node tuberculosis

Huang Liping, Gu Wenju, Bao Peiyu, Shen Jiayi, Song Yanzheng, Zhang Lin

Chinese Journal of Antituberculosis. 2026, 48(9):  1324-1330.  doi:10.19982/j.issn.1000-6621.20260179

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Objective: To investigate the current status of preoperative anxiety among patients with cervical lymph node tuberculosis, identify independent influencing factors, and provide a scientific basis for targeted nursing interventions to alleviate anxiety and promote postoperative recovery. Methods: A convenience sample of 94 patients with cervical lymph node tuberculosis scheduled for elective surgery at Shanghai Public Health Clinical Center from October 2023 to September 2024 was enrolled. Data were collected using a demographic questionnaire, the Self-Rating Anxiety Scale (SAS), and the Social Support Rating Scale (SSRS). Statistical analysis was performed using SPSS 26.0. Results: The mean preoperative anxiety standard score of the 94 patients was 59.06±17.89, significantly higher than the Chinese national norm (33.80±5.90, t=12.345, P<0.001). Among them, 28 (29.8%) had no anxiety, 14 (14.9%) had mild anxiety, 21 (22.3%) had moderate anxiety, and 31 (33.0%) had severe anxiety; 55.3% (52/94) exhibited moderate or higher anxiety. The total social support score was 42.87±13.29. Pearson correlation analysis showed a significant negative correlation between preoperative anxiety and social support (r=-0.499, P<0.001). Multivariate linear regression identified female sex (β=6.515,95%CI:0.925-12.105), college degree or above (β=12.007,95%CI:6.232-17.782), history of ≥2 tuberculosis-related surgeries (β=12.462,95%CI:5.690-19.235), lack of disease awareness (β=-11.471,95%CI:-17.286--5.657), and low social support score (β=-0.228,95%CI:-0.527--0.033) related to preoperative anxiety. Conclusion: Preoperative anxiety is highly prevalent and severe in patients with cervical lymph node tuberculosis. High-risk groups include female patients, those with higher education, multiple previous tuberculosis-related surgeries, insufficient disease awareness, and low social support. Personalized nursing interventions are recommended to alleviate anxiety before surgery.

Research on performance comparison and selection strategies of digital PCR platforms for tuberculosis detection

Zhao Yuchuan, Chen Yanmei, Zhang Chenchen, Yu Meiling, Peng Kehao, Xu Liuyue, Liang Hongdi, Chen Xunxun

Chinese Journal of Antituberculosis. 2026, 48(9):  1331-1337.  doi:10.19982/j.issn.1000-6621.20260071

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Objective: This study aimed to systematically compare the performance differences of three digital PCR (dPCR) platforms on detection of Mycobacterium tuberculosis (MTB) nucleic acid, and to provide a scientific basis for platform selection in different application scenarios. Methods: Genomic DNA of the MTB standard strain H37Rv was extracted and serially diluted two-fold to prepare 22 samples with different concentration gradients. Three commercial dPCR platforms, namely TargetingOne D20 (Platform A), Snjper DQ24 (Platform B), and Maccura D610 (Platform C), along with their matched MTB detection kits, were used for testing. Evaluation metrics included detection sensitivity (the highest dilution at which a positive signal could be detected) and quantitative linear range (the span of consecutive concentration gradients meeting a coefficient of determination, R²≥0.99). A comprehensive analysis integrated core instrumental parameters (e.g., partition number, detection principle) and reagent kit characteristics (target genes, cost) was performed. Results: Regarding detection sensitivity, Platforms A, B, and C could detect positive signals at the highest dilution of 2²¹, 2⁹, and 2¹¹, respectively. Regarding the quantitative linear range (R²≥0.99), Platform A covered 11 consecutive concentration gradients, outperforming Platform B (5 gradients) and Platform C (4 gradients). Technical correlation analysis indicated that the high droplet count (100000) and the laser-photomultiplier tube (PMT) detection system of Platform A were the basis for its high sensitivity and wide linear range. The vibrating droplet and complementary metal oxide semiconductor (CMOS) imaging design adopted by Platforms B and C offered relative advantages in terms of cost and operational speed. For the accompanying reagent kits, both kits for Platform A and B contained target IS1081 and IS6110, enabling both qualitative and quantitative detection, while the kit for Platform B additionally integrated probes for drug resistance mutations rpoB and gyrB. The kit for Platform C contained only a single target IS6110, resulting in relatively limited functionality. Conclusion: Platforms following different technical pathways showed distinct differences in performance, functionality, and cost. Appropriate selection can be made according to specific needs, including scientific research monitoring, routine clinical diagnosis, and large-scale screening with emphasis on cost-effectiveness.

Predictive value of ARIMA model and Holt-Winters exponential smoothing method for pulmonary tuberculosis incidence in Xinjiang Uygur Autonomous Region

Gulijiamali Rexiding, Gulina Badeerhan, Wang Mingzhe, Paziliya Aini, Yipar Aihaiti, Wang le, Liu Nianqiang, Dong Xiao, Wang Senlu

Chinese Journal of Antituberculosis. 2026, 48(9):  1338-1345.  doi:10.19982/j.issn.1000-6621.20260085

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Objective: To evaluate the predictive value of the Autoregressive Integrated Moving Average (ARIMA) model and the Holt-Winters exponential smoothing model for pulmonary tuberculosis incidence in the Xinjiang Uygur Autonomous Region (abbreviated as “Xinjiang”), aiming to provide references for formulating pulmonary tuberculosis prevention and control strategies in the region. Methods: Monthly reported cases of pulmonary tuberculosis in Xinjiang from January 2014 to June 2024 were collected from the “Tuberculosis Management Information System”, a subsystem of the “China Disease Prevention and Control Information System”. Data from January 2014 to June 2023 were used as the training set to construct ARIMA and Holt-Winters exponential smoothing models. These two models were then employed to predict the reported incidence of pulmonary tuberculosis from July 2023 to June 2024. Finally, the predictive accuracy of both ARIMA and Holt-Winters models was evaluated by comparing the predicted values with the actual values. Results: Joinpoint regression analysis showed that the reported incidence of pulmonary tuberculosis in Xinjiang exhibited a general trend of first rising and then declining, with fluctuations at low levels in recent years from 2014 to 2024. It steadily increased from 176.00/100000 (39851/22643000) in 2014 to a peak of 304.94/100000 (74549/24446712) in 2018, followed by a rapid decline starting in 2019 (169.05/100000 (42043/24869966)), and further decreased to 77.68/100000 (20182/25980011) in 2024, demonstrating an overall downward trend (AAPC (95%CI)=-9.85% (-17.45% to -1.55%), P=0.026). Monthly seasonal indices for reported tuberculosis cases ranged from 81.51% (February) to 127.01% (June), indicating the time series fluctuated periodically over time with distinct seasonality. Following stationarity testing and systematic model identification—including examination of ACF and PACF plots, automated ARIMA selection via the auto.arima() function in R, and comparison of Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) information criteria—the multiplicative seasonal ARIMA(0,1,0)(1,0,0)₁₂ model was selected as the optimal model (AIC=1857.65; BIC=1863.10; MAPE=19.78%). In parallel, Holt-Winters modeling identified the multiplicative variant as superior to the additive form (MAPE=20.77%). For the predicted tuberculosis incidence from July 2023 to June 2024, the ARIMA(0,1,0)(1,0,0)₁₂ model demonstrated lower prediction errors, with RMSE=309.13, MAE=248.58, and MAPE=13.01%, compared to the Holt-Winters additive model (RMSE=786.48, MAE=732.00, MAPE=45.17%), indicating a better fitting effect. Discussion: The ARIMA model has a significantly better fitting effect for the monthly incidence of tuberculosis in Xinjiang compared to the Holt-Winters exponential smoothing model, and can serve as a more effective predictive tool.

Prevalence and influencing factors of latent Mycobacterium tuberculosis infection in patients with pneumoconiosis: a meta-analysis

Yang Qiuping, Wen Haoyu, Yu Ya

Chinese Journal of Antituberculosis. 2026, 48(9):  1346-1355.  doi:10.19982/j.issn.1000-6621.20260055

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Objective: To systematically evaluate the current epidemiological status and its risk factors of latent tuberculosis infection (LTBI) among pneumoconiosis patients, aiming to provide a reference for the formulating and improving prevention, control and management strategies for pneumoconiosis complicated wth tuberculosis. Methods: A systematic search was conducted using a combination of subject headings and free-text terms to identify Chinese and English-language research literature on pneumoconiosis complicated with LTBI from database inception to October 2025. Databases included CNKI, Wanfang, VIP, PubMed, the Cochrane Library and Web of Science. Following inclusion and exclusion criteria, a preliminary screening was performed based on titles and abstracts, followed by a re-screening through full-text review. Finally, relevant information was extracted from eligible studies. A random-effects model was employed to conduct meta-analysis, sensitivity analysis and subgroup analysis (by study type, region, location, population and type of pneumoconiosis) of LTBI prevalence, and to summarize and analyze factors associated with LTBI prevalence. Results: Following keyword searching, initial screening of titles and abstracts, and full-text re-screening, a total of nine studies were ultimately included, comprising eight Chinese studies and one German study. All studies utilized a Mycobacterium tuberculosis-specific quantitative interferon-gamma enzyme-linked immunosorbent assay (ELISA) to detect LTBI in the pneumoconiosis population. The LTBI prevalence varied considerably across studies (excluding one German study), ranging from 4.11% to 66.4%, with high heterogeneity (I²=94.00%, 95%CI: 90.37%-96.26%, P<0.001). The pooled LTBI prevalence was 44.69% (95%CI: 26.27%-64.69%). In the sensitivity analysis, after excluding studies with extreme LTBI prevalence and those with small sample sizes, respectively, high heterogeneity persisted across studies (I²=89.28%, 95%CI: 80.42%-94.13%, P<0.001; I²=94.65%, 95%CI: 91.24%-96.73%, P<0.001). In the subgroup analysis, heterogeneity was reduced in studies focusing on silicosis and coal worker’s pneumoconiosis, but statistical heterogeneity persisted in both (I²=86.05%, 95%CI: 59.52%-95.20%, P<0.001; I²=65.18%, 95%CI: 0.00%-90.00%, P=0.056). However, heterogeneity among studies on other types of pneumoconiosis significantly reduced after excluding studies with extreme LTBI prevalence (I²=48.07%, 95%CI: 0.00%-82.79%, P=0.123). Occupational factors (occupation type, workplace ventilation, type of dust exposure and duration of exposure), personal behaviors, lifestyle (smoking, alcohol consumption and dietary nutritional status), and social factors were associated with LTBI in the pneumoconiosis population. Conclusion: The prevalence of LTBI in pneumoconiosis patients is significantly higher than that in the general population; however, the LTBI prevalence varies considerably across studies, and the infection rate is influenced by occupational, personal behaviors and lifestyle habits, and social factors, future research should prioritize multi-center, prospective cohort studies to investigate key risk factors for LTBI in pneumoconiosis patients, thereby facilitating the development of more targeted interventions.

Evaluation of the intervention effect of an online prize-winning quiz on residents’ core knowledge of pulmonary tuberculosis prevention and control

Xie Cifu, Song Lixin, Yin Pengliang, Xiong Zi

Chinese Journal of Antituberculosis. 2026, 48(9):  1356-1363.  doi:10.19982/j.issn.1000-6621.20260278

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Objective: To evaluate the intervention effect of online prize-winning quiz activities on residents’ awareness rate of core knowledge on pulmonary tuberculosis (PTB) prevention and control, and to provide evidence for optimizing TB health education strategies. Methods: Two rounds of online prize-winning quizzes on PTB prevention and control knowledge were released via the official WeChat public account of Changsha Center for Disease Control and Prevention in 2022 and 2023, with online questionnaire surveys conducted among all residents. Propensity score matching was applied to control for confounding factors. Among participants of the 2023 activity, those who had joined the 2022 activity were assigned to the intervention group (n=6638), and those who had not were assigned to the control group (n=6638). The differences in the overall awareness rate and item-specific awareness rate of core PTB prevention and control knowledge in the 2023 activity were compared between the two groups. Meanwhile, changes in the overall awareness rate of core PTB prevention and control knowledge within the intervention group were compared between 2022 (pre-intervention) and 2023 (post-intervention). The log-binomial regression model based on generalized estimating equations was used to calculate the risk ratio (RR) and ratio of risk ratios (RRR). Results: Cross-sectional comparison showed that the overall awareness rate reached 89.18% (29598/33190) in the intervention group and 81.38% (27009/33190) in the control group; the overall awareness rate of the intervention group was 1.10 times (95%CI: 1.09-1.10) that of the control group. Subgroup analysis revealed that the intervention effect was optimal among populations aged under 20 years (RR=1.37, 95%CI: 1.23-1.53). Among all core information items, the second core item (“Pulmonary tuberculosis is mainly transmitted through the respiratory tract, and everyone is susceptible to infection”) achieved the best intervention effect (RR=1.14, 95%CI: 1.12-1.16), while the third core item (“Those with cough and expectoration for more than 2 weeks should be suspected of pulmonary tuberculosis and seek medical care promptly”) had a relatively lower intervention effect (RR=1.06, 95%CI: 1.05-1.07). The overall awareness rate of the intervention group in 2023 (89.18%) was steadily elevated compared with its baseline level in 2022 (86.39%, 28674/33190)(RR=1.03, 95%CI: 1.03-1.04). The improvement magnitude was correlated with the number of quiz attempts and total quiz duration: participants with ≥2 attempts and cumulative quiz duration ≥2 minutes presented better improvement in awareness rate. Conclusion: Participation in online prize-winning quiz activities exerts a significant enhancement effect on residents’ mastery of core knowledge on PTB prevention and control. It is recommended to incorporate online prize-winning quizzes into routine TB health education approaches, adopt differentiated designs for different populations, and guide participants to take quizzes repeatedly and extend effective learning time to deepen the intervention effect.

Risk prediction of catastrophic household cost among patients with rifampicin-susceptible pulmonary tuberculosis in Chongqing Municipality

Zhou Ran, Deng Jing, Chen Haiyi, Zhang Ting, Zheng Denghu

Chinese Journal of Antituberculosis. 2026, 48(9):  1364-1374.  doi:10.19982/j.issn.1000-6621.20260223

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Objective: To analyze the occurrence of catastrophic household cost among patients with rifampicin-susceptible pulmonary tuberculosis in Chongqing and to develop a risk prediction model, so as to provide evidence for identifying and supporting high-risk households during treatment management. Methods: A stratified multistage sampling method was used to select 355 patients with rifampicin-susceptible pulmonary tuberculosis who had received treatment for more than two weeks and were managed by tuberculosis designated hospitals in five counties/districts of Chongqing from January 2023 to December 2024. The participants were randomly divided into a training set and a validation set at a ratio of 7∶3, with 249 cases in the training set and 106 cases in the validation set. LASSO regression was used to screen potential predictors, followed by multivariable logistic regression analysis. A nomogram prediction model was constructed based on the results. The discrimination, calibration, and clinical utility of the model were evaluated using ROC curve, calibration curve, and decision curve analysis. Results: Among the 355 patients with rifampicin-susceptible pulmonary tuberculosis, the incidence of catastrophic household cost was 58.59% (208/355). Multivariable logistic regression analysis showed that hospitalization (OR=5.906, 95%CI: 2.752-13.279), occupational change (OR=12.074, 95%CI: 4.844-33.425), being the main household income earner (OR=2.388, 95%CI: 1.174-4.985), and comorbidity with chronic diseases (OR=3.304, 95%CI: 1.485-7.686) were predictors of catastrophic household cost. AUC of the risk prediction model based on these variables was 0.883 (95%CI: 0.843-0.924) in the training set and 0.867 (95%CI: 0.800-0.935) in the validation set. The calibration curves of both the training and validation sets were generally consistent with the ideal curve. Decision curve analysis showed that the model had a high net benefit when the threshold probability ranged from 0.20 to 0.96. Conclusion: The incidence of catastrophic household cost among patients with rifampicin-susceptible pulmonary tuberculosis in Chongqing was relatively high. The nomogram-based risk prediction model developed in this study showed good predictive performance and may provide a scientific basis for early identification of high-risk households and targeted assistance during tuberculosis treatment management.

Quality evaluation of tuberculosis prevention and control work in Guangxi based on Entropy Weight-TOPSIS and RSR method

Huang Quanjiang, Huang Minying, Cui Zhezhe

Chinese Journal of Antituberculosis. 2026, 48(9):  1375-1385.  doi:10.19982/j.issn.1000-6621.20260166

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Objective: To explore the key indicators influencing the comprehensive evaluation through the comprehensive quality assessment of tuberculosis prevention and control work in cities of Guangxi Zhuang Autonomous Region from 2021 to 2024, so as to provide a reference for cities to improve the quality of tuberculosis prevention and control. Methods: A comprehensive evaluation of tuberculosis prevention and control performance across various cities was carried out by integrating the entropy-weighted Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) with the rank-sum ratio (RSR) method. Results: There were significant regional differences in the comprehensive evaluation of tuberculosis control efforts across 14 cities in Guangxi Zhuang Autonomous Region. Laibin and Hezhou consistently ranked in the higher tier (Probit >6). Baise, Yulin, Wuzhou, Chongzuo, Beihai, and Qinzhou remained in the middle tier over time (4≤Probit≤6). Nanning, Fangchenggang, Guigang, Hechi, Liuzhou, and Guilin showed certain fluctuations in their evaluations: Nanning was in the lower tier (Probit <4) from 2022 to 2023 but jumped to the upper tier (Probit >6) in 2024; Fangchenggang was in the middle tier (4≤Probit≤6) from 2021 to 2023 but dropped to the lower tier (Probit <4) in 2024; Liuzhou was in the lower tier (Probit <4) from 2021 to 2022 but rose to the middle tier (4≤Probit≤6) from 2023 to 2024; Guigang was in the middle tier (4≤Probit≤6) from 2021 to 2022 but declined to the lower tier (Probit <4) for two consecutive years from 2023 to 2024. Cluster analysis revealed marked regional differentiation in pulmonary tuberculosis prevention and control quality across Guangxi. The northern region exhibited stable growth; the central region showed polarization, with Nanning characterized as high-start and high-growth, while Guigang and Laibin were classified as slow decline and fluctuating adjustment types, respectively; the eastern region and southern coastal areas (except Fangchenggang) were fluctuating adjustment types, whereas Fangchenggang was a rapid decline type; the western and border regions displayed the strongest spatial heterogeneity, with Chongzuo showing stable growth, Hechi exhibiting slow decline, and Baise being fluctuating adjustment. Lag-one-year correlation analysis did not reveal a significant relationship between the comprehensive score of tuberculosis control performance and changes in reported incidence rate (r=-0.019, P=0.950) or mortality rate (ρ=-0.167, P=0.568). Conclusion: The quality of tuberculosis prevention and control efforts across Guangxi demonstrates considerable instability. Certain areas in the western and central regions—potentially influenced by a high epidemic burden and socioeconomic constraints—have persistently performed at suboptimal levels. The current performance evaluation indicators do not directly capture the impact on epidemic trends.

Trend of pulmonary tuberculosis reported incidence in four core megacities of China from 2015 to 2024: a population-based study using Joinpoint regression model

Chen Anni, Meng Yujie, Li Tao, Zheng Huan, Wang Songwang

Chinese Journal of Antituberculosis. 2026, 48(9):  1386-1393.  doi:10.19982/j.issn.1000-6621.20260181

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Objective: To analyze the temporal trends in pulmonary tuberculosis (PTB) incidence in major Chinese megacities (Beijing, Shanghai, Guangzhou, and Shenzhen) from 2015 to 2024 using Joinpoint regression, providing evidence for the formulation of targeted prevention and control measures. Methods: Data on reported PTB cases in core megacities from 2015 to 2024 were collected; descriptive analysis was used to assess incidence characteristics, and Joinpoint regression was applied to analyze temporal trends. Results: From 2015 to 2024, the average annual reported incidence rates per 100000 population were 30.55 in Beijing, 56.24 in Guangzhou, 24.83 in Shanghai, and 36.68 in Shenzhen. Joinpoint regression analysis revealed that the reported incidence rate in Beijing showed a gradual downward trend from 2015 to 2021 (APC=-4.36%, P=0.070) and a rapid downward trend from 2021 to 2025 (APC=-11.58%, P<0.001); In Guangzhou, the annual average reported incidence rate showed the greatest decline (AAPC=-10.03%, P<0.001), with a rapid decline from 2015 to 2021 (APC=-11.41%, P<0.001) and a gradual decline from 2021 to 2024 (APC=-7.19%, P=0.008). The reported incidence rates among men in the four cities of Beijing, Shanghai, Guangzhou and Shenzhen (38.22 per 100000, 32.30 per 100000, 64.10 per 100000 and 43.82 per 100000) were all higher than those among women (22.34 per 100000, 16.85 per 100000, 33.54 per 100000, 28.09 per 100000). In Beijing and Shanghai, the rate of decline in the reported incidence among men (AAPC=-6.88%, -8.85%) was higher than that among women (AAPC=-6.38%, -7.32%); while in Guangzhou and Shenzhen, the rate of decline in reported incidence among men (AAPC=-9.43%, -5.30%) was slower than that among women (AAPC=-10.36%, -5.98%); The decline in reported incidence rates was greater in the 15-59 age group than in other age groups (AAPC=-9.10%, P<0.001; AAPC=-10.02%, P=0.001; AAPC=-12.06%, P<0.001; AAPC=-9.72%, P=0.003). Conclusion: From 2015 to 2024, the standardized reported incidence rates of pulmonary tuberculosis in the four major core megacities all showed a downward trend, while the etiological positivity rates all showed an upward trend. The standardized reported incidence rate in males was consistently higher than that in females, and the average annual reported incidence rate among the elderly aged 60 years and above was the highest. It is recommended that regionalized periodic screening be implemented for the elderly population, health education in occupational settings be strengthened for young and middle-aged men, and screening strategies be dynamically adjusted based on the smart monitoring systems of megacities, in order to promote a shift in tuberculosis control from passive detection to active intervention.

Dual comparative study on active case finding for pulmonary tuberculosis among the migrant population in Tongxiang City, Zhejiang Province, 2024—2025

Cao Yuan, Xu Hao, Yao Xiaoying, Sheng Zhongjia, Chen Songhua

Chinese Journal of Antituberculosis. 2026, 48(9):  1394-1401.  doi:10.19982/j.issn.1000-6621.20260244

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Objective: With a dual comparative study on active case finding (ACF) for pulmonary tuberculosis (PTB) patients among migrant population in Tongxiang City, Zhejiang Province from 2024 to 2025, to provide evidences for optimizing regional TB control strategies. Methods: Data on all notified PTB patients in Tongxiang City from 2024 to 2025 were collected from the Tuberculosis Management Information System, a subsystem of the China Information System for Disease Control and Prevention. The first comparison was conducted to explore differences in epidemiological and clinical characteristics between active and passive case finding among the migrant population and the second comparison was performed to study characteristic differences between migrant and local patients among all cases identifed through ACF. Cross-validation was performed by combining the results of the two comparisons to identify coverage gaps in the current ACF system. Results: A total of 175 migrant PTB patients were notified in Tongxiang City from 2024 to 2025, with 66 (37.71%) identified through ACF and 109 (62.29%) through passive case-finding (PCF). The first comparison showed that the proportions of patients residing in industrial core areas (90.91%, 60/66) and with bacteriologically negative results (51.52%, 34/66) in ACF group were higher than those in PCF group (77.98%, 85/109; 26.61%, 29/109) respectively, while the proportion of diagnostic delay (31.82%, 21/66) was lower than that in the PCF group (62.39%, 68/109), with statistically significant differences (χ²=4.837, P=0.028; χ²=11.071, P<0.001; χ²=15.368, P<0.001). Multivariate logistic regression revealed that ACF was a protective factor against bacteriologically positive PTB among migrant patients (OR=0.387, 95%CI: 0.197~0.761). The second comparison showed that a total of 156 patients were identified through ACF during the same period, including 66 migrants (42.31%) and 90 local residents (57.69%). The proportions of patients aged 25-64 years (83.33%, 55/66), working as migrant workers (63.64%, 42/66), residing in industrial core areas (90.91%, 60/66), and with bacteriologically negative results (51.52%, 34/66) among the migrant population were significantly higher than those among the local residents (54.44%, 49/90; 27.78%, 25/90; 74.44%, 67/90; 28.89%, 26/90), with statistically significant differences (Fisher’s exact test, P<0.001; χ²=35.299, P<0.001; χ²=6.820, P=0.009; χ²=8.236, P=0.004). Correspondingly, the local subgroup had statistically significantly higher proportions of elderly patients aged ≥65 years (40.00%, 36/90) and residents of peripheral townships (25.56%, 23/90) than the migrant subgroup (4.55%, 3/66; 9.09%, 6/66). Conclusion: ACF facilitates early identification of bacteriologically negative PTB patients among the migrant population and is associated with a lower proportion of diagnositc delay. There are significant differences in the current ACF coverage characteristics between the migrant population and local residents, with migrants residing in peripheral townships identified as the coverage gap.

Short Articles

Analysis of characteristics and trends of patient delay in elderly pulmonary tuberculosis patients in Shandong Province, 2010—2024

Shangguan Shichao, Hu Qingping, Zhen Lili, Pan Wei, Jiang Xuemei, Dai Bingqin

Chinese Journal of Antituberculosis. 2026, 48(9):  1402-1408.  doi:10.19982/j.issn.1000-6621.20260108

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Data of pulmonary tuberculosis (PTB) patients aged ≥60 years residing in Shandong Province registered from 2010 to 2024 was extracted from the Tuberculosis Management Information System, a subsystem of China Information System for Disease Control and Prevention. Descriptive statistical methods were used to analyze patient delay, and Joinpoint regression analysis was applied to examine change trend of patient delay rates. Results showed that the median patient delay (interquartile range) among elderly PTB patients in Shandong was 37 (27, 68) days, with a patient delay rate of 71.83% (107787/150061). The delay rates demonstrated an initial decline trend followed by an upward trend: decreasing at an annual rate of 0.48% (t=-0.987, P>0.05) during 2010—2016, declining by 2.27% annually (t=-2.541, P<0.05) during 2016—2021, and increasing by 2.72% annually (t=1.877, P>0.05) during 2021—2024. Higher delay rates were observed among younger elderly (60-69 years: 72.15%) patients, farmers (72.33%), homemaker/unemployed individuals (73.54%), non-key surveillance populations (71.89%), patients without comorbidities (71.96%), those with concurrent other tuberculosis (73.63%), and retreatment cases (74.15%). In 2024, Linyi (83.55%), Heze (78.21%), and Weihai (77.16%) exhibited higher delay rates. Between 2010 and 2024, Liaocheng and Weihai experienced the most significant increases in delay rates (17.86% and 13.48%, respectively). The patient delay rates among elderly PTB patients in Shandong Province showed a declining-then-rising trend from 2010 to 2024, suggesting that prevention and control work still faces challenge and calls for targeted measures focusing on key populations and regions.

Clinical Case Discussion

Concomitant spinal tuberculosis and multiple myeloma in an elderly female: a diagnostic challenge and case report

Liu Yishuang, Liu Qibin, Xu Feng, Xu Fang, Wang Jie, Wei Shuang

Chinese Journal of Antituberculosis. 2026, 48(9):  1409-1414.  doi:10.19982/j.issn.1000-6621.20260295

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In July 2025, a 74-year-old female patient with spinal lesions was admitted to the Department of Spine Surgery, Wuhan Pulmonary Hospital. The patient was hospitalized for “low back pain for 1 year, aggravated with right lower limb numbness for 1 month”, with a past medical history of type 2 diabetes mellitus and hypertension. After admission, lumbar magnetic resonance imaging (MRI) was performed, revealing L3 vertebral body collapse and paravertebral abscess; computed tomography (CT) scan showed osteolytic “perforating-like” destruction. Pathological examination of percutaneous needle biopsy specimens showed inflammatory changes, and metagenomic next-generation sequencing detected Mycobacterium tuberculosis complex. The initial diagnosis was spinal tuberculosis. The patient received standard anti-tuberculosis treatment for more than 1 month, but had minimal symptomatic improvement. Follow-up MRI showed no absorption of the abscess. Due to poor therapeutic response, surgical debridement of the lesion, spinal canal decompression and internal fixation were performed. Postoperative immunohistochemical staining confirmed multiple myeloma with focal granulomas, and the final diagnosis was lumbar tuberculosis complicated with multiple myeloma. The patient recovered well after surgery and was discharged 2 weeks later. Chemotherapy for myeloma was not administered due to advanced age. The patient was lost to follow-up after subsequent onset of hemoptysis and a space-occupying lesion in the left lung. The authors suggest that for destructive spinal lesions, especially in elderly patients with complex immune status, a single positive etiological result cannot rule out the possibility of coexisting malignant lesions. Percutaneous needle biopsy has inherent sampling bias. When the response to targeted therapy is unsatisfactory, concurrent dual pathologies should be highly suspected, and surgical biopsy should be performed promptly to confirm the definitive diagnosis.

Review Articles

Research progress of heme oxygenase-1 in tuberculosis

Meng Die, Zhu Liang

Chinese Journal of Antituberculosis. 2026, 48(9):  1415-1421.  doi:10.19982/j.issn.1000-6621.20260205

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Heme oxygenase-1 (HO-1) is a key enzyme in heme metabolism. It plays a critical regulatory role in processes such as oxidative stress, immune response, and cellular metabolism. In recent years, HO-1 has become a focal point of tuberculosis research. Starting from the biological characteristics of HO-1, this article systematically elucidates its dual role in the development of pulmonary tuberculosis. On this basis, we further explore the predictive value of HO-1 as a potential biomarker for tuberculosis diagnosis, treatment guidance, and prognosis assessment. The article also reviews recent advances in host-directed therapeutic strategies targeting HO-1, including pharmacological interventions and their synergistic effects with existing anti-tuberculosis drugs. Finally, we analyze the current controversies and key challenges in the field and provide future perspectives. The aim is to offer a theoretical foundation and research directions for the development of novel diagnostic and therapeutic approaches, as well as for the improvement of tuberculosis prevention and control practices.

Research progress on the precision diagnosis and treatment of Brucella meningitis

Musitapa Abulizi, Maierdan Abulai, Yang Li

Chinese Journal of Antituberculosis. 2026, 48(9):  1422-1427.  doi:10.19982/j.issn.1000-6621.20260402

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Brucellar meningitis (BM) is the most common subtype of neurobrucellosis (NB). This disease features an insidious onset, creates formidable obstacles to its differentiation from tuberculous meningitis, and frequently results in delayed diagnosis and management, which may leave disabling sequelae such as hearing impairment and cognitive dysfunction. The authors systematically retrieved domestic and international literature published over the past five years, synthesized a stepwise stratified diagnostic system for BM, summarized multi-omics differential diagnostic tools and stratified individualized antibacterial regimens, and standardized the criteria for glucocorticoid application as well as salvage strategies for recurrent infections. This review intends to refine clinical differential diagnostic procedures and standardize full-cycle anti-infective administration. Further multicenter controlled studies are recommended to develop an integrated diagnostic model for BM and tuberculous meningitis, and to investigate de-escalation antibacterial protocols customized for mild cases, children and pregnant patients.

Research progress on the mechanisms of bone tissue cell damage caused by Brucella

Zhao Meng, Abdusalam Alimujiang, Wang Xi, Zhang Jun, Xu Ziyi, Liao Junru, Ma Chuang

Chinese Journal of Antituberculosis. 2026, 48(9):  1428-1435.  doi:10.19982/j.issn.1000-6621.20250531

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Brucellosis is a zoonotic, natural focal infectious disease caused by invasion of Brucella into human body, with a wide distribution globally. It exhibits pronounced systemic invasiveness, affecting multiple systems, among which damage to the osteoarticular (bone and joint) system stands out as one of the most prevalent complications. The precise pathogenic mechanism by which Brucella induces osteoarticular system damage remains incompletely understood. Furthermore, due to the atypical early clinical symptoms and imaging manifestations, its clinical diagnosis and treatment encounter significant challenges. By the time most patients receive a definitive diagnosis, the disease has often already progressed to an advanced stage, characterized by severe destruction of bone tissue, leading to catastrophic functional impairment and a sharp decline in quality of life. To enhance clinical practitioners’ awareness and understanding of Brucella-induced osteoarticular system damage, we reviewed the pathogenic mechanisms of Brucella on osteoblasts, osteoclasts, and bone cells, aiming to provide novel insights and directions for the research and treatment of this disease.

Research progress on novel detection techniques for HIV-associated tuberculosis

Song Juemin, Shi Liang, Liang Bianxiang, Kang Hui

Chinese Journal of Antituberculosis. 2026, 48(9):  1436-1443.  doi:10.19982/j.issn.1000-6621.20260060

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HIV-associated tuberculosis constitutes a major public health challenge in global health field, and the complex interaction between these two diseases accelerates the progression of each, significantly increasing the hospitalization and mortality of patients. Among people living with HIV, the early diagnosis of tuberculosis is crucial for timely anti-tuberculosis treatment and improved prognosis, and the relevant tuberculosis detection techniques play an essential role. Currently, the World Health Organization regards bacteriological testing as the key method for the diagnosis of tuberculosis. However, the diagnostic value is limited due to the influence of the human immune status on the sensitivity and specificity. In recent years, novel diagnostic techniques such as immunological methods, molecular diagnostic techniques, and imaging and artificial intelligence-assisted diagnostic techniques have developed rapidly and shown high sensitivity and specificity in the population with HIV/TB, providing strong support for improving the accuracy of diagnosis. This paper systematically reviews the novel diagnostic strategies for HIV/TB coinfection, including molecular diagnostic, emerging immunological methods, non-conventional specimen testing techniques, and imaging and artificial intelligence-assisted diagnosis, etc., providing a certain clinical value for the early detection and diagnosis of HIV-associated tuberculosis.