Table of Content

20 December 2012, Volume 1 Issue 3

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Expert Forum

The role of international health project in China TB prevention and control

XU Guang-bao

Journal of Tuberculosis and Lung Health. 2012, 1(3):  155-158. 

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The author noted that the international health projects have played an important role in tuberculosis (TB) control in China: First, they gave a strong finance support to TB control, and promote the rational allocation of health resource; Second, they introduced and promoted the international advanced technology and experience; Third, they promoted the establishment of the nationwide TB control system; Fourth, they effectively promoted the implementation of objective-oriented management and process monitoring, greatly improved the working efficiency; Fifth, they carried out health education and operational research, and promoted the formation of long-term mechanism. Through the implementing of international health projects, the DOTS coverage, the case-finding rate and the cure rate of TB patients has improved rapidly, and effectively put the TB epidemic under control and achieved a remarkable social and economic benefits, and provided a useful experience for public health project ma-nagement in China. The international health project is an important platform for the introduction of advanced concepts and technology, and keeping in contact with the international societies. Therefore, the government at all levels should continue to attach importance to the introduction of international health projects, and to strengthen the management. Through the implementation of the international health projects, to better and faster achieve the goal of TB control program.

Original Articles

A comparative study of serum protein mass spectrometry between the tuberculosis patients and healthy persons

LIU Zhi-hui^*, TAN Shou-yong, LIU Yu-mei, LUO Qiang-sheng, YUN Jing-ping, LI Xin-jie, LIU Jian-xiong

Journal of Tuberculosis and Lung Health. 2012, 1(3):  159-162. 

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Objective To look for specific tuberculosis (TB)-related serum proteins and further to discover new serological diagnostic markers of TB by comparison of the serum protein mass spectra between TB patients and healthy persons. Methods The serum proteins from 62 healthy controls (control group) and 117 TB patients (TB group),including 54 cases with bacterium-positive pulmonary TB (bacterium-positive group) and 45 cases with bacterium-negative pulmonary TB (bacterium-negative group) and 18 cases with extra-pulmonary TB (extra-pulmonary group), were detected using the WCX protein-chip and the surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) technology. Then the detected data of serum protein mass spectra were analyzed by ClinProTools Software to find the different proteins. Results There were 19, 14, 26 and 30 significantly different protein peaks respectively in bacterium-positive group vs control group, bacterium- negative group vs control group, extra-pulmonary group vs control group, and TB group vs control group.There were 11, 9, 15 and 15 protein respectively to be up-regulated expression in each TB group. Four protein peaks at 1060、1944、2081 and 3954 m/z differentially existed between all of TB groups and control group, in which 1060 m/z protein was down-regulated expressd in all of TB groups. Conclusion The serum protein spectra had difference between TB patients and healthy persons. The new TB serological diagnostic markers need be further studied to be confirmed.

Evaluation of light emitting diodes (LEDs) for the fluorescent microscopic on the detection of acid-fast bacilli in sputa

HU Pei-lei, TAN Yun-hong, LIU Feng-ping, YI Song-lin, LONG Hai-bo, TAN Xiao, CHEN Zhong-nan, GONG Dao-fang

Journal of Tuberculosis and Lung Health. 2012, 1(3):  163-165. 

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Objective To evaluate of light emitting diodes (LEDs) for the fluorescent microscopic on the detection acid-fast bacilli (AFB) in sputa. Methods 194 sputa were collected from patients with symptoms suggestive of pulmonary TB who presented to Hunan Provincial Center for Tuberculosis Control and Prevention from January to April 2010, each sputum was detected by LED and Ziehl-Neelsen (Z-N) staining with liquid culture as a gold standard, the sensitivities and specificities of LED and Z-N were also evaluated. Comparative analysis was done with χ² test, and P<0.05 was regarded as significant. Results Of 68 culture-positive specimens, 35 specimens were Z-N positive and 45 specimens were LED positive. The sensitivities of Z-N and LED were 51.5% (35/68) and 66.2% (45/68), respectively. Of 122 culture-negative specimens, 121 specimens were Z-N negative and 119 specimens were LED negative. The specificities of Z-N and LED were 99.2% (121/122) and 97.5% (119/122), respectively. The sensitivity had significant difference between Z-N and LED (χ²=5.78, P<0.05), and the specificity had no significant difference (χ²=0.25, P>0.05). Conclusion LED has higher sensitivity and similar specificity compared with Z-N, is low cost and user -friendliness. LED have more potential to be used widely in low-income and high burden countries.

Theoretical research on effect of iodine flow rate on pulmonary angiography in multi-slice CT

SUN Xiao-li^*, HOU Dai-lun, LIU Cheng

Journal of Tuberculosis and Lung Health. 2012, 1(3):  166-169. 

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Objective To investigate the effect of iodine flow rate (iodine flow quantity in unit time) on pulmonary angiography in multi-slice computed tomography (CT), and to guide the optimal use of contrast material. Methods From September 2010 to December 2011 in Shandong Medical Imaging Research Institute, 121 patients without significant pulmonary diseases were performed thorax enhanced CT scan, 40 patients were selected from them (81 cases with cardiac failure, pulmonary hypertension, pulmonary embolism, stenosis, pulmonary significant variation, deformity, or disagreement with the examination were excluded). Forty patients were randomly assigned to two groups (group A and group B, each group including 20 patients). The patients of group A were administrated intravenously 80 ml of 300 mg I/ml at a flow rate of 4.0 ml/s, and the group B were 60 ml of 400 mg I/ml at 3.0 ml/s followed by 20 ml saline at the same flow rate. All patients underwent dynamic scanning at the same pulmonary artery level. The pulmonary arterial peak time (PT), peak value (PV), the beginning time of more than 200 HU (Tb200) and duration time (T200) were analyzed according to time-dose curve (TDC). Results The peak value of pulmonary artery of group A and group B were (372.45±58.60) HU and (398.45±84.80) HU, respectively. There was no significant difference between them (t=1.044, P>0.05). The PT, Tb200 and T200 of group A was (19.90±2.63) s, (8.80±1.61) s, (19.95±4.65) s, and those of group B was (25.00±2.58) s, (14.31±4.42) s, (16.08±2.75) s with significant difference between group A and group B (t=5.490, 5.108, 2.702;P<0.05). Conclusion Using higher concentration contrast material, the dose and injected rate should be decreased appropriately, and the image quality was not weaken. Therefore, the higher concentrations of the contrast agent should be used in MSCT pulmonary angiography examination in practice.

The epidemic situation of pulmonary tuberculosis among patients aged between 15 and 29 years in Shanghai, 2005—2010

LI Xiang-qun, XIA Zhen, CHEN Jing, LUAN Rui-rong, MEI Jian

Journal of Tuberculosis and Lung Health. 2012, 1(3):  170-175. 

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Objective To analyze the epidemic situation of pulmonary tuberculosis among local residents aged between 15 and 29 years in Shanghai from 2005 to 2010, and to explore the effective measures to prevent TB infection and reduce active TB cases in this age group. Methods 4231 TB patients’ characteristics including gender, age, geographic distribution and profession, which were recorded in TB registration system in Shanghai from 2005 to 2010 were analyzed, and which were compared with the whole patients registered at the same period. Results The notification rate of new TB patients decreased 6.64% in Shanghai from 28.6/100 000(3874) in 2005 to 26.7/100 000(3760) in 2010. However, the TB notification rate among patients aged between 15 and 29 years increased 18.9% from 22.8/100 000(668) in 2005 to 27.1/100 000(739) in 2010. Among this group, the male aged between 20-24 years had an extremely higher increase of 45.9% (in 2010, 217 cases, 42.3/100 000; in 2005, 155 cases, 29.0/100 000). The cure rate of smear positive patients in this group was 95.1% (1209/1272) which was significantly higher than that of the whole population (85.8%,6105/7115) (χ²=6.08, P=0.0137). The mortality rate was 0.2% (2/1272), which was significantly lower than that of the whole population (8.5%,604/7115) (χ²=88.86, P<0.0001). Conclusion TB epidemic among patients aged 15-29 years should be paid more attention to. It’s ne-cessary to enhance the health education and disease surveillance at key locations like schools, internet bar. Health screening to close contact of TB patients should also be strengthened, so that TB epidemic can be controlled in this group.

Factors impacting on not arriving at TB dispensaries of TB cases reported and referred by non-TB control institutions in Baoan and Longgang districts of Shenzhen

FANG Lan-jun, ZHOU Lin, LI Jian-wei, JIANG Li, PAN Qi-li, ZHONG Qiu

Journal of Tuberculosis and Lung Health. 2012, 1(3):  176-179. 

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Objective To identify the factors impacting on not arriving at TB dispensaries (TD) of TB cases reported and referred by non-TB control institutions (NTI) in Baoan district and Longgang district of Shenzhen, and provide the evidence for developing policies to strengthen PPM. Methods During May to July 2010, 60 cases from Baoan and Longgang who arrived at TD and 60 cases who were reported in the same districts but didn’t arrived at TD were recruited to receive questionnaire interviews as control and case groups respectively. Chi-square test was used for analysis, and the difference had statistical significance if P<0.05. Results In non-arrival group, physicians in NTI did not issue referral sheets to 13 cases (21.7%, 13/60), while in arrival group the number was 5 cases (8.3%, 5/60), and the difference had statistical significance (χ²=4.18, P<0.05). The proportion of patients knowing TD was the professional institute for tuberculosis diagnosis and treatment in non-arrival group (85.0%, 51/60) was less than that from arrival group of (98.3%, 59/60), with statistical significance (χ²=6.98, P<0.01). The proportion of cases knowing the place of TD (73.3%, 44/60) in non-arrival group was significantly lower than arrival group (98.3%, 59/60) (χ²=15.42, P<0.01). Less patients trusted the TD’s capability of diagnosis and treatment (60.0%, 36/60) in non-arrival group than arrival group (90.0%,54/60) (χ²=14.4, P<0.01). The significant difference also existed in the number of patients knowing curative effect of TB drugs provided by TD (30.0%,18/60 vs 80.0%,48/60, χ²=30.3, P<0.01). More proportion of patients in non-arrival group reported inconvenient transportation (90.0%, 54/60 vs 53.3%, 32/60). The difference was statistically significant (χ²=19.86, P<0.01). Conclusion The major factors affecting the arrival rate in Baoan district and Longgang district of Shenzhen were physicians in NTI not issuing referral sheets to cases, inadequate publicity of national free policy on tuberculosis and institutions themselves by TD, and inconvenient transportation.

Analysis on the tuberculosis epidemic situation in Hubei province Enshi prefecture in 2006—2010

LIU Wen-sheng,WANG Ke-kun,LIU Xiao-qin

Journal of Tuberculosis and Lung Health. 2012, 1(3):  180-184. 

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Objective Through analyzing the tuberculosis epidemic situation in Enshi prefecture in order to provide a scientific basis for further control of tuberculosis epidemic. Methods We collected the data of 8 counties from TB Control Monthly and Quarterly report and TB information management system from 2006 to 2010. A total of 58 549 cases of TB suspects visited TB dispensaries during this time period in all counties, among which, 22 316 active TB patients were registered, and of them 12 175 cases were smear positive pulmonary tuberculosis. Results The average annual active TB registration rate was 123.26/100 000(22 316/18 104 321), with the highest in 2007(132.09/100 000, 4775/3 614 899), and declining by year afterwards(129.04/100 000 in 2008,124.46/100 000 in 2009,111.96/100 000 in 2010) (χ²_{active TB}=76.58,P=0.000). The annual registration rate of smear positive and new smear positive was 67.25/100 000 and 52.53/100 000 respectively, both highest in 2006(78.29/100 000 and 61.06/100 000),showed a decreasing trend afterwards (66.17/100 000 and 51.79/100 000 in 2007, 66.14/100 000 and 51.40/100 000 in 2008, 65.10/100 000 and 50.86/100 000 in 2009, 60.53/100 000 and 47.56/100 000 in 2010) (χ²_{smear positive}=93.94,P=0.000;χ²_{new smear positive}=70.44,P=0.000). The annual registration rate of active TB was highest in Xianfeng county(165.03/100 000), lowest in Laifeng County(97.63/100 000). The male annual active TB and new smear positive registration rate(158.56/100 000,68.63/100 000)were higher than female(84.95/100 000,35.07/100 000) (χ²_{active TB}=1989.04,P=0.000;χ²_{new smear positive}=969.27,P=0.000). In terms of occupation, farmers accounted the highest proportion in active and new smear positive TB, 80.70%(18 008/22 316) and 81.71%(7771/9511)respectively. Conclusion The TB epidemic showed a declining trend from 2006 to 2010, however remained at a high level, there is a need for the government to increase the funding input, and promote the full implementation of DOTS strategy.