Table of Content

30 November 2013, Volume 2 Issue 4

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Progress on adjuvant treatment of drug-resistant tuberculosis

ZENG Xi-ling, CHU Nai-hui, LIU Zhi-min

Journal of Tuberculosis and Lung Health. 2013, 2(4):  222-227.  doi:10.3969/j.issn.2095-3755.2013.04.002

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Drug-resistant tuberculosis (TB) is the keystone and difficulty in TB control at home and abroad. In recent years, many scholars have applied immune agents in the adjuvant treatment of drug-resistant TB and obtained positive efficacy. Currently the most active research of immune agents are cytokines and mycobacterial vaccine formulations. However, the effects of these immune agents in the treatment of drug resistant TB are different, some have achieved good results, but others have no obvious effect. The paper reviews the leukemia cytokine and other immune agents that play an immunotherapy role in the adjuvant treatment of drug resistant TB, and it is anticipated to provide reference for the application of immune agents in the adjuvant treatment of drug resistant TB.

The diagnosis and treatment of severe community acquired pneumonia

YU Hua-peng

Journal of Tuberculosis and Lung Health. 2013, 2(4):  228-234.  doi:10.3969/j.issn.2095-3755.2013.04.003

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Community-acquired pneumonia (CAP) is a frequent and severe infection, and is considered the primary cause of death from infection, and the sixth most common cause of overall mortality in Western countries. Consequently, CAP represents one of the leading causes of infectious admissions to the intensive care unit (ICU).Indeed, the latest studies have reported that up to 10% of all patients hospitalised with CAP require ICU management. In specific subgroup of severely ill patients, the overall mortality rate remains unacceptably high despite improvement in critical care management. Furthermore, the medical burden of CAP is very high in terms of direct costs, associated morbidity and long-term disability.

Discussion on the current situation of the establishment of the bacteriological negative pulmonary tuberculosis diagnosis model

LIN Yuan, TAN Shou-yong

Journal of Tuberculosis and Lung Health. 2013, 2(4):  235-238.  doi:10.3969/j.issn.2095-3755.2013.04.004

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Bacteriological negative pulmonary tuberculosis (PTB) is the present difficulty in the diagnosis of PTB, as we don’t have a diagnosis model which is clear, unified and authoritative. In this paper, the situation of the establishment of the bacteriological negative PTB diagnosis model is discussed. Through analyzing the modeling method, the object of study and so on, it is anticipated to guide the establishment of clinical guidelines for the diagnosis and treatment of bacteriological negative PTB, and standardize the rapid diagnosis of active PTB.

Progress of screening of childhood tuberculosis cases in close contacts with TB patients

LI Yan-qiong, LIU Zhi-hui, TAN Shou-yong

Journal of Tuberculosis and Lung Health. 2013, 2(4):  239-242.  doi:10.3969/j.issn.2095-3755.2013.04.005

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Timely detection and thorough treatment of childhood tuberculosis cases impacted on the overall TB control. The screening of childhood tuberculosis case among close contacts with TB patients has been proved to be an effective strategy. To clarify the definition of childhood tuberculosis, and TB screening policies, techniques and strategies could contribute the implementation of the screening.

Analysis of characteristics of pulmonary tuberculosis patients registered in the infectious diseases recording & reporting system from 2001 to 2010

CHEN Wei, DU Xin, XIA Yin-yin, CHEN Qiu-lan, WANG Li-xia

Journal of Tuberculosis and Lung Health. 2013, 2(4):  243-248.  doi:10.3969/j.issn.2095-3755.2013.04.006

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Objective To understand the characteristics of pulmonary tuberculosis (PTB) patients registered in the infectious diseases recording & reporting system from 2001 to 2010. Methods PTB patients’ data from infectious diseases recording & reporting system were collected and analyzed. The time trend of onset, geographic and population distribution were mainly analyzed. Age, gender and occupation were mainly analyzed in population cha-racteristics. Results In 2001, 527 336 PTB cases were reported, and the TB incidence was 41.32/100 000(527 336/1 276 270 000). 163 055 were smear positive TB cases and the incidence of smear positive was 12.78/100 000(163 055/1 276 270 000). In 2010, 991 350 PTB cases were reported, and the TB incidence was 74.27/100 000(991 350/1 334 740 000). 456 677 were smear positive TB cases and the incidence of smear positive was 34.21/100 000(456 677/1 334 740 000). The TB incidence increased 79.7% and the incidence of smear positive increased 167.7% compared with those of 2001. The average PTB incidence in eastern,middle and western areas were 58.34/100 000, 76.67/100 000 and 92.97/100 000 respectively. The reported incidence rate showed a rising trend with the increase of age. The reported incidence rate in 65-, 25- and 15- age groups were 108.11/100 000,48.12/100 000 and 40.59/100 000 respectively in 2001, while those were 183.78/100 000, 76.22/100 000 and 75.72/100 000 respectively in 2010. In 2010 in 65- age group, the reported incidence rate of PTB was 285.40/100 000 in male and 91.34/100 000 in female. 60.31%-62.19% of the cases were farmers and herdsmen, 6.52%-8.57% were workers. Conclusion The incidence of PTB shows a rising trend year by year, and is higher in western area than middle and eastern areas, and higher in male than in female. Most of the reported cases are in middle and elder age group and are farmers and herdsmen. The key areas and focus groups are fixed by data analysis, so that special intervention measures can be taken.

Analysis of the status of tuberculosis epidemic in demonstration district of Guangdong province

CHEN Yu-hui,LI Jian-wei, JIANG Li, CHEN Liang, YIN Jian-jun, ZHOU Lin, ZHONG Qiu

Journal of Tuberculosis and Lung Health. 2013, 2(4):  249-254.  doi:10.3969/j.issn.2095-3755.2013.04.007

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Objective To understand the TB epidemiological features of the demonstration district of Guangdong province, in order to evaluate the implementation of TB control measures and provide evidence base for floating population TB control strategies development. Methods The age, sex, occupational and treatment outcome of 3203 active PTB cases were analyzed based on the registered data of the demonstration district in 2012. Results (1)In 2012, a total of 3203 PTB cases were registered, in which there were 2349 cases of floating population, accounting for 73.3%.(2) In all cases, the proportion of male (68.5%, 2195/3203) were more than female(31.5%, 1008/3203). Among the smear positive cases of floating population the female had a higher proportion (32.8%,382/1164) than resident population (27.0%,116/429)(χ²=12.73, P<0.01).(3) In terms of the occupational distribution of TB cases of the floating population cases, domestic chores and unemployed accounting for 47.7%(1120/2349)and more than half both in initial treatment and retreatment smear positive cases. (4) In the new smear positive PTB cases, the sputum negative conversion rate at the end of 2th months (91.9%,351/382) and at the end of 3th months (96.3%,368/382) of resident population were significantly higher than that of floating population(79.8%,776/972;88.8%,863/972) (χ²=28.53,18.92,P<0.01),and that was similar in retreatment cases.(5) The smear positive PTB cure rate was 93.2%(400/429) in resident population which was significantly higher than the floating cases(85.1%,991/1164) (χ²=18.59,P<0.01).The cure rate of new smear positive PTB cases of resident population(94.5%,361/382)was higher than the floating cases (86.1%,837/972)(χ²=18.94,P<0.01). But the treatment failure rate(6.8%,79/1164) and cases loss rate(3.4%,39/1164)of smear positive PTB cases were higher in floating population than that of resident population(1.9%,8/429;0.9%,4/429) (χ²=14.71,6.78,P<0.01). Conclusion The demonstration area still have high TB burden in floating population. So we should further improve floating population TB prevention and control strategies.

Prognosis of nontuberculous mycobacterial lung disease

LIU Guo-biao, TAN Shou-yong, LUO Chun-ming, DENG Hong

Journal of Tuberculosis and Lung Health. 2013, 2(4):  255-257.  doi:10.3969/j.issn.2095-3755.2013.04.008

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Objective To investigate the prognosis of patients with nontuberculous mycobacteria(NTM). Methods The therapeutic responses of 67 patients with NTM from 2006 to 2012 were assessed after 6 month treatment, One- and two-year follow-up were carried out on those patients by NTM culture and sputum smear. 48 patients were followed up for more than 1 years, and 29 patients were followed up for more than 2 years. Results After 6 months treatment, clinical symptoms were improved or disappeared in 45 cases (67.2%), focus absorption in 36 cases (53.7%), culture negative in 28 cases (41.8%). After treatment the sputum smear was ne-gative conversion in 34 cases among 45 cases with smear positive initially. The negative conversion rates of NTM culture and smear in one- and two-year follow-up were 43.8%(21/48), 66.7%(22/33) vs. 41.4%(12/29), 76.5%(13/17) respectively. The differences were significant statistically between the two groups (the χ² values were 4.124 and 5.319, the P values were 0.042 and 0.021). Conclusion Clinical symptoms, lesion absorption, sputum negative conversion of NTM patients were improved after treatment. However, unfavorable prognosis was indicated for negative NTM culture.

Nocardiosis misdiagnosed as tuberculosis: a case report and a review of the literature

LI Hong-tao, ZHOU Feng-li, ZHU Jia-xin, HUANG Jing, WU Ben-quan, ZHANG Tian-tuo

Journal of Tuberculosis and Lung Health. 2013, 2(4):  258-262.  doi:10.3969/j.issn.2095-3755.2013.04.009

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Objective To describe the clinical features, imaging features, pathogenic characteristics and drug resistance of pulmonary nocardiosis and to explore the reasons that nocardiosis is misdiagnosed as tuberculosis (TB). Methods The clinical and radiological materials of one pulmonary nocardiosis patient, who initially was misdiagnosed as TB and presented in the 3rd Affiliated Hospital of Sun Yat-sen University in September 2012, were reviewed; a literature review to the related papers in Chinese or English published since 1980 was conducted. Thus, 26 pulmonary nocardiosis cases with completed clinical materials, who initially were misdiagnosed as TB, were involved in the analysis together with the reported case in this paper. Results Among the 27 cases of nocardial infection, there were 21 cases with underlying diseases, including acquired immunodeficiency syndrome (AIDS) (9 cases) which was the most common, autoimmune diseases, chronic lung disease, chronic renal disease and diabetes mellitus (DM); and 25 cases were reported in the high TB burden countries. Nocardia asteroid were identified in 16 cases, nocardia brasiliensis in 4 cases and the other 7 cases were not classified. Lung was the most frequently affected organ (20 of 22 cases). Among 13 cases who had imaging abnormalities in lungs, 10 cases showed bilateral lesions. Mass shadows, patchy infiltration, consolidation or cavitations and pleural effusions were the main manifestations of chest radiology. Conclusion Immunosuppression is the most import predisposing factor for nocardia infection. Nocardia asteroid is the most common species to be isolated from clinical specimens.

Disseminated Penicilliosis marneffei misdiagnosed as tuberculosis: a case report and literatures review

LI De-xian,TAN Shou-yong, TAN Yao-ju,HE Qiao

Journal of Tuberculosis and Lung Health. 2013, 2(4):  263-269.  doi:10.3969/j.issn.2095-3755.2013.04.010

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Objective To improve the knowledge of disseminated Penicilliosis marneffei as to help differential diagnosis this disease from tuberculosis in immunocompetent patient. Methods The clinical, chest imaging, bacteriological and pathological characteristics and the diagnostic and therapeutic course from one patient with immunocompetent patient who was admitted to Guangzhou Chest Hospital in November 2007, misdiagnosed initially as tuberculosis and then confirmed as Penicilliosis marneffei, were analyzed retrospectively. Meanwhile the literatures on Pecicilliosis marneffei were reviewed. Results A 60-year-old cantonese male without HIV infection was presented as cough, fever, weight loss, enlargement of multiple lymph nodes, multiple subcutaneous abscesses and rapidly progressive respiratory failure. Chest imaging showed bilateral pulmonary infiltrates, enlargement of mediastinal lymph nodes, bilateral pleural effusion and pericardial effusion. The laboratory examination showed white cell counts increased rapidly up to 45.23×10⁹/L in the peripheral blood,353 cells/μl in CD4⁺ T-lymphocyte count, 1.19 in CD4/CD8 ratio and HIV seronegative. The early culture from the pleural effusion was negative. The patient, who was early diagnosed as TB by pathology twice and failed to response to antituberculosis therapy, was finally proved as a disseminated Penicilliosis marneffei by the fungus positive in clinical specimens from blood, pleural effusion and purulent exudates by microscopy and culture. And the lymph node biopsy was performed again to prove the disease, with microscopic demonstration of intracellular Penicillium marneffei yeast cells in the infected tissue. The antituberculosis therapy and corticosteroid treatment were discontinued, and the antifungal therapy with voriconazole was implemented. The patient developed subsequently respiratory and circulatory failure, and died after 4 days with voriconazole administration. Conclusion Patients with Penicilliosis marneffei have a poor prognosis without the appropriate antifungal treatment.The early clinical features, imaging findings and pathological characteristics of the disease were easily confused with those of TB. Patient from areas where the infection is endemic, Penicillium marneffei infection should be suspected when the patient failed to response to antituberculosis therapy even if immunocompetence. Early identified the fungus in clinical specimens from purulent exudates by culture at different temperatures (25 ℃ and 37 ℃) should be considered.

Analysis of pathogens isolated from lower respiratory tract in 44 elderly patients with multidrug-resistant pulmonary tuberculosis

HAO Xiao-hui, YAO Lan, WANG Nuan, ZHANG Zhan-jun, LIU Yi-dian,TANG Shen-jie

Journal of Tuberculosis and Lung Health. 2013, 2(4):  270-274.  doi:10.3969/j.issn.2095-3755.2013.04.011

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Objective To investigate the distribution and drug resistance of pathogens in elderly multidrug-resistant pulmonary tuberculosis (MDR-TB) patients with lower respiratory tract infection, and to guide rational clinical therapy. Methods From January 2007 to January 2011, 83 elderly multidrug-resistant pulmonary tuberculosis patients were registered in the hospital, among which 44 sputum culture-positive cases with lower respiratory tract infection were enrolled as elderly group. There were 153 young and middle-aged (older than 18 years and younger than 60 years old) sputum culture-positive multidrug-resistant pulmonary tuberculosis patients with lower respiratory tract infection during the same period, 50 cases selected according to the registered number were enrolled as control group. All patients were examined for sputum culture, bacterial identification and susceptibility test. The data retrieved from the two groups were compared using cohort analysis. Comparisons of categorical variables were performed using the Pearson Chi-square tests or Fisher’s exact tests. Statistical significance was set as P<0.05. Results A total of 54 pathogenic bacteria strains were isolated from sputum samples retrieved from 44 cases of elder multidrug-resistant pulmonary tuberculosis with lower respiratory tract infection. Among them, the proportion of gram-negative bacillus was in the first place, accounting for 53.70% (29/54),compared with the control group (66.10%, 39/59), there was no significant difference (χ²=1.808, P>0.05). The second was fungi at the percentage of 42.59% (23/54), compared with the young and middle-aged multidrug-resistant pulmonary tuberculosis patients (30.51%,18/59), there was no statistically significant difference(χ²=1.781, P>0.05).The proportion of gram-positive bacteria accounted for 3.70% (2/54) in elderly group and 3.39% (2/59) in control group, without statistically significant difference (Fisher’s exact test; P>0.05). Mixed infection rate was 22.72% (10/44) in elderly group, which was higher than that of the control group (18.00%, 9/50) (χ²=0.215,P>0.05). The drug susceptibility test (DST) of gram-negative bacteria showed that there was statistically significant difference between the two groups. Moreover, the sensitivity rates to amikacin (100.00%,29/29), gentamycin (65.52%, 19/29) and cefazolin (58.62%,17/29) in the elderly group were significantly higher than those in the control group (41.03% (16/39), 33.33% (13/39) and 12.82% (5/39) respectively (χ²=25.844,6.915,15.941,all P<0.05). Conclusion The primary pathogenic bacteria of lower respiratory tract infection in the elderly MDR-TB patients were gram-negative pathogen, and the mixed infection rate was high. In clinical settings, attention should be paid to bacterial culture and drug sensitivity test in order to reduce improper use of the antibiotics.

Study on the dose and course of dexamethasone in tuberculous meningitis treatment

DU Juan, XU Jie

Journal of Tuberculosis and Lung Health. 2013, 2(4):  275-277.  doi:10.3969/j.issn.2095-3755.2013.04.012

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Objective To explore the course of treatment and decrement method of dexamethasone in the treatment of tuberculous meningitis, and to improve the cure rate and reduce the adverse outcome. Methods Thirty-seven patients with tuberculous meningitis treated in the Twelfth People’s Hospital of Chongqing from 2008—2012 were enrolled in this study. The dose and course of treatment with dexamethasone, and the clinical outcome were analyzed retrospectively. Results After diagnosis confirmed, all of 37 patients were given the anti-tuberculosis treatment with 3-6HREZ/15HRE or 2HREZS/1-4HREZ/15HRE, and glucocorticoid was simultaneously administered (intravenous drip dexamethasone 10 mg/d). Meanwhile, all of them were given intrathecal injection of isoniazid and dexamethasone once or twice a week. During the deduction of dexamethasone, 13 patients’ illness were repeated, among whom 8 cases reduced hormone within 1 month treatment. The symptoms of 6 patients whose protein of the cerebrospinal fluid fluctuated were not exacerbated. After 2-3 months prolonged treatment with glucocorticoid, cerebrospinal fluid protein recovered to normal. The 18 patients whose illness was not repeated were given dexamethasone 10 mg/d for 2-3 months followed by the decrement of dexamethasone. Among 37 patients, 30 patients were followed up routinely and were clinically cured, 9 cases had sequela of dysnoesia, neurological or mental disorder. Conclusion The course of treatment of glucocorticoids in treatment of tuberculous meningitis should be prolonged, and the decrement of dexamethasone after 2-3 months can reduce the occurrence of illness repeated

The cost benefit analysis of implementation of tuberculosis control program in Heilongjiang province(2001—2010)

WEI Song-ting,ZHENG Gui-lan, YAN Xing-lu, LI Fa-bin, SUN Yan-bo

Journal of Tuberculosis and Lung Health. 2013, 2(4):  278-282.  doi:10.3969/j.issn.2095-3755.2013.04.013

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Objective To understand the total social investment cost and the entire economic output after implementation of tuberculosis control program in Heilongjiang province(2001—2010) (referred to as “Program”), and analyze the cost-benefit. Methods The data selected from the final assessment report of the tuberculosis control program in Heilongjiang (2001—2010) and the Heilongjiang part of the final evaluation report of the national tuberculosis control program (2001—2010), The data were analyzed by Excel 2007. The social total investment cost was composed of central budget, various level governmental funding, and international program financing. The social effects were reflected by the population protected from infection, the number of new cases of tuberculosis, and reduction of tuberculosis fatality. The socioeconomic performance was attributed to both of the direct and the indirect social economic benefits. The “cost-benefit ratio” was calculated by the formula of “cost/benefit ratio=the total social investments cost/the entire economic output”. Results From 2001 to 2010, Heilongjiang province invested a total of 273 million RMB to control and prevent tuberculosis, detected 323 914 cases of patients with active tuberculosis, successfully treated 302 402 cases, reduced 79 580 cases of deaths, prevented 1 406 789 cases of new infections, avoided 140 681 new cases, saved medical expenses 96 million RMB, restored total 22.486 billion RMB of social value. It was estimated that investment of 143.26 could save a DALY. Every one RMB invested can generate social and economic value of 98.8 RMB. Conclusion The implementation of Program in Heilongjiang province achieved remar-kable effects on controlling the tuberculosis epidemic and promoting economic development.

Effect evaluation of implementation of Tai’an tuberculosis control programme (2001—2010) in Shandong province

LI Jian-zhi, MENG Fan-liang

Journal of Tuberculosis and Lung Health. 2013, 2(4):  283-288.  doi:10.3969/j.issn.2095-3755.2013.04.014

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Objective To evaluate the implementation effect of Tai’an tuberculosis (TB) control programme during 2001—2010, and to summarize the experience, analyze the existing problems and the inadequacies, and to provide the scientific evidence and support for sustainable development of TB control and prevention in Tai’an city. Methods According to the implementation plan of final assessment of the national TB control programme (2001—2010), the data of evaluation of TB control programme implementation and evaluation reports, and the routine surveillance data and information from TB management information system of Tai’an and its 6 counties during 2001—2010 were collected. EpiData 3.1 and Excel 2003 were used for data cleaning and analysis. Results During 2001—2010, the DOTS coverage rate reached 100.00% (6/6). The total funds for TB prevention and control was 15 167 900 Yuan. 111 690 patients with suspicious symptoms of TB sought health care, among whom 23 335 active pulmonary TB cases were detected, and the average annual notification rate was 42.41/100 000 (23 335/55 021 500). The re-ferral arrival rate was 38.11% (2735/7177), and the tracing arrival rate was 80.12% (3559/4442) and the overall arrival rate was 88.10% (6323/7177). The cure rate of new smear positive TB patients was 94.30% (12 734/13 504), and that of retreated smear positive TB cases was 90.38% (2752/3045), and the overall cure rate was 93.58% (15 486/16 549). 21 893 active pulmonary TB cases were treated successfully, which avoided 104 449 people from TB infection, avoided 10 445 people from TB, and 5689 people from death. 7.1157 million Yuan was saved on medical care, and 1.921 billion Yuan of social economic loss was saved. Conclusion The implementation of tuberculosis control programme in Tai’an during 2001—2010 has achieved remarkable results.

Influence of family support on treatment compliance and cure rate of MDR-TB patients

SU Jing-yi,DU Yu-hua, ZHANG Feng-ling, LIN Yin, DU Cai-yun, OUYANG Cai-hong,CAO Man-xia, LI Yi-fen

Journal of Tuberculosis and Lung Health. 2013, 2(4):  289-291.  doi:10.3969/j.issn.2095-3755.2013.04.015

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Objective To study the influence of family support on treatment compliance and cure rate of MDR-TB patients. Methods A total of 44 MDR-TB patients were registered who finished the full course treatment in the Guangzhou Chest-Disease Hospital from Jan. 2010 to Jun. 2013. The patients were interviewed by the self-designed questionnaires and the relationship between family support,treatment compliance and cure rate were analyzed. All questionnaires were returned. At same time, we analyzed treatment compliance and cure rate between different family support by Chi-square statistics test, P<0.05 was considered statistically significant. Results The family support can improve the MDR-TB patients’ treatment compliance and cure rate. patients with good family support had good treatment compliance(90.9%,30/33) and cure rate (81.8%,27/33). But the treatment comp-liance and cure rate were 54.5%(6/11) and 45.5% (5/11)respectively in patients with low family support. The two groups were significantly different in treatment compliance and cure rate (corrected χ²=5.09, 3.82, P<0.05). Conclusion The family support is very important to the treatment results of MDR-TB patients. We should pay attention to the health education for MDR-TB cases’ family members and ensure the patients to get the high quality family support.

Analysis of streptomycin resistance of Mycobacterium tuberculosis situation in Suzhou city

YE Zhi-jian, TANG Pei-jun, SHI Mei-hua, SHEN Xing-hua, WU Mei-ying, XIAO Yu-mei

Journal of Tuberculosis and Lung Health. 2013, 2(4):  292-295.  doi:10.3969/j.issn.2095-3755.2013.04.016

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Objective To investigate the streptomycin resistance of anti-TB drugs in patients with pulmonary tuberculosis (PTB) in Suzhou city. Methods Retrospectively analysis were carried out on the 1749 patients with PTB of Suzhou city between September 2008 and May 2011 to investigate the streptomycin-resistance rate and the incidence of resistance rate of streptomycin combination with isoniazid, rifampicin or ethambutol and the streptomycin resistance rate’s composition in the multidrug-resistant TB(MDR-TB). The Chi-square test was used for statistical analysis, P<0.05 is considered statistically significant. Results In recent 3 years in Suzhou city, the total streptomycin-resistance rate was 24.7%(432/1749) and 87.4%(160/183) of MDR-TB cases were streptomycin-resistant. The streptomycin-resistance rate in retreatment cases was 44.3%(160/361), which is significantly higher than 19.6%(272/1388) in new cases (χ²=94.16,P<0.01). 93.5％(87/93)of patients in retreatment cases were streptomycin-resistant, which is also significantly higher than 81.1％(73/90)in new cases (χ²=6.44,P<0.05). Conclusion The streptomycin-resistance rate had highest single drug resistance in patients with PTB in Suzhou city, and streptomycin-resistance rate were high both in new and retreatment of MDR-TB patients.

Comparative analysis of epidemiological characteristics of active pulmonary tuberculosis patients between Nujiang Lisu Autonomous prefecture and Yunnan province

ZHANG Li-fang, XU Lin,GAO Xiao-jiao, CHEN Liu-ping

Journal of Tuberculosis and Lung Health. 2013, 2(4):  296-298.  doi:10.3969/j.issn.2095-3755.2013.04.017

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Objective To provide evidence for pulmonary tuberculosis (PTB) control through a contrastive analysis of epidemiological characteristics of active PTB cases between Nujiang Lisu Autonomous prefecture (NUJ) and Yunnan province. Methods Data of 2482 active PTB cases in NUJ and 90 546 active PTB cases in Yunnan from 2008—2011, that obtained from tuberculosis information management system, were compared. Results The average age of active PTB cases in NUJ (35.8±14.77) was younger than that in Yunnan (41.9±17.37) (t=17.24, P<0.01). There was no significant difference in the proportion of male cases between NUJ (68.7%(1705/2482)) and Yunnan (68.1%(61 658/90 546)) (χ²=0.399, P>0.05). The proportion of cases in household register population of NUJ (99.3%(2464/2482)) was higher than the provincial level (95.7%(86 623/90 546)) (χ²=77.49, P<0.01). There were more cases seeking health care actively in NUJ (91.7%(2275/2482)) than in Yunnan (82.0%(74 277/90 546)) (χ²=153.6, P<0.01). The proportion of retreated cases was higher in NUJ (10.6%(263/2482)) than that at the provincial level (7.5%(6813/90 546)) (χ²=32.439, P<0.01). There were more non-smear positive (smear negative, no sputum examination and tuberculous pleurisy) cases in NUJ (54.4%(1349/2482)) than the provincial level (39.9%(36 111/90 546)) (χ²=206, P<0.01). The median of patient delay in NUJ (70 d) was longer than that in Yunnan (46 d). Conclusion The epidemic situation of active PTB in NUJ is severer than the provincial level, so that we should take specific TB prevention and control strategies in NUJ.

Effect analysis of Zhangdian tuberculosis control and prevention programme in Zibo city of Shandong province from 2001 to 2012

ZHANG Wen-na

Journal of Tuberculosis and Lung Health. 2013, 2(4):  299-302.  doi:10.3969/j.issn.2095-3755.2013.04.018

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Objective To evaluate the implementation effect of Zhangdian tuberculosis control and prevention programme in Zibo city of Shandong province from 2001 to 2012,and to provide scientific evidence for sustainable development of TB control. Methods The referral and tracing situation of 1929 TB suspects from 2005 to 2010, of which data were from the annual report of the TB management information system of Zhangdian were collected and analyzed, as well as the detection, treatment and management situation of 2395 TB patients registered from 2001 to 2012. Results (1)A total of 2395 active pulmonary tuberculosis cases were detected from 2001 to 2012,among which 1297 were smear positive cases and 1160 were new smear positive cases.The registration rate of active pulmonary tuberculosis was 32.56/100 000 (2395/7 355 400), and that of new smear positive cases was 15.77/100 000 (1160/7 355 400).(2)The referral rate of TB suspects was 96.58% (1863/1929), the tracing arrival rate was 85.87% (808/941), and the overall arrival rate of TB suspects was 81.49% (1572/1929) during 2005—2012. (3)The treatment success rate of active pulmonary tuberculosis was 95.16% (2279/2395), the cure rate of smear positive cases was 92.91% (1205/1297), and that of new smear positive cases was 94.05% (1091/1160) from 2001 to 2012. Conclusion Zhangdian has made substantial progress on TB control, while there are still some new challenges and difficulties to be addressed during the implementation of the twelfth five-year plan.