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Table of Content

    20 February 2024, Volume 5 Issue 1
    Guideline·Standard·Consensus
    Clinical practice guidelines for early detection of pulmonary tuberculosis in general medical facilities
    National Center of Medical Quality Control for Respiratory Diseases , Tuberculosis Branch of Chinese Medical Association , Tuberculosis Control Branch of Chinese Antituberculosis Association , China⁃Japan Friendship Hospital
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  1-14.  doi:10.19982/j.issn.1000-6621.20230428
    Abstract ( 146 )   HTML ( 24 )   PDF (3750KB) ( 156 )   Save
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    The diagnosis delay of pulmonary tuberculosis not only results in aggravation and treatment challenges for patients but also leads to the continuously group spreading of tuberculosis. Early detection in general medical facilities, the main primary diagnosis healthcare contact for pulmonary tuberculosis patients, plays a crucial role in achieving the goal of “End tuberculosis strategy”. The National Center of Medical Quality Control for Respiratory Diseases, Tuberculosis Branch of Chinese Medical Association, Tuberculosis Control Branch of Chinese Antituberculosis Association, and China-Japan Friendship Hospital jointly organized experts to formulate the Clinical practice guidelines for early detection of pulmonary tuberculosis in general medical facilities based on the results of China’s tuberculosis prevention practice and the relevant guidelines of the World Health Organization and supplement relevant research evidence at home and abroad. The guideline systematically summarizes the characteristics of different diagnostic techniques for pulmonary tuberculosis and proposes tuberculosis screening strategies for different target populations seeking treatment in comprehensive medical institutions, providing evidence for improving and optimizing early detection of pulmonary tuberculosis in national and regional comprehensive medical institutions.

    Interpretation of Standards
    Interpretation of WHO global tuberculosis report 2023
    hu Wei, Liu Yuhong
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  15-19.  doi:10.19983/j.issn.2096-8493.2024006
    Abstract ( 370 )   HTML ( 35 )   PDF (1076KB) ( 309 )   Save
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    In November 2023, the World Health Organization published the Global tuberculosis report 2023, which focuses on the updated global burden of the tuberculosis epidemic, notifications, treatment outcomes, innovation, and development. The authors interpret the burden of global tuberculosis, status of diagnosis and treatment s of the Global Report and provides a reference for peers to comprehensively understand global strategies, actions, and progress on tuberculosis prevention and control.

    Original Articles
    Analysis of risk factors and construction of risk prediction model for anemia in patients with chronic obstructive pulmonary disease
    Fu Yiting, Liu Lei, Zhao Qian, Meng Jixian, Zhen Ziyi, Wang Yang, Li Rongmei
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  20-27.  doi:10.19983/j.issn.2096-8493.2024003
    Abstract ( 63 )   HTML ( 6 )   PDF (1650KB) ( 16 )   Save
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    Objective: To explore the risk factors of anemia in patients with chronic obstructive pulmonary disease (COPD), and construct a nomograph prediction model. Methods: COPD patients admitted to the Respiratory Department of the Second Affiliated Hospital of Shenyang Medical College from December 2019 to March 2023 were retrospectively selected as the study objects (492 patients). LASSO regression was used to screen risk factors, and logistic regression analysis was used to construct a prediction model of anemia in COPD patients, and a nomogram prediction model was constructed. The model was validated internally by Bootstrap resample method. The calibration curve and its C-index were used to evaluate the differentiation of the model. The area under receiver operating characteristic (ROC) curve and clinical decision curve (DCA) were used to evaluate the prediction ability and clinical applicability of the nomogram prediction model, respectively. Results: A total of 492 COPD patients were included, 19.51% (96/492) of them had anemia. Nine candidate predictors were identified by LASSO regression analysis: gender, creatinine, hypoproteinemia, diabetes, hypertension, COVID-19 infection, red blood cells (RBC), hemoglobin (Hb), body mass index (BMI). They were included in logistic regression analysis, and the results showed that gender being female (OR=3.353, 95%CI: 1.530-7.349), elevated creatinine levels (OR=1.024, 95%CI: 1.010-1.037), elevated Hb levels (OR=0.928, 95%CI: 0.905-0.951), hypoproteinemia (OR=6.239, 95%CI: 2.845-13.678), diabetes mellitus (OR=0.198, 95%CI: 0.056-0.703) were all independent influencing factors for anemia. Calibration curve of the nomogram prediction model showed good fitness, with a C-index of 0.933 (95%CI: 0.910-1.848), indicating that the model was well distinguished. The area under the curve was 0.933 (95%CI: 0.910-0.957), and DCA curve showed good clinical applicability of the model. Conclusion: The prediction model of COPD combined with anemia is simple and accurate, has certain value in early clinical screening of high-risk groups of anemia and the formulation of individualized precise prevention and treatment plans.

    Analysis of drug resistance status and influencing factors in 203 aged patients with pulmonary tuberculosis combined with type 2 diabetes
    Ni Nan, Chen Qing, Tang Xianzhen, Zou Liping, Liang Li, Wu Guihui, Mao Li
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  28-36.  doi:10.19983/j.issn.2096-8493.2024004
    Abstract ( 70 )   HTML ( 11 )   PDF (922KB) ( 24 )   Save
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    Objective: To explore the characteristics and the related influencing factors of drug resistance in aged pulmonary tuberculosis patients combined with type 2 diabetes. Methods: A retrospective study was conducted to collect the drug sensitivity test results and clinical data of 203 aged pulmonary tuberculosis patients combined with type 2 diabetes who were admitted to Public Health Clinical Center of Chengdu from January 1, 2021 to December 31, 2022 and identified as Mycobacterium tuberculosis with positive sputum culture. The characteristics of drug resistance and the influencing factors of drug resistance were analyzed by univariate and multivariate logistic regression models. Results: In 203 aged pulmonary tuberculosis patients combined with type 2 diabetes, the total drug resistance rate of was 40.4% (82/203), the rate of single drug resistance was 12.3% (25/203), the rate of poly-resistant tuberculosis was 4.9% (10/203) and the rate of multi-drug resistant tuberculosis was 12.8% (26/203). The top three drug resistance rates of 14 anti-tuberculosis drugs were INH (22.7% (46/203))>RFP (15.8% (32/203))>Sm (14.8% (30/203)), and the drug resistance rates of Mfx (11.3% (23/203)) and Lfx (10.8% (22/203)) were higher. Multivariate logistic regression analysis showed that retreatment (OR=4.528, 95%CI: 2.031-10.099, P<0.001), hypoproteinemia (OR=2.106, 95%CI: 1.116-3.972, P=0.021) and CD4+T lymphocyte count <414 cell/μl (OR=1.887, 95%CI: 1.011-3.532, P=0.046) were independent risk factors for drug resistance in aged pulmonary tuberculosis patients combined with type 2 diabetes. Conclusion: The drug resistance rate of aged pulmonary tuberculosis patients combined with type 2 diabetes is high, and the drug resistance is mainly caused by first-line anti-tuberculosis drugs. Drug resistance screening should be actively carried out, and prevention and control measures should be taken as soon as possible for patients with retreatment, hypoproteinemia and CD4+T lymphocyte count <414 cell/μl.

    Evaluation of next generation sequencing for the diagnosis of osteoarticular tuberculosis infection
    Yao Xiaowei, Liu Shuren, Jing Yanse, Jia Chenguang
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  37-43.  doi:10.19983/j.issn.2096-8493.20230094
    Abstract ( 56 )   HTML ( 6 )   PDF (1028KB) ( 20 )   Save
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    Objective: To evaluate the application value of next generation sequencing (NGS) technology in the diagnosis of osteoarticular tuberculosis. Methods: A retrospective study method was used to collect the clinical data of 185 patients with suspected osteoarticular tuberculosis admitted to the Department of Orthopedics of Hebei Provincial Chest Hospital from Dec 2019 to Dec 2022 with reference to the enrollment criteria. The patients were categorized into the tuberculosis group (osteoarticular tuberculosis, 155 cases) and the non-tuberculosis group (non-osteoarticular tuberculosis, 30 cases) according to the final clinical diagnosis. All patients’ lesion specimens were obtained during surgery or puncture (including 51 pus, 89 granulation tissue and 45 bone tissue specimens), and all of them were sent for NGS, BACTEC MGIT 960 mycobacterial liquid culture (culture), and rifampicin resistance real-time fluorescence quantitative nucleic acid amplification assay (GeneXpert MTB/RIF, Xpert). The final clinical diagnosis was used as the reference standard to compare the efficacy of the three methods in the diagnosis of osteoarticular tuberculosis, and to analyze the positivity of the three methods in the detection of pus, granulation tissue and bone tissue specimens. Results: Of the 185 patients with suspected bony joint tuberculosis, the positive rate of NGS for detecting osteoarticular tuberculosis (63.24%, 117/185) was significantly higher than that of Xpert (54.05%, 100/185) and culture (35.68%, 66/185), and the differences were statistically significant (χ2=24.982, P<0.001; χ2=37.934, P<0.001). Using the final clinical diagnosis as the reference standard, the sensitivity of NGS, Xpert and culture methods for the diagnosis of osteoarticular tuberculosis were 74.84% (116/155), 64.52% (100/155) and 42.58% (66/155), respectively, and the specificity were 96.67% (29/30), 100.00% (30/30) and 100.00% (30/30), the diagnostic compliance rates were 78.38% (145/185), 70.27% (130/185) and 51.89% (96/185), respectively, and the Kappa values were 0.799, 0.590 and 0.504, respectively, and the AUC (95%CI) values were 0.867 (0.693-0.941), 0.703 (0.612-0.784) and 0.623 (0.529-0.717), respectively. The positive rates of pus detected by NGS was 80.39% (41/51), respectively, which were significantly higher than that granulation (62.92% (56/89)) and bone tissue specimens (44.44% (20/45)), and the differences were all statistically significant (χ2=4.560, P=0.031; χ2=13.335, P<0.001). Conclusion: NGS technology can significantly increase the pathogenetically positive detection rate in patients with osteoarticular tuberculosis with high detection efficacy, and has the highest diagnostic value with pus specimens.

    Analysis of treatment outcome and influencing factors of 308 patients with multidrug-resistant pulmonary tuberculosis
    Xue Jianhang, Cao hong, Li Lu, Liu Xunrui, Ma Guilin, Zheng Rongrong, Ke Ran
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  44-50.  doi:10.19983/j.issn.2096-8493.20230085
    Abstract ( 73 )   HTML ( 6 )   PDF (1202KB) ( 39 )   Save
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    Objective: To screen and evaluate the factors affecting treatment outcomes in patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB). Methods: Treatment outcome data of 308 patients with MDR-PTB in Xiamen from 2010 to 2019 were collected through the “Tuberculosis Information Management System”, a subsystem of the “China Disease Prevention and Control Information System”, then risk factors affecting the treatment outcome were analyzed, and the prediction model was built. Results: Of 226 (73.38%) out of these 308 patients were successfully treated. There were 82 cases (26.62%) getting adverse outcomes, including 52 cases (16.88%) with treatment failure, 17 cases (5.52%) died, and 13 cases (4.22%) getting adverse outcome with other causes. Factors influencing the treatment outcome were: male (OR=2.877, 95%CI: 1.356-6.104), age ≥50 years old (OR=1.833, 95%CI: 1.011-3.323), housewife/without a job (OR=0.352, 95%CI: 0.196-0.631), retreatment (OR=6.357, 95%CI: 1.842-21.944), sputum culture negative at 3 month (OR=0.162, 95%CI: 0.063-0.416). The area under ROC curve of the predictive model was 0.909 (95%CI: 0.871-0.938) based on combined predictors to predict the outcome of MDR-TB patients. Conclusion: Male, age ≥50 years old, retreatment patients and sputum culture positive at month 3 were risk factors for adverse outcomes in MDR-PTB patients, housewife/without a job were protective factor for adverse outcomes in MDR-PTB patients. The combined predictor model had fairly strong ability to predict adverse outcomes in patients with MDR-PTB after treatment.

    Epidemiological characteristics analysis of hospitalized patients with extrapulmonary tuberculosis in Xinjiang Uygur Autonomous Region from 2018 to 2022
    Niu Peixuan, A Ertai, Li Yuanyuan, Guan Wenlong, Zheng Tian, Su Dongdong, Du Qingqing, Du Caiyun
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  51-57.  doi:10.19983/j.issn.2096-8493.2024014
    Abstract ( 70 )   HTML ( 9 )   PDF (840KB) ( 17 )   Save
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    Objective: To analyze the epidemiological characteristics of hospitalized patients with extrapulmonary tuberculosis in Xinjiang Uygur Autonomous Region from 2018 to 2022. Methods: A retrospective study was conducted to collect the information of 4520 inpatients with extrapulmonary tuberculosis from the medical record system of the Eighth Affiliated Hospital of Xinjiang Medical University from January 1, 2018 to December 31, 2022, including gender, age, nationality, occupation, address, admission diagnosis, cumulative location of the focus, etiology examination results, clinical symptoms, discharge diagnosis, etc. Descriptive analysis was used to analyze the sociodemographic and clinical characteristics, and the risk factors for multiple types of extrapulmonary tuberculosis were analyzed using multivariate logistic regression model. Results: Among the 4520 patients with extrapulmonary tuberculosis, the most patients were admitted in the second quarter (April to June), with a total of 1327cases (29.4%); there were 2844 (62.9%) female patients and 1676 (37.1%) male patients; the number of patients aged 25-34 was the highest (n=1026, 22.7%); the most patients were cadres and staff (n=853, 18.9%); there were 2237 (49.5%) Uyghur patients; 1510 (33.4%) patients were from the southern Xinjiang and 2387 (52.8%) patients were from the northern Xinjiang. Among patients with extrapulmonary tuberculosis, lymph node tuberculosis was the most common, with a total of 1326 (29.3%) cases; 1031 patients (22.8%) had two or more types of extrapulmonary tuberculosis. Multivariate logistic regression analysis showed that, with simple extrapulmonary tuberculosis as a reference, male (OR(95%CI)=1.207 (1.046-1.393)) and fever (OR(95%CI)=1.185 (1.016-1.381)) were risk factors for the combination of multiple extrapulmonary tuberculosis. Conclusion: The proportion of lymph node tuberculosis in extrapulmonary tuberculosis in Xinjiang is the highest, and there are more female patients, more patients were young and middle-aged, and more patients were in southern Xinjiang. In clinical practice, we should focus on early screening and standardized diagnosis and treatment, and extrapulmonary tuberculosis should be included in China’s tuberculosis prevention and control planning and management as soon as possible, and then gradually form a systematic and perfect diagnosis, treatment and prevention system according to local conditions.

    Analysis of patient delay and its influencing factors among elderly pulmonary tuberculosis patients in Tongzhou District of Beijing, 2016—2022
    Yang Chao, Wang Jing, Tang Guilin, Gao Hanqing, Wang Bin
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  58-63.  doi:10.19983/j.issn.2096-8493.2024010
    Abstract ( 70 )   HTML ( 8 )   PDF (833KB) ( 24 )   Save
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    Objective: To analyze the current situation and influencing factors of patient delay among elderly (≥60 years old) pulmonary tuberculosis (PTB) in Tongzhou District of Beijing from 2016 to 2022, and to provide scientific basis for reducing the patient delay in the future. Methods: Data of 963 cases of PTB patients in the elderly people in Tongzhou District of Beijing from 2016 to 2022 were extracted from the Tuberculosis Management Information System of China Information System for Disease Control and Prevention, including medical records, diagnosis and treatment information, and so on. Descriptive statistics was used to analyze the distribution and trend of patient delay. Influencing factors of patient delay was analyzed by multivariable logistic regression. Results: From 2016 to 2022, the median and quartile of patient delay days was 5 (0,32) days. The average patient delay rate was 40.08% (386/963). The median of patient delay days went down from 12 (0,37) days in 2016 to 0 (0,24) days in 2022. The patient delay rate changed from 34.39% (54/157) in 2016 to 50.42% (60/119) in 2019, showing a upward trend ( χ t r e n d 2=7.605,P=0.006), and then decreased to 30.99% (44/142) in 2022, showing a downward trend ( χ t r e n d 2=7.138,P=0.008). Multivariable logistic regression analysis showed that patient registered during 2020—2022 (OR=0.667,95%CI:0.508-0.876) was the protective factor for patient delay. Non-urban area (OR=1.368,95%CI:1.037-1.804) was the risk factor for patient delay. Conclusion: The patient delay showed an upward-then-downward trend from 2016 to 2022. The patient delay was related to year of registration and current address. It is necessary to perform targeted intervention measures.

    Epidemiological characteristics of pulmonary tuberculosis in Taicang City from 2017 to 2022
    Zhang Taifa, Zhou Hua
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  64-69.  doi:10.19983/j.issn.2096-8493.20230125
    Abstract ( 61 )   HTML ( 8 )   PDF (836KB) ( 34 )   Save
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    Objective: To analyze the epidemiological characteristics of pulmonary tuberculosis (PTB) in Taicang City from 2017 to 2022, and to provide direction and basis for PTB prevention and control. Methods: Medical records of 1444 PTB patients registered in the “Tuberculosis Management Information System”, a subsystem of the “China Disease Prevention and Control Information System” in Taicang City from 2017 to 2022 were extracted, and then the morbidity characteristics of those patients were described, and the distribution characteristics about time, area, people were analyzed. Results: A total of 1444 patients with active PTB were registered in Taicang City from 2017 to 2022, among which 676 were etiologically positive, accounting for 46.81%, with an average registration rate of 30.92/100000 (1444/4669900), changed from 34.79/100000 (249/715800) in 2017 to 22.88/100000 (193/843600) in 2022, showing a downward trend ( χ t r e n d 2=35.942, P=0.001). The average registration rate in 2020—2022 was 26.10/100000 (656/2513700), lower than that in 2017—2019 (36.55/100000, 788/2156200), and the difference was statistically significant (χ2=13.662, P=0.001). The top three towns in terms of the number of patients were Chengxiang Town (332 cases, 22.99%), High-tech Zone (303 cases, 20.98%) and Fuqiao Town (225 cases, 15.58%), and the lowest was Huangjing Town (125 cases, 8.66%). The number of male patients (1023 cases, 70.84%) was higher than that of female patients (421 cases, 29.16%). The peak age of disease onset was concentrated between 25—34 years old (350 cases, 24.24%). The occupation with the highest number of cases was farmers (534 cases, 36.98%). Conclusion: The tuberculosis registration rate in Taicang City showed a downward trend from 2017 to 2022. In the future work, attention should be paid to key towns and key groups to strengthen publicity and education, improve the diagnosis level, and improve the management and treatment system.

    Review Articles
    Research progress of comprehensive treatment for tuberculosis
    Liang Chen, Tang Shenjie, Lin Minggui
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  70-80.  doi:10.19983/j.issn.2096-8493.20230112
    Abstract ( 116 )   HTML ( 17 )   PDF (1006KB) ( 103 )   Save
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    Tuberculosis is a chronic infectious disease caused by the infection of Mycobacterium tuberculosis complex. Although the success of BCG vaccine and effective anti-tuberculosis drugs has provided effective means of tuberculosis prevention and treatment, it is still quite challenging to cure tuberculosis completely with the continuous flow of population, and continuous emergence of HIV infection, usage of immunosuppressive drugs for special diseases and drug-resistant tuberculosis, especially for that the prevalence of COVID-19 since the end of 2019 has set back the epidemic control of tuberculosis for at least 5-8 years. Curing tuberculosis patients thoroughly is still the key measure to cut off the transmission of Mycobacterium tuberculosis and eliminate disease transmission. On the basis of anti-tuberculosis chemotherapy, combined with comprehensive treatment methods such as surgical treatment, interventional therapy, immunotherapy, nutritional therapy, traditional Chinese medicine treatment, psychological therapy, and rehabilitation therapy, it is beneficial to improve the patient’s cure rate and reduce adverse reactions. Clinicians need to comprehensively evaluate the specific condition of patients and choose individualized comprehensive treatment plans in a targeted manner to achieve the optimal treatment effect. This article reviews the research progress of tuberculosis comprehensive treatment in recent years.

    New progress in research on the influencing factors of the severity of Mycoplasma pneumoniae pneumonia in children
    iu Liming, Li Ming
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  81-87.  doi:10.19983/j.issn.2096-8493.2024013
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    Mycoplasma pneumoniae (MP) infection is a heterogeneous disease. Clinically, in children diagnosed with Mycoplasma pneumoniae pneumonia (MPP), severe Mycoplasma pneumoniae pneumonia (SMPP), refractory Mycoplasma pneumoniae pneumonia (RMPP) and critical MPP, in addition to causing serious impacts on children’s life safety such as treatment difficulties and poor prognosis, various degrees of sequelae often exist. To explore the influencing factors and to improve the early warning indicators of MPP severity, is of great significance for early intervention, reducing the morbidity and sequelae of SMPP and RMPP, and reducing the mortality rate of SMPP and RMPP. In clinical practice, mycoplasma drug resistance, clinical manifestations, laboratory indicators, imaging manifestations, and the application of bronchoalveolar lavage (BAL) in children infected with MPP are related to the occurrence of MPP severity. This paper reviews the research progress of the above related factors.

    Current situation of tuberculosis epidemic in schools and research progress in prevention and control
    Cao Hong, Qian Bing, Wu Jinju
    Journal of Tuberculosis and Lung Disease. 2024, 5(1):  88-92.  doi:10.19983/j.issn.2096-8493.20230115
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    In the special period of growth and development, unbalanced nutrition, high pressure for further education and employment, and other reasons, result in that students are at high-risk of tuberculosis (TB). Recently, TB clusters epidemic in schools have been reported, and clusters of mutidrug-resistant tuberculosis have also occurred, which seriously affected the physical and mental health of students and caused adverse social impacts. The author reviewed the current situation and prevention and control measures of TB in schools in recent years, summarized and analyzed the problems, and provided the basis for better control of TB in schools.

Bimonthly, Established in June 2020
ISSN 2096-8493
CN 10-1695/R

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    China Association for Scienceand Technology
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    Chinese Antituberculosis Association
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    TANG Shen-jie(唐神结)
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    FAN Yong-de(范永德)
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    Chinese Journal of Antituberculosis Publishing House
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