[The relationship between monocyte chemoattractant protein-1 gene polymorphisms and the susceptibility to pulmonary tuberculosis].

OBJECTIVE: To explore the possible relationship between the -2518 A/G single nucleotide polymorphisms in monocyte chemoattractant protein-1 (MCP-1) gene of Chinese Han population and the susceptibility to pulmonary tuberculosis. METHODS: A 1:1 matched case-control study was conducted from March 2008 to August 2008. The - 2518 MCP-1 A/G polymorphisms were detected in 167 pairs of subjects by reaction-restriction fragment length polymorphism (PCR-RLFP) technique. General characteristics, current disease history, past medical history and related environmental factors of tuberculosis were collected using a questionnaire designed by ourselves. Univariate analyses and multivariate conditional logistic analyses were conducted. RESULTS: The genotype frequencies of AA, GA and GG in the case group and the control group were 21/167 (12.6%), 62/167 (37.1%), 84/167 (50.3%) and 42/167 (25.2%), 83/167 (49.7%), 42/167 (25.1%), respectively. There was a significant difference in genotype frequencies between the case and the control groups in the univariate analysis (chi2 = 24.041, P<0.01). The significant association remained after adjusting environmental factors between genotype GG (OR 1.989, 95% CI 1.154 - 3.428, chi2 = 6.124, P<0.05) and the susceptibility to pulmonary tuberculosis. CONCLUSION: The -2518 MCP-1 GG genotype might be associated with susceptibility to pulmonary tuberculosis in Chinese Han population.

[Study on the epidemiology and determinants of drug-resistant tuberculosis in northern rural area of Jiangsu province].

OBJECTIVE: To understand the determinants and epidemiology of drug-resistant tuberculosis (TB) in rural area. METHODS: All the diagnosed TB patients in a county with directly observed treatment (DOTS) short-course program in 2002 and a sample of patients in another county without DOTS program located in northern Jiangsu province were surveyed with questionnaires. Drug susceptibility testing (DST) for positive cultures were performed by standardized proportion method. Univariable analysis and multivariate nonconditional logistic regression modeling were applied for data analysis. RESULTS: Among the 152 patients with DST results, 32.9% of the cases showed resistance to at least one of the first-line anti-tuberculosis drugs with 26.3% to isoniazid, 18.4% to rifampin and 17.1% to both isoniazid and rifampin respectively. Previous treatments for TB and residence in the county without DOTS program were independent risk factors for isoniazid and rifampin resistance. TB patients showing indifferent to their health and delayed health seeking for more than 1 month were more likely to have rifampin resistance. Independent predictors of multidrug-resistant TB would include delayed health seeking for more than 1 month (OR = 4.66, 95% CI: 1.26 - 17.24), residing in the county without a DOTS program (OR = 3.01, 95% CI: 1.10 - 8.22), indifference to their health condition (OR = 5.13, 95% CI: 1.06 - 24.90) and suffering from chronic diseases (OR = 0.22, 95% CI: 0.05 - 0.87). CONCLUSION: Drug-resistant TB was quite serious in this rural areas, mainly associated with man-made factors but partly due to the availability of the transmission.