Geographical distribution regarding the prevalence rates of pulmonary tuberculosis in China in 2010 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To describe the geographical distribution regarding the prevalence rates of pulmonary tuberculosis (TB) in 2010, to provide reference for eliminating the regional unbalance of TB prevalence in China.</p><p><b>METHODS</b>Thiessen Polygon Method, dealing with spatial analysis in geographical information system, was used to analyze data from the 5th national TB epidemiological survey.</p><p><b>RESULTS</b>The prevalence rates of active pulmonary TB(PAPT), Mycobacterium-positive pulmonary TB (PMPT) and smear-positive pulmonary TB (PSPT) were 62-548/100 thousand population (OHTP),0-120/OHTP and 0-68/OHTP, which were all relatively lower in most parts of Beijing, Tianjin, Hebei, Shanghai, Jiangsu, Zhejiang and Shandong than in other areas. PAPT (549-1656/OHTP), PMPT (121-366/OHTP) and PSPT (69-181/OHTP) were relatively higher in most parts of Guangxi, Sichuan, Guizhou, Yunnan, Xizang, Qinghai and Xinjiang than in other areas, in which PAPT, PMPT and PSPT of some areas could be seen as high as 1657-2646/OHTP, 367-625/OHTP and 182-285/OHTP, respectively. PAPT, PMPT and PSPT manifested jigsaw pattern distribution between 320-548/OHTP adn 549-919/OHTP, among 67-120/OHTP, 121-207/OHTP and 208-366/OHTP, and among 38-68/OHTP, 69-115/OHTP and 116-181/OHTP, respectively, in the rest of the provinces or autonomous regions.</p><p><b>CONCLUSION</b>The geographical distribution for TB prevalence significantly presented the fact that it was relatively low in the eastern parts and high in the western parts, and a jigsaw transition pattern between the low and high rates, in the central part of the country.</p>

Clinical and radiographic predictors in diagnosing sputum smear-negative pulmonary tuberculosis in HIV-negative patients: a cross-sectional study in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In county-level tuberculosis (TB) dispensaries in China, the accurate diagnosis of sputum smear-negative pulmonary tuberculosis (SNPT) needs to be improved by developing and validating clinical and radiographic predictors.</p><p><b>METHODS</b>The study was conducted simultaneously in three counties per province in Chongqing Municipality and Liaoning Province in China between May 2005 and May 2006. A total of 432 new SNPT patients who are HIV-negative and more than 15 years old diagnosed by expert panels in county-level TB dispensaries were recruited. Their sputum samples were collected for culture before anti-TB treatment, and the treatment outcomes (changes of X-rays) were followed up at the end of the 6th month.</p><p><b>RESULTS</b>Of the 432 SNPT patients, sputum culture positive (9.7%) or culture negative with good changes of X-rays at the end of the 6th month (73.6%) was validated as SNPT. Four predictive variables were associated with validated SNPT in the multivariate logistic regression model: age ≤55 years old (odds ratio (OR) 5.66; 95% CI 2.69-11.91), >60 days of cough (OR 3.73; 95% CI 1.10-12.65), ≥10% of pulmonary consolidation in the lungs (OR 5.40; 95% CI 2.90-10.06), and pulmonary consolidation in the upper lobe anterior segment (OR 3.00; 95% CI 1.57-5.72). The area under the receiver operating characteristic curve of the model was 0.77 (95% CI 0.71-0.83).</p><p><b>CONCLUSION</b>Four predictors of clinical and radiological characteristics that had a good diagnostic performance of SNPT deserve to be recommended as index indicators of SNPT diagnosis in county-level TB dispensaries in China.</p>

Achievements and challenges of the World Bank Loan/Department for International Development grant-assisted Tuberculosis Control Project in China / 中华医学杂志(英文版)

In March 2002, the government of China launched the World Bank Loan/ Department for International Development-supported Tuberculosis (TB) Control Project to reduce the prevalence and mortality of TB. The project generated promising results in policy development, strengthening of TB control systems, patient treatment success, funds management, and the introduction of legislation. In light of the global TB epidemic and control environment, it is useful to review the TB control priorities of the project, summarize the achievements and experiences around its implementation.

Prevention and control of tuberculosis in China / 中国医学科学院学报

Tuberculosis (TB) is one of the global major public health problems. China has the second highest TB burden worldwide. This article introduces the epidemiology of TB in China and elucidates the progress and challenges in TB prevention and control.

Analysis on the relationship between tuberculosis case detection and short-course coverage of directly observed treatment in China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze factors influencing tuberculosis (TB) case detection so as to predict the trend of case detection in the year of 2005.</p><p><b>METHODS</b>Data was collected and analyzed regarding the correlation between the registration rate of newly identified smear-positive TB case and the directly observed treatment short-course (DOTS) coverage from 1996 to 2003. Based on the correlation analysis, regression equation was built to predict the case registration rate in 2005.</p><p><b>RESULTS</b>Both case registration rate and case detection rate showed an increasing trend from 1996 to 1998 and kept a platform between 1999 and 2002, followed by a zooming change in 2003 to reach a 45% case detection rate while the smear-positive TB case registration rate and DOTS coverage showed highly correlative (r = 0.849, P = 0.008). The regression equation was: y = b(0) + b(1) X = 1.754 + 0.217X (95% CI of beta: 0.082 - 0.352), F = 15.43, P = 0.008; R(2) = 0.72. If the DOTS coverage rate reaches 100% in 2005, the national new smear-positive registration rate will have become 23.5/100 000 (95% CI: 10.0 - 37.0) and the national new smear-positive case detection rate will have reached 51.8% (95% CI: 22.0 - 81.5).</p><p><b>CONCLUSION</b>Our research finding revealed that not only the expansion of DOTS could promote the rate of TB case detection but the quality of DOTS also played an important role in the TB control program. In order to reach the target of 70% case detection rate in 2005, programs as accelerating the DOTS expansion to increase the DOTS coverage and improving the quality of DOTS as well as other control measures need to be strengthened.</p>