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Objective@#To investigate the delay in identification, healthcare-seeking, and definitive diagnosis of tuberculosis among students in Urumqi City from 2010 to 2019, and to identify the influencing factors, so as to provide insights into tuberculosis control among students.@*Methods@#The demographic and diagnosis data of tuberculosis patients in Urumqi City from 2010 to 2019 were captured from the Tuberculosis Information Management System of Chinese Disease Control and Prevention Information System. The delay in identification, healthcare-seeking and definitive diagnosis of tuberculosis was analyzed among students, and the factors affecting the delay in identification, healthcare-seeking and definitive diagnosis of tuberculosis were identified using a multivariable logistic regression model. @*Results@#A total of 996 tuberculosis cases were identified among students in Urumqi City from 2010 to 2019. There were 702 students with delay in identification of tuberculosis (70.48%), 500 students with delay in healthcare-seeking (55.22%) and 534 students with delay in definitive diagnosis (53.61%). Multivariable logistic regression analysis identified active identification (OR=0.116, 95%CI: 0.032-0.420) as a factor affecting delay in identification of tuberculosis, women (OR=1.424, 95%CI: 1.104-1.836), non-local household registration (OR=1.311, 95%CI: 1.016-1.694) and active identification (OR=0.232, 95%CI: 0.064-0.848) as factors affecting delay in healthcare-seeking, and active identification (OR=0.143, 95%CI: 0.032-0.644) as a factor affecting delay in definitive diagnosis of tuberculosis among students.@*Conclusions@#There is a high proportion of delay in identification, healthcare-seeking and definitive diagnosis of tuberculosis among students in Urumqi City from 2010 to 2019, and female and non-locally household-registered students were at a high risk of delay in healthcare-seeking for tuberculosis. Active detection and screening of tuberculosis should be reinforced.
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Objective To investigate the predictive value of clinical and radiographic features in fungal pathogen identification in immunocompromised patients with pulmonary invasive fungal infection (IFI).Methods All consecutive immunocompromised adult patients with pulmonary IFI in respiratory intensive care unit (ICU)in the First Affiliated Hospital of Xinjiang Medical University were recruited during a 2 year period.All patients met the 2008 European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC /MSG) criteria were studied for proved or probable IFI responding to antifungal agents.The data of demographic,clinical and radiographic features,as well as serological test results of the patients were collected.Differences in the clinical and radiographic features of pulmonary IFIs caused by yeasts and molds were compared by χ2 test.A logistic regression model was used to perform discriminant analysis,and the effect of discrimination was assessed for accuracy.Results The study included 143 patients with a probable diagnosis of IFI who had the following risk factors:diabetes mellitus (43.4%),chronic lung disease (32.2%),broad-spectrum antibiotics administration (≥14 days;35.7%),malignancy (23.1%),corticosteroid therapy (≥14 days;23.1%),chronic renal failure and renal replacement therapy (16.1%),and immunological disease (10.5%).Frequent broad-spectrum antibiotics administration was associated with yeast infection (P <0.05 ),while mold infection was associated with chronic lung disease (P <0.05 ) .Yeast was more often isolated from patients with concurrent bacterial infection and on mechanical ventilation (P <0.05 ) . Thoracic high-resolution computed tomography (HRCT)showed the following images:bronchial pneumonia/pulmonary consolidation (53.1%),massive shadowing (29.4%),small nodules (24.5%),large nodules (18.9%),pleural effusion (18.9%),halo sign (14%),and cavity (9.8%).Imaging showed that mold was more common than yeast in patients with pleural and pericardial effusions (P <0.05).Logistic regression modeling showed that broad-spectrum antibiotics administration,prolonged mechanical ventilation,and pleural and pericardial effusions were statistically significant in fungal identification (P <0.05 ),with a predictive accuracy of 77.6%.Conclusions For immunocompromised patients with pulmonary IFI,most of the risk factors ,the main clinical and chest HRCT features did not help to predict the type of fungal pathogen,and yeast but not cryptococcus may be accompanied or colonized.
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Objective The main purpose is to investigate the status of brucellosis infection in high-risk areas of Urumqi and population characteristics,and to provide a basis for prevention of brucellosis.Methods In Urumqi City,Dabancheng District,Gaoxin District,Midong,Zone and Urumqi County were selected as survey sites;according to pastoral,agro-pastoral and agricultural,all towns in each survey site were classified into three categories;150 to 200 residents in each township were selected as subjects.Basic demographic information was collected,and blood samples were collected for serological detection.rose bengal plate agglutination test (RBPT) was used for preliminary screening,RBPT positive persons were further confirmed by standard tube agglutination test (SAT).Different regions,gender,age,occupation,exposure difference and brucellosis infection rates were studied.x2 test was used to compare rates.Results The infection rate was 5.42％ (29/535).Furthermore,the infection rate ofthe Dabancheng District [10.34％ (12/116)] was higher than those of Gaoxin District [2.94％ (3/102)] and Urumqi County [2.58％ (4/155),x2 =4.643,7.199,all P ＜ 0.05],the differences were statistically significant (x2 =9.327,P ＜0.05).Besides,infection rate of the average exposure occupation [8.33％ (24/288)] was higher than those of low exposure occupation [0(0/61)] and high exposure occupation [2.72％ (5/184),x2 =5.459,6.140,all P ＜ 0.05].The differences were statistically significant (x2 =10.846,P ＜ 0.05).The differences of infection rates in ages and nations showed no statistical significance (x2 =2.396,4.639,all P ＞ 0.05).Conclusions High risk areas of brucellosis are still exist in Urumqi.Health education should be strengthened in the future,in order to enhance residents' seff-protection awareness in exposed population.
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We used the Brucella data in Xinjiang between year 2009 to 2010 to explore and analyze the spatial clustering fea‐tures of brucellosis in Xinjiang ,and provided the basis for prevention and control on brucellosis in Xinjiang ,China .The time and population distribution of brucellosis in Xinjiang was analyzed for statistical analysis with descriptive epidemiology .Mean‐while ,we also used quartile classification methods to map the incidence of brucellosis in Xinjiang spatial distribution ,and calcu‐lated the Global Moran’s I index on the spatial clustering analysis .Results showed that brucellosis in Xinjiang had obvious sea‐sonal differences (peaked in May‐September) ,more cases for male than that for female (gender ratio‐‐2 .96∶1) ,and the total incidence of 74% were farmer and herdsman ,mainly concentrated at th e age of 40 to 60 years old .Compared with the onset range of brucellosis in 2009 ,there were clear tendency to spread in 2010 .The Global Moran’s I index was 0 .116 4 (P=0 .017) ,showing the spatial clustering on the incidence of brucellosis in Xinjiang .The incidence of hot spots concentrated in Tacheng and Altay ,and the incidence of cold spots concentrated in Kashi .The incidence level brucellosis has significant spatial aggregation in the area of Xinjiang ,which should be strengthened the prevention and control of high‐risk areas .