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Purpose: To increase pulmonary tuberculosis (PTB) treatment adherence in Xinjiang Region, an electronic DOTS (eDOTS) system developed was applied and evaluated. Methods: An eDOTS system comprised electronic medicine boxes, mobile phones and a central processing platform. Between April and June 2016, persons with active PTB (PAPTB) were recruited from villages and a city and were prescribed a six-month course of antibiotics using either DOTS or eDOTS. Treatment adherence rate and chest X-ray digital radiography (DR) score were used to evaluate usefulness of eDOTS. Results: A total 167 PAPTB were recruited with 81 participants from villages and 86 from neighbourhoods. Of the 81 village patients, 43 (53%) used eDOTS and 38 (47%) used DOTS. Among the 86 patients from neighbourhoods, 50 (58%) used eDOTS and 36 (42%) used DOTS. After 6 months of treatment, the average treatment compliance of the village patients who used eDOTS were 47.0%±20.5% compared to 26.7%±21.1% who used DOTS (t=-4.475, p<0.001). The patients using eDOTS from both the villages and city had significantly lower X-ray DR scores than the patients using DOTS by 1.81 points, 95% CI (0.72-2.90) and 1.05 points, 95% CI (0.15-1.95), respectively. Conclusion: eDOTS is an effective means of managing the treatment of active PTB patients through daily reminding and monitoring of patient compliance. Ease of contact with doctors and special education programs encouraged PAPTB to complete their treatment course as required.
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ObjectiveTo determine the current status and characteristics of tuberculosis （TB） registration and treatment in Kashgar， and to provide scientific evidence for targeted prevention and control measures in future. MethodsKashgar registered TB cases information in 2011 to 2020 was exported from the National Tuberculosis Management Information System. Descriptive epidemiological analysis was conducted using Stata 12.0. ResultsFrom 2011 to 2020， number of Kashgar registered TB patients showed rising trend， followed by a falling one. Average proportion of annual decline in registered TB incidence was 40.48% from 2018 to 2020. From 2011 to 2016， number of registered TB patients in women was always higher than that in men， with a gender ratio （male ： female） of about 0.90. In 2017， the gender ratio was 1.00. From 2018 to 2020， the gender ratios were 1.05， 1.20， and 1.12， respectively. Moreover， number of registered TB cases increased with age （χ2=547.79， P<0.001）. Proportion of registered TB cases was relatively large in Shache County （16.43%‒23.64%）， Yengisar County （9.51%‒13.87%） ， Kashgar City （8.11%‒11.40%）， Yecheng County （6.98%‒13.40%） and Bachu County（4.92%‒16.65%）. Proportion of recurrent TB cases in Kashgar had increased to 27.29%， 20.77% and 28.39% in 2018， 2019 and 2020， respectively. Multivariate analysis showed that age， drug resistance， calendar year and etiological diagnosis were significantly correlated with the proportion of recurrent cases （all P<0.05）. ConclusionSince 2018， TB incidence has decreased significantly due to the increasing efforts for identification and treatment of TB cases. However， Kashgar remains facing a high TB incidence. TB cases that are elderly， drug-resistant and positive for pathogen are susceptible to recurrent treatment. In future， targeted prevention and control measures should be improved for these groups.
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ObjectiveTo evaluate the current situation of human resource allocation in district and county centers for disease control and prevention （CDCs） in Kashgar ， identify existing problems and influencing factors， and to provide scientific evidence for optimizing the human resource allocation. MethodsA survey was conducted among all CDCs in Kashgar in February 2022. The questionnaire included the institutional and individual questions. ResultsThe overall staff size approved for the CDCs in Kashgar was 604， with a staffing rate of 76.17%， among which the staffing rates in 5 county CDCs were less than 60%. Currently， there were a total of 524 approved staff members in all CDCs， resulting in a vacancy rate of 13.25%. In the district CDC， 85 staff members were on duty， while the median of staff on duty was 34 in each county CDC. The staff in the district CDC was ageing， of which those aged over 45 accounted for 67.06%. The staff in the county CDCs was generally young， of which those aged less than 35 accounted for 54.22%. Moreover， the proportion of staff with bachelor’s degree or above in the district and county CDCs was 31.76% and 24.95%， respectively. The proportion of staff without professional title was 32.94% and 48.03%， respectively. In contrast， the proportion of those with middle and senior professional title was 57.89% and 22.02%， respectively. In addition， in recent 3 years， 24 staff members resigned in the CDCs， all of whom had professional titles. ConclusionHuman resources are insufficient in CDCs in Kashgar. Furthermore， staff structure is unreasonable， with a serious loss of human resources. In particular， the district CDC needs to optimize the allocation of human resources.
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Introduction: National Notifiable Disease Reporting System (NNDRS) plays an important role in the early detection and control of tuberculosis (TB) in China. This study analyzed the epidemiological characteristics of pulmonary tuberculosis (PTB) in Kashgar Prefecture, Xinjiang Uygur Autnomous Region, China from 2011 to 2020 to provide a scientific basis for developing TB control strategies and measures in Kashgar.Methods:The data were collected from the NNDRS, which included the geographical distribution, age, sex, occupation, and pathogenic classification of reported PTB cases in 12 counties/cities of Kashgar Prefecture from 2011 to 2020. Descriptive statistics were used to describe the characteristic of PTB epidemic in Kashgar.Results: There were 189,416 PTB cases reported during 2011-2020, with a mean annual PTB case notification rate (CNR) of 451.29/100,000. A rising trend in the rate of reported PTB between 2011 and 2017 (χ 2 trend=26.09, P<0.01) and a declining trend between 2018 and 2020 (χ 2 trend=314.44, P<0.01) were observed. The months with the highest reported number of PTB cases were March to May and November to December. The mean annual rate of reported PTB was 451.88/100,000 for males and 450.67/100,000 for females. In addition, 19.76% of patients were bacteriologically-confirmed (Bac+) cases (37,425/189,416), and the mean annual Bac+ CNR was 89.17/100,000, rising from 64.76/100,000 in 2011 to 139.12/100,000 in 2020 (χ 2 trend=74.44, P<0.01).Conclusions: The CNR of reported PTB in Kashgar showed a significant declining trend in the past three years. Males, elderly population, winter and spring, and farmers as an occupation were the main factors associated with high incidence of tuberculosis in Kashgar. Targeted prevention and treatment of TB should be strengthened in key groups in this region.