Intervention Effect of New Tuberculosis Control Model on Tuberculosis Incidence in Xinjiang.

Objective: To quantitatively evaluate the intervention effect of the "Xinjiang model" policy on pulmonary tuberculosis (PTB) incidence in Xinjiang, and to compare the difference of policy effect between areas with different tuberculosis burdens. Methods: We retrospectively collected data on the registered incidence of PTB patients in 14 prefectures of Xinjiang from January 2012 to December 2021 and used Joinpoint model to describe the time trend of registered incidence, single-group interrupted time series (ITS) model to analyze the dynamics of registered incidence before and after the policy intervention, and controlled interrupted time series (CITS) model to compare the differences in the effects of the policy in different tuberculosis burdened areas. Results: The areas with high registered incidence of PTB in Xinjiang were mainly located in the four prefectures of southern Xinjiang. The time trend of registered incidence of PTB in Xinjiang from 2012 to 2021 showed a general downward trend (AAPC=-3.4%), an upward trend from 2012 to 2018 (APC=12.1%), and a rapid downward trend from 2018 to 2021 (APC=-28.3%). Single-group ITS results showed that registered incidence in Xinjiang increased by 13.806/100,000 one month after policy was implemented (P<0.001); the long-term effect of policy was a downward trend in registered incidence (ß3<0, P<0.001), decreasing by 0.690/100,000 per month. In high-, medium-, and low-burden areas of PTB, the long-term effect of policy was a monthly decrease in registered incidence of 1.460/100,000, 0.227/100,000, and 0.064/100,000, respectively. The long-term effects of policy interventions in high- and medium-burden areas showed a faster decline in registered incidence than in low-burden areas (ß7 was -1.548 and -0.194, respectively, P<0.001). Conclusion: A dynamic causal relationship exists between "Xinjiang model" policy and registered incidence, and its continued implementation is effective in controlling the spread of tuberculosis.

Alterations in the Gut Microbiome of Individuals With Tuberculosis of Different Disease States.

Objective: There is evidence that the gut microbiota play a regulatory role in the occurrence and progression of tuberculosis. The purpose of the current study was to explore the alterations in gut microbiome under different tuberculosis disease stages in the Uyghur population, clarify the composition of microbial taxonomy, search for microbial biomarkers and provide innovative ideas for individual immune prevention and for control strategies. Design: A case-control study of Uyghur individuals was performed using 56 cases of pulmonary tuberculosis (PTB), 36 cases of latent tuberculosis infection (LTBI) and 50 healthy controls (HC), from which stool samples were collected for 16S rRNA gene sequencing. Results: The results showed that the alpha diversity indexes of the PTB group were lower than those of the other two groups (P <0.001), while only observed species were different between LTBI and HC (P <0.05). Beta diversity showed differences among the three groups (P = 0.001). At the genus level, the relative abundance of Bifidobacterium and Bacteroides increased, while Roseburia and Faecalibacterium decreased in the PTB group, when compared with the other two groups, but the changes between the LTBI and HC groups were not significant. The classifier in the test set showed that the ability of the combined genus to distinguish between each two groups was 81.73, 87.26, and 86.88%, respectively, and the validation efficiency was higher than that of a single screened genus. Conclusion: The gut microbiota of PTB patients was significantly disordered compared with LTBI and HC, while the changes of LTBI and HC were not significant. In the future, gut microbiota could be used as a non-invasive biomarker to assess disease activity.

A Tuberculosis Outbreak at a School - Xinjiang Uygur Autonomous Region, China, 2019.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Worldwide, tuberculosis (TB) continues to be the most important cause of death from a single infectious agent, and China has a high TB burden. Although the reported incidence of TB in students is lower than that in general population, TB outbreaks in schools have continuously been reported in the past years, suggesting that schools are a high-risk setting for TB transmission. WHAT IS ADDED BY THIS REPORT?: In total, 31 TB patients were founded in students. Epidemiological linkage among all TB cases could not be determined due to absence of genome sequencing. However, based on the analysis of screening results, the index case was probably the source of transmission. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: The preventative measurements should be implemented in schools. Adding TB examinations into entrance examinations and strengthening health education could find TB cases early, and improving ventilation could decrease the risk of TB transmission in schools.