Study on treatment outcome and risk factors of multidrug-resistant pulmonary tuberculosis patients in Shanghai / 上海预防医学

ObjectiveTo describe the characteristics of treatment outcomes of multidrug-resistant tuberculosis （MDR-TB） patients enrolled in second-line treatment in Shanghai from 2017 to 2018， and to analyze the influencing factors of treatment outcomes. MethodsTotally 182 MDR-TB patients were analyzed by using data collected from the China tuberculosis management information system， the hospital's electronic medical record information system， whole genome sequencing results and a questionnaire survey， and logistic regression analysis was used to analyze the factors affecting the success of treatment. ResultsIn 182 MDR-TB patients， the success rate of treatment was 65.4%， the loss to follow-up rate was 8.2%， the mortality rate was 4.9%， the unassessable rate was 13.7%， and the drug withdrawal rate was 7.7%. The factors affecting the success of treatment in MDR-TB patients included age （35‒ years old， OR=5.28， 95%CI： 1.58‒17.59， P=0.007； 55‒ years old， OR=16.30， 95%CI： 4.36‒60.92， P<0.001） and compliance to medication （OR=0.55， 95%CI： 0.42‒0.72， P<0.001）. ConclusionThe treatment success rate of MDR-TB patients in Shanghai from 2017 to 2018 is significantly higher than the average level in China. Older patients and patients with less compliant are at higher risk of adverse treatment outcomes.

Latent tuberculosis infection status and its risk factors among tuberculosis-related health-care workers in Shanghai / 上海预防医学

ObjectiveTo obtain the status of latent tuberculosis infection （LTBI） among tuberculosis （TB）-related health-care workers （HCWs） in Shanghai， and to explore the risk factors related to TB infection. MethodsA multi-center cross-sectional study was conducted by recruiting medical workers from multiple designated TB hospitals， centers for disease control and prevention， and community health service centers in Shanghai. Each subject was required to complete a questionnaire and to provide a blood sample for TB infection test. Univariate and multivariate analysis ware made in order to find risk factors relating to TB infection. ResultsA total of 165 medical workers were recruited， and the proportion of TB infection was 16.36% （95%CI： 11.49%‒22.76%）. Multivariate logistic analysis showed that clinical doctors and nurses （adjusted OR=9.756， 95%CI： 1.790‒53.188）， laboratory staffs （adjusted OR=78.975， 95%CI： 8.749‒712.918）， and nursing and cleaning workers （adjusted OR=89.920， 95%CI： 3.111‒2 598.930） had higher risk of TB infection. ConclusionThe overall LTBI prevalence among TB-related HCWs is low. However， working as doctors， nurses， laboratory staffs， nursing workers and cleaning workers are risk factors of TB infection. TB-related HCWs who work at hospitals are at risk of TB infection comparing to medical staffs who work outside hospitals.

The impact of agricultural insurance on farmers' income: Guangdong Province (China) as an example.

This paper aims to test whether agricultural insurance significantly impacts farmers' income increase or not. We have used the ordinary least squares method (OLS), panel fixed effects, and system generalized moment estimation (GMM) for the test. The results show that the increase in agricultural insurance density and the increase in agricultural insurance per capita compensation positively impact farmers' income growth significantly. Agricultural insurance density and per capita compensation are the indicators used in this article to measure agricultural insurance development. Therefore, it can be considered that the development of agricultural insurance in Guangdong Province (China) can effectively increase the income level of farmers. Based on the results of theoretical and empirical analysis, combined with the current situation of agricultural insurance development in Guangdong Province, this paper finally puts forward relevant countermeasures and suggestions. It provides some ideas for giving full play to the role of agricultural insurance in promoting farmers' income from the perspectives of pertinent system design, subsidy methods, insurance innovation, service level, and publicity.

Study on the socioeconomic factors of treatment failure among 92 bacillary-positive pulmonary tuberculosis patients / 中华疾病控制杂志

Objective To determine the socioeconomic factors and main causes of treatment failure among bacillary-positive pulmonary tuberculosis patients in Shanghai.Methods A 1:1 matched case-control study was performed.Ninety two cases who were treated longer than 18 months,and 85 controls who completed treatment during 2003-2004 in Shanghai were selected.Cases and controls were matched by sex,age,and previous treatment.Results Adjusted by sex,age,and previous treatment,the associated factors of treatment failure among bacillary-positive pulmonary tuberculosis patients were drug resistance (?2=14.764,P