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Objective@#To investigate the spatio-temporal distribution characteristics of pulmonary tuberculosis in Ningbo City from 2015 to 2020, so as to provide insights into tuberculosis control.@*Methods@#The data of pulmonary tuberculosis cases in Ningbo City from 2015 to 2020 were collected from Tuberculosis Management Information System of China Disease Control and Prevention Information System, and were linked with the geographic information database of Ningbo Planning Design and Research Institute. The software SaTScan version 10.3 was employed for monthly spatio-temporal scanning and cluster analysis of reported pulmonary tuberculosis cases, populations, longitude and latitude in 153 townships of Ningbo City from 2015 to 2020. @*Results@#There were one class Ⅰ cluster and two class Ⅱ clusters of pulmonary tuberculosis cases in Ningbo City from 2015 to 2020, and the class Ⅰ cluster was centered in Song'ao Township and covered 37 townships, with aggregation time from January 1, 2015 to December 31, 2017, while class Ⅱ clusters were covered 38 tounships which were centered in Sanqishi Township of Yuyao County, and one township in Hangzhou Bay New Town. The aggregation time was from January to June in 2015 and 2016, from March to August between 2017 and 2019 and between May and October, 2020. The overall reported incidence of pulmonary tuberculosis appeared a tendency towards a decline in each township of Ningbo City from 2015 to 2020; however, the incidence of pulmonary tuberculosis was more than 80 per 100 thousand in Fuming Township of Yinzhou District and Juexi Township of Xiangshan County in 2020.@*Conclusions@#There were significant spatio-temporal clustering characteristics of pulmonary tuberculosis incidence at a township level in Ningbo City from 2015 to 2020, and the clusters were mainly concentrated in the central and eastern Ningbo City. The reported incidence of pulmonary tuberculosis is high in Fuming Township of Yinzhou District and Juexi Township of Xiangshan County, where targeted regional tuberculosis control strategies should be implemented.
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Objective To investigate the incidence of Mycobacterium tuberculosis (TB) infection among human immunodeficiency virus (HIV)-infected individuals in Shanghai and Yunnan Province and to analyze the risk factors of TB infection.Methods Seventy HIV-infected individuals from Yunnan Province and 67 from Shanghai were enrolled.T-SPOT.TB was employed to detect TB-specific T cells in the peripheral blood mononuclear cells (PBMC).CD4+ and CD8+ T cells in PBMC from the enrolled subjects were detected by flow cytometry.Data were analyzed using Mann-Whitney test,Fisher's exact test and Logistic regression.Results The incidence of latent tuberculosis (LTB) infection among HIV-infected individuals in Yunnan Province was 64.3 ％ (45/70),which was much higher than Shanghai (20.8％ [14/ 67]).The median CD4+ T cell count of HIV-infected individuals with LTB infection in Yunnan Province was 509/μL,while that in Shanghai was 324/μL,which was significant different (U=148,P=0.003).The median CD4+ T cell count in HIV single infected individuals from Yunnan Province was 418/μL,which was not significantly different from that of H IV + LTB individuals from that area (U =378,P =0.120).Moreover,the median CD8+ T cell counts of HIV-infected individuals with latent tuberculosis infection in Yunnan Province and Shanghai were 409/μL and 781/μL,respectively (U=109,P＜0.01).Conclusions The incidence of LTB infection among HIV-infected individuals in Yunnan Province is significantly higher than Shanghai.CD4+ and CD8+ T cell counts are correlated with TB infection among HIV-infected individuals.
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Objective To evaluate the relationship between CD4+ T lymphocyte count and results of enzyme-linked immunospot (ELISPOT) assay in human immunodeficiency virus (HIV)-Mycobacterium tuberculosis (M.tb) coinfected patients.Methods A total of 193 HIV-infected individuals in Yunnan Province and Shanghai were enrolled.T-SPOT.TB assay was employed to detect M.tb specific T lymphocyte in the peripheral blood mononuclear cells (PBMC).CD4+ T lymphocyte in PBMC from the enrolled subjects was detected by flow cytometry.Data were analyzed using t test.ResultsThe incidence of latent tuberculosis in HIV-infected individuals was 30.6％.The CD4+ T lymphocyte counts in HIV-infected individuals with active tuberculosis were 190×106/L,which were significantly lower than those in HIV-infected individuals with latent tuberculosis (484×106/L; t=6.665,P＜0.01).The HIV-infected individuals were stratified according to CD4+ T lymphocyte counts of ＞500×106/L,200×106-500×106/L,and ＜200×106/L and the constituent ratios of active tuberculosis/latent tuberculosis were 1∶16.2,1∶1.3 and 5.6∶1,respectively.Among 79 subjects with positive T-SPOT.TB results,20 were coinfected with active tuberculosis,in which 14 had CD4+ T lymphocyte counts of ＜200 ×106/L,5 had 200×105-500×106/L and 1 had ＞500×106/L.Fifty-two in 59 HIV/latent tuberculosis patients individuals had CD4+ T lymphocyte counts of ＞200×106/L.ConclusionsThe prevalence of latent tuberculosis in HIV-infected individuals is high in China.Cellular immunity in HIV-infected individuals with active tuberculosis is severely impaired.With the decrease of CD4 ′ T lymphocyte counts,patients with latent tuberculosis are prone to develop active tuberculosis in HIV-infected individuals.The negative predictive value of T-SPOT.TB is significantly diminished in patient with low CD4+ T lymphocyte counts,especially less than 200×106/L.