ABSTRACT
Objective To explore the effect of first-line anti-tuberculosis treatment on vitamin D level in patients with pulmonary tuberculosis,and to master the changes of vitamin D level in the course of treatment,so as to provide a scientific basis for tuberculosis and nutrition health education in Shenzhen.Methods A total of 100 patients diagnosed as smear-positive pulmonary tuberculosis and receiving initial treatment in 2016 were enrolled and all the patients were treated with the standardized short-course chemotherapy regimens.The blood samples were extracted before treatment and at the ends of intensive and continuation phase.The 25-hydroxyvitamin D [25-(OH) D] concentrations were determined by chemiluminescence (CLIA) at each time point.The change of 25-(OH) D concentrations during anti-tuberculosis treatment was analyzed and the differences of vitamin D levels between different time points were identified.Results 79 (79.0％),94 (94.0％) and 96 (96.0％) patients were found vitamin D deficiency before treatment and at the end of the intensive and continuation phases respectively,which showed an upward trend (x2=15.543,P＜0.001) and the 25-(OH)D concentrations were (15.74±6.54) ng/ml,(12.56±5.15) ng/ml,(11.51±4.28) ng/ml,respectively.During the whole course of treatment,the 25-(OH) D concentration decreased by 26.9％ or (4.23 ± 6.75) ng/ml (t =6.257,P＜0.001),wherein it decreased (3.18 ± 5.24) ng/ml in intensive phase (t =6.069,P＜ 0.001) and (1.05±4.86) ng/ml in continuation phase (t =2.154,P =0.034).The former had a greater decreased value (t=2.836,P=0.006).There were 77 (77.0％) and 55 (55.0％) patients with 25-(OH)D concentration reduction in intensive and continuation phases respectively (x2 =9.680,P =0.003),of which 41 patients (41.0％) continued to decline.Conclusion Once anti-tuberculosis treatment is conducted,the vitamin D level will decrease rapidly in the intensive phase and continue decreasing throughout the course of treatment,which leads to a general lack of vitamin D in patients with primary pulmonary tuberculosis.First-line anti-tuberculosis drugs may be the main cause for vitamin D level reduction.Therefore,it is necessary for clinicians to strengthen vitamin D health education for each patient throughout the treatment period,especially for those at high risk of vitamin D deficiency who should be recommended adjuvant vitamin D supplementation therapy.
ABSTRACT
Objective To understand the situation of drug resistance( DR) and multi-drug resistance( MDRTB) tuberculosis in Shenzhen and provide scientific evidence for TB control in Shenzhen. Methods According to drug resistance TB guidelines issued by WHO/IUALD, all new smear positive cases and.new registered retreatment smear positive cases in 2005 and 2009 were included in the surveillance. A total of 1856 strains of mycobacterium tuberculosis were isolated and drug susceptibility test were performed with the proportional method. Results In 2005, the overall DR rate was 18. 3% , 17. 2% and 31. 3% for initial and acquired DR respectively, overall MDR rate was 4. 74% ,3.25% and 21.9% respectively for initial and acquired MDR. In 2009, the overall DR rate was 17.4% , 16% and 39. 3%for initial and acquired DR respectively,overall MDR rate was 3.8% ,3.02% and 16.4% respectively for initial and acquired MDR. In 2005,2009, the rates of acquired DR and acquired MDR were significantly higher than the rates of initial DR and initial MDR. Conclusion The incidence of TB drug resistance in Shenzhen was high and merits attention.
ABSTRACT
Objective To analyze outcome of pulmonary tuberculosis(TB) patients in different household in Shenzhen in 2008, and provide scientific basis for development of TB control strategy. Methods The data from monthly,quarterly,annual report as well as the TB report card and other related information were collected and analyzed. Results A total of 4 826 active pulmonary tuberculosis patients were found in 2008, in which 86.0% were mobile population;2 349 cases of new smear positive pulmonary tuberculosis patients were found;Mobile population cure rate of new smear positive(75.0%) was significantly lower than that of household population(P＜0.01). Mobile population moving out or loss rate of new smear positive(13.5%) was significantly higher than that of household population(P＜0.01). Conclusion Mobile population cure rate of new smear positive was lower and moving out or loss rate of new smear positive(13.5%) was higher. Mobile population TB control in Shenzhen was the key and difficult.