Analysis on status quo of TB/HIV dual infection screening and diagnosis and treatment management in Guangxi / 重庆医学

Objective To analyze the data of TB/HIV dual infection screening and treatment monitoring in Guangxi during 2010-2015 and to evaluate the prevention and treatment status quo and development trend.Methods The annual monitoring report forms of TB/HIV dual infection during 2010-2015 were collected for deriving the special data of AIDS in corresponding years.Then the data were conducted the comparison and trend analysis.Results The acceptance rates of HIV detection among Guangxi TB patients and the acceptance rate of TB related screening detection in patients with HIV infection/AIDS showed the increasing trend year by year (P＜0.05);the positive detection rate of two-way showed the decreasing trend year by year (P＜0.05).The patients with TB/HIV dual infection were mainly concentrated in the central area of Guangxi.The annual monitoring report table data in annual monitoring TB/HIV dual infection prevention and treatment work trended to be consistent with the twoway registration and screening data in the special report system,but the errors still existed;the rate of receiving anti-TB and anti-viral combined therapy in the patients with TB/HIV dual infection was lower,which was fluctuated from 20％ to 60％;the treatment success rate was still elevated year by year,but which was affected by death,lose and other outcomes.Conclusion The TB/HIV dual epidemic situation has already obtained a certain effect along with comprehensively promoting the dual infection prevention and control work in Guangxi area.

Feature analysis on patients died from co-infection of Mycobacterium tuberculosis and human immunodeficiency virus in Guangxi, from 2007 to 2012 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To understand the general feature of patients with Mycobacterium tuberculosis (MTB) and human immunodeficiency virus (HIV) co-infectious (TB/HIV) in Guangxi, from 2007 to 2012.</p><p><b>METHODS</b>Information regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System, together with bacterium smear or culture results, onset of TB, time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death, age, occupation, the underlying cause of death among TB patients, bacterium distribution, average age of death, interval from onset to death, percentage of TB/HIV co-infection patients among all the patients etc, were all analysed.</p><p><b>RESULTS</b>203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24% (ranging from 3.94% in 2007 to 13.27% in 2012) among all the deaths of HIV infection while it accounted for 9.90% (ranging from 2.56% to in 2007 to 26.88% in 2012) among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66% (ranging from 8.83% to 13.27%)and 22.17% (ranging from 20.60% to 26.88%)among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1, with the average age of death as 44.65 (44.65 ± 15.52) years;median time from TB symptoms onset to diagnosis as 37 (mean 94.31, standard deviation 206.07) days, record as (94.31 ± 206.07); median time from diagnosis to death as 46 (165.22 ± 282.19) days, 54.68% TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 (257.68 ± 340.79) days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases.</p><p><b>CONCLUSION</b>Compare to those TB patients without HIV, less bacterium evidence was found in TB/HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years, suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.</p>

Analysis on tuberculosis screening results among school students in some area of Guangxi during 2010 to 2012 / 重庆医学

Objective To understand the development situation of the purified protein derivative of tuberculin (PPD) test ,the prevalence of tuberculosis(TB) among the school students in Guangxi and the related influence factors of strong positive result in order to provide the basis for establishing the physical examination system of student TB in Guangxi .Methods The PPD test was conducted in the students participating in the survey firstly ,then the students with strong positive PPD test results and the TB sus-picious symptoms and the suspected TB cases were performed chest X-ray and sputum smear examination .The related factors in the students with strong positive PPD test results and non-strong positive PPD test results were comparatively analyzed .Results To-tally ,53 217 students received the PPD test with the positive rate of 5 .74% (3 055 cases) and the strong positive rate of 1 .46%(775 cases) .The detection rate of active TB was 0 .03% (15 cases) .The χ2 test and the Logistic regression analysis showed that the age group and the regional distribution were the influence factors of strong positive PPD test result (P<0 .05) .Conclusion The preliminary screening by the PPD test and then conducting chest X-ray and sputum smear examination are the effective method for find TB in school and the TB clinic .At the same time the TB screening should be strengthened in the schools in high epidemic areas of TB ,especially the college students .

Analysis on transformation situation of tuberculosis diagnosis and treatment mode in Guangxi during 2011-2012 and countermeasure discussion / 重庆医学

Objective To analyze the transformation situation of the tuberculosis (TB) diagnosis and treatment mode in 18 coun-ties(cities) of Guangxi and to explore the countermeasure for perfecting the TB control service system in Guangxi .Methods The self-designed questionnaire was adopted to retrospectively investigate the transformation situation of the TB diagnosis and treatment mode in 18 counties(cities) .Results In the 18 counties(cities) ,there were 8 counties(cities) ,accounted for 44 .4% ,with the trans-formation reason of the qualification was not completed in the original agency;there were 16 counties (cities ) ,accounted for 88 .9% ,with issuing the formal documents and arranging relevant work by the local health bureau before the transformation ;the number of full-time TB staff was reduced in 14 counties(cities) ,accounted for 77 .8% ,after the transformation ;there were 8 coun-ties(cities) ,accounted for 44 .4% ,set up the independent TB outpatient in the designated hospital ;there were 4 counties(cities) ,ac-counted for 22 .2% ,received the evaluation of very goodandgoodfor the TB control work after the transformation .Conclusion The health administrative department should actively promote the counties (cities) without the completed medical qualification to transform the TB diagnosis and treatment mode and coordinate the related works to carry out smoothly .

Feature analysis on patients died from co-infection of Mycobacterium tuberculosis and human immunodeficiency virus in Guangxi,from 2007 to 2012 / 中华流行病学杂志

Objective To understand the general feature of patients with Mycobacterium tuberculosis(MTB)and human immunodeficiency virus(HIV)co-infectious(TB/HIV)in Guangxi, from 2007 to 2012. Methods Information regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System,together with bacterium smear or culture results,onset of TB,time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death,age,occupation,the underlying cause of death among TB patients, bacterium distribution,average age of death,interval from onset to death,percentage of TB/HIV co-infection patients among all the patients etc,were all analysed. Results 203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24%(ranging from 3.94%in 2007 to 13.27%in 2012)among all the deaths of HIV infection while it accounted for 9.90%(ranging from 2.56%to in 2007 to 26.88%in 2012)among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66%(ranging from 8.83% to 13.27%) and 22.17%(ranging from 20.60% to 26.88%) among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1,with the average age of death as 44.65 (44.65 ± 15.52)years;median time from TB symptoms onset to diagnosis as 37(mean 94.31,standard deviation 206.07)days,record as(94.31 ± 206.07);median time from diagnosis to death as 46(165.22 ± 282.19)days,54.68%TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 (257.68 ± 340.79) days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases. Conclusion Compare to those TB patients without HIV,less bacterium evidence was found in TB/HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years,suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.

Feature analysis on patients died from co-infection of Mycobacterium tuberculosis and human immunodeficiency virus in Guangxi,from 2007 to 2012 / 中华流行病学杂志

Objective To understand the general feature of patients with Mycobacterium tuberculosis(MTB)and human immunodeficiency virus(HIV)co-infectious(TB/HIV)in Guangxi, from 2007 to 2012. Methods Information regarding individuals that the contributory causes of death were due to MTB infection among HIV as the underlying cause of death from the Vital Registration System,together with bacterium smear or culture results,onset of TB,time that TB was diagnosed and entered an Internet base TB surveillance system was collected and checked. Data including information on time of death,age,occupation,the underlying cause of death among TB patients, bacterium distribution,average age of death,interval from onset to death,percentage of TB/HIV co-infection patients among all the patients etc,were all analysed. Results 203 patients died from HIV associated with TB from the Guangxi Vital Registration System were identified between 2007 and 2012. The average percentage of TB/HIV co-infection cases accounted for 8.24%(ranging from 3.94%in 2007 to 13.27%in 2012)among all the deaths of HIV infection while it accounted for 9.90%(ranging from 2.56%to in 2007 to 26.88%in 2012)among patients with MTB infection in the same period. The average percentage of deaths from TB/HIV co-infection in 2010 and 2012 accounted for 10.66%(ranging from 8.83% to 13.27%) and 22.17%(ranging from 20.60% to 26.88%) among patients died of HIV and TB infection respectively. The male-female ratio was 4.21 for 1,with the average age of death as 44.65 (44.65 ± 15.52)years;median time from TB symptoms onset to diagnosis as 37(mean 94.31,standard deviation 206.07)days,record as(94.31 ± 206.07);median time from diagnosis to death as 46(165.22 ± 282.19)days,54.68%TB/HIV patients died within two months of being diagnosed with TB and the median time from TB symptoms onset to death as 131 (257.68 ± 340.79) days. 16.26% of the TB/HIV cases were bacterium confirmed TB cases. Conclusion Compare to those TB patients without HIV,less bacterium evidence was found in TB/HIV patients. High burden caused by HIV disease was seen if they were co-infected with TB. An increasing proportion of deaths was noticed among patients co-infected with HIV and TB in the last three years,suggesting that the coverage of antiretroviral therapy be scaled up together with the strengthening of the capability on early TB case-finding among people live with HIV.

Research on characteristics and related factors of adverse reactions of anti-tuberculosis among Zhuang nationality patients with smear-positive pulmonary tuberculosis / 中华传染病杂志

Objective To understand the characteristics and related factors of adverse reactions (ADR) of anti-tuberculosis drugs among Zhuang nationality patients with smear-positive pulmonary tuberculosis (TB) and to provide basis to ADR control.Methods During Dec 2007 to May 2008,408smear-positive pulmonary TB cases of Zhuang nationality in 14 counties were selected by simple random sampling,and followed up for 6-8 months.Questionnaires were performed and liver/renal functions were tested during the research.Data were analyzed by chi square test and Logistic regression model.Results The incidence of ADR of Zhuang nationality people was 17.2％,which was higher than national level ( 12.62 ％ ).The incidence of allergic reaction was highest of all ADR ( 5.9 ％ ) and the incidences among different types of ADR were significantly different ( x2 =36.9,P=0.000).Serious ADR types were allergic reaction,gastrointestinal reaction,liver damage,nerve damage and kidney damage.And 24.3 ％ of the cases had two or three kinds of ADR.ADR occurred at the median of 21.5th day of anti-TB treatment,and the gastrointestinal reaction occurred the earliest (6th day).81.4 ％ of the ADR occurred in the first 2 months of anti-TB treatment.The rates of drug withdrawal and interruption were 11.5 ％ and 9.2 ％,respectively.Liver damage and nerve damage were the main causes of treatment withdrawal and interruption.Multiple factor non-conditional Logistic regression analysis showed that the ADR was correlated with age and the risk of ADR in ≥60years old patients was 3.3 times of that in 14-34 years old patients (OR=3.275,P=0.006).Thus,ADR incidence was increased with aging.Conclusions The incidence of ADR is higher in Zhuang nationality patients than that in general patient population.ADR monitoring and intervention must be strengthened in high-risk groups during high-risk period to reduce the adverse effect of anti-TBtreatment.

The influence of Mycobacterium tuberculosis co-infection and other factors on HIV-1 replication in Guangxi, China / 中华微生物学和免疫学杂志

ObjectiveTo investigate the influence of Mycobacterium tuberculosis (MTB) co-infection and other factors on the HIV replication level in antiretroviral treatment na(i)ve patients.MethodsSix hundred TB patients and 465 HIV infectors were recruited between April 2010 and September 2010.TB coinfections were diagnosed in HIV infected cases with chest X-ray,checking TB in sputum with anti-acid staining and culture of the sputum,histopatholo diagnosis and clinical diagnosis.HIV infections were screened in TB patients with the 3rd generation ELISA antibody test.Sixty-one antiretroviral treatment na(i)ve HIV/TB co-infectors and 34 HIV infectors with CD4 T cell count below 350 cells/μl were included in this study.Information about the demography,epidemiology and results of clinical diagnostic tests of HIV and TB was collected through pathography and questionnaires from all participants.HIV viral load were detected with COBAS AmpliPrep/COBAS TaqMan(R) System of Roche Company.ResultsThe viral load of HIV/TB co-infectors was (5.05±0.93) lg copies/ml,while the viral load of HIV infectors was (5.06±0.76) lg copies/ml,after control of age,race,marital status,education,route of HIV infection,HIV clade and CD4 T cell count,there was no significant difference between the two groups (P=0.94).CRF01_AE HIV-1 infection was associated with higher HIV viral load compared with non CRF01_AE (OR=8.07,95％ CI 1.07-61.20,P=0.04).ConclusionNo obvious effect of MTB co-infection on HIV replication level of HIV infected cases with relatively low CD4 T cell count in Guangxi region,while the CRF01_AE HIV infected individuals showed higher viral load,we should raise concern on the monitoring and treatment on this population.