Evaluation of the diagnostic efficacy of EC-Test for latent tuberculosis infection in ambulatory people with HIV.

BACKGROUND: Latent tuberculosis infection (LTBI) co-infected with human immunodeficiency virus (HIV) is more likely to develop into active tuberculosis (ATB), recombinant Mycobacterium tuberculosis fusion protein ESAT6/CFP10 (EC-Test) is a latest developed method for LTBI. Compared with the interferon γ release test assays (IGRAs), the diagnostic performance of EC-Test to LTBI screening in HIV needs to be evaluated. METHODS: A population-based multicenter prospective study was conducted in Guangxi Province, China. The baseline data was collected and LTBI were measured by QuantiFERON-TB Gold In-Tube (QFT-GIT), EC-Test and T-cell spot of the TB assay (T-SPOT.TB). RESULTS: A total of 1478 patients were enrolled. when taking T-SPOT.TB as reference, the value of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and consistency that EC-Test to diagnosis LTBI in HIV was 40.42, 97.98, 85.26, 85.04 and 85.06% respectively; when taking QFT-GIT as reference, the value was 36.00, 92.57, 55.10, 85.09 and 81.13%, respectively. When the CD4 + cell count was <200 cells/µl, the accuracies of EC-Test to T-SPOT.TB and QFT-GIT were 87.12 and 88.89%, respectively; when it was 200 ≤ CD4 + ≤ 500 cells/µl, the accuracies of EC-Test was 86.20 and 83.18%, respectively; when the CD4 + cell count >500 cells/µl, the accuracies of EC-Test were 84.29 and 77.94%, respectively. The incidence of adverse reactions in EC-Test was 34.23% and the serious adverse reactions were 1.15%. CONCLUSION: EC-Test has good consistency compared with IGRAs in detecting LTBI in HIV no matter in different immunosuppression status or different regions, and the safety of EC-Test is also well, suitable for LTBI screening in HIV in high prevalence settings.

Visual-spatial and temporal characteristics related to infectious Tuberculosis epidemics in Guangxi Zhuang Autonomous Region, 2012-2015 / 中华流行病学杂志

Objective To study the spatial and temporal mode of infectious TB transmission in Guangxi Zhuang Autonomous Region (Guangxi).Methods Data related to infectious TB case (Include smear and/or culture positive patients) in Guangxi were collected from the National Notifiable Disease Reported System (NNDRS) from 2010 to 2015.Spatial-temporal analysis and prediction were performed by SaTScan 7.0.2,GeoDa 1.8.12,R program v 3.3.1 and SPSS 19.0 software,using the time series model,Moran' s I global and local spatial autocorrelation (Empirical Bayes adjustment).Kulldorff ' s space-time scan statistics displayed by R software was used to identify the temporal and spatial trend of TB.Results The total number of infectious TB cases,collected from NNDRS was 76 151,and showing a decreasing trend on annual incidence (value of Chi-square for Linear trend=3 464.53,P-value=0.000).The forecast value of TB cases in 2016 was 7 764 (4 971-10 557),with peak in March,analyzed through the Winters' multiplicative model.The Moran' s I global Statistics was greater than 0 (0.257-0.390).TB cluster seemed to have been existed for several years.The most significant hot spots seemed to be mainly located in the central and western parts of Guangxi,shown by local spatial autocorrelation statistics and the result from space-time scanning.Counties or districts that located in the east parts of Guangxi presented the low-low relation (significant cold spots).The situation of infectious TB seemed migratory.Conclusions Our data showed an annual decreasing trend of incidence on infectious TB with temporal concentration in spring and summer.Main clusters (hot spots) were found to be located in the central and western parts of Guangxi.Hopefully,our findings can provide clues to uncover the real mode of TB transmission at the molecular-biological level.

Visual-spatial and temporal characteristics related to infectious Tuberculosis epidemics in Guangxi Zhuang Autonomous Region, 2012-2015 / 中华流行病学杂志

Objective To study the spatial and temporal mode of infectious TB transmission in Guangxi Zhuang Autonomous Region (Guangxi).Methods Data related to infectious TB case (Include smear and/or culture positive patients) in Guangxi were collected from the National Notifiable Disease Reported System (NNDRS) from 2010 to 2015.Spatial-temporal analysis and prediction were performed by SaTScan 7.0.2,GeoDa 1.8.12,R program v 3.3.1 and SPSS 19.0 software,using the time series model,Moran' s I global and local spatial autocorrelation (Empirical Bayes adjustment).Kulldorff ' s space-time scan statistics displayed by R software was used to identify the temporal and spatial trend of TB.Results The total number of infectious TB cases,collected from NNDRS was 76 151,and showing a decreasing trend on annual incidence (value of Chi-square for Linear trend=3 464.53,P-value=0.000).The forecast value of TB cases in 2016 was 7 764 (4 971-10 557),with peak in March,analyzed through the Winters' multiplicative model.The Moran' s I global Statistics was greater than 0 (0.257-0.390).TB cluster seemed to have been existed for several years.The most significant hot spots seemed to be mainly located in the central and western parts of Guangxi,shown by local spatial autocorrelation statistics and the result from space-time scanning.Counties or districts that located in the east parts of Guangxi presented the low-low relation (significant cold spots).The situation of infectious TB seemed migratory.Conclusions Our data showed an annual decreasing trend of incidence on infectious TB with temporal concentration in spring and summer.Main clusters (hot spots) were found to be located in the central and western parts of Guangxi.Hopefully,our findings can provide clues to uncover the real mode of TB transmission at the molecular-biological level.

Advance in application of syndromic surveillance for detection of emerging infectious diseases and outbreak alerts / 中华预防医学杂志

Over the past decade, syndromic surveillance, as supplementation of disease surveillance, has provided possibility of early alert in a real-time way for detection of emerging infectious diseases and outbreaks of widespread infectious diseases, resulting in improvement in sensitivity of outbreak detection and public health alert capacity. This tool has been highly valued and widely used in the world, and effective implementation has been observed in China. Upon abundant literature search, the authors reviewed the progress and advance of syndromic surveillance in early alert of emerging infectious diseases and outbreaks, and analyzed the problem met in the current situation in China when implementing syndromic surveillance in local facilities, which are high cost, lack of medical information platform, lack of real-time digital alert system and lack of a comprehensive information exchange platform. The authors suggested that syndromic surveillance should be implemented considering the local situation and performed in a more effective way in the current situation. Syndromic surveillance has to be integrated into the conventional public health surveillance systems and advanced laboratory networks. Digital information system is urgently needed to achieve real-time alert.