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infectious Diseases of Poverty 2021年第2期10卷 92-93页

作者： Wei-Xi Jiang Zhi-Peng Li Qi Zhao Meng-Qiu Gao Qian Long Wei-Bing Wang Fei Huang Ni Wang Sheng-Lan Tang 不详 National Center for tuberculosis Control and Prevention China CDCNo.27 Nanwei RoadXicheng DistrictBeijing 100050China Duke Global Health institute Duke University310Trent DriveDurhamNC 27710USA

Background:The China National Health Commission-Gatestb project Phase iii implemented a comprehensive tb control model including multiple interventions to address the burden of drug-resistant tb(DRtb).This study aims to evaluate the quality of DRtb clinical services and assess the financial burden of DRtb patients during the intervention period.

关键词： Drug-resistant tuberculosis Quality of health services Financial burden

The Current Status and Challenges Regarding tuberculosis infection Control in Health care Facilities in China

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Biomedical and Environmental Sciences 2015年第11期28卷 848-854页

作者： ZHAO Fei CHENG Jun CHENG Shi Ming ZHANG Hui ZHAO Yan Lin ZHANG Can You HU Dong Mei FAN Hai Ying HUANG Fei QU Yan HE Guang Xue WANG Li Xia National Center for tuberculosis Control and Prevention Chinese Center for Disease Control and Prevention Science and Technology Department Chinese Center for Disease Control and Prevention

Health care facilities are a high-risk environment for generating and spreading respiratory infectious diseases such as tuberculosis （tb）. The tb prevention and treatment staff in health care facilities are responsi... 详细信息

关键词： tb The Current Status and Challenges Regarding tuberculosis infection Control in Health care Facilities in China

Effect of using electronic medication monitors on tuberculosis treatment outcomes in China: a longitudinal ecological study

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infectious Diseases of Poverty 2021年第2期10卷 74-74页

作者： Ni Wang Lei Guo Hemant Deepak Shewade Pruthu Thekkur Hui Zhang Yan-Li Yuan Xiao-Meng Wang Xiao-Lin Wang Miao-Miao Sun Fei Huang Yan-Lin Zhao National Center for tuberculosis Control and Prevention Chinese Center for Disease Control and PreventionBeijingChina 不详

Background:in China,an indigenously developed electronic medication monitor(EMM)was designed and used in 138 counties from three *** studies showed positive results on accuracy,effectiveness,acceptability,and feasibility,but also found some ineffective *** this paper,we assessed the effect of implementation of EMMs on treatment ***:The longitudinal ecological method was used at the county level with aggregate secondary programmatic *** the notified tb cases in 138 counties were involved in this study from April 2017 to June 2019,and rifampicinresistant cases were *** fitted a multilevel model to assess the relative change in the quarterly treatment success rate with increasing quarterly EMM coverage rate,in which a mixed effects maximum likelihood regression using random intercept model was applied,by adjusting for seasonal trends,population size,sociodemographic and clinical characteristics,and clustering within counties.

关键词： tuberculosis Treatment outcome Medication monitoring Digital technology Longitudinal study

The impact of COViD-19 on tuberculosis Patients’Behavior of Seeking Medical care——China,2020

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China CDC weekly 2021年第26期3卷 553-556页

作者： Yinyin Xia Fei Huang Hui Chen Ni Wang Xin Du Wei Chen Tao Li Shitong Huan Miaomiao Sun Jianjun Liu Yanlin Zhao Chinese Center for Disease Control and Prevention BeijingChina China office The Bill&Melinda Gates FoundationBeijingChina China office PATHBeijingChina

Summary What is already known on this topic?The coronavirus disease 2019(COViD-19)pandemic has disrupted the tuberculosis(tb)service ***,the impact on tb patients in China remains *** is added by this report?This report firstly addressed the impact of COViD-19 on tb patients in *** half of tb patients did not revisit the hospital due to personal *** reasons for irregular medication and postponing or cancelling examination after full treatment course were different.

关键词： Patients Medical tuberculosis

Are free anti-tuberculosis drugs enough? An empirical study from three cities in China

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infectious Diseases of Poverty 2015年第1期4卷 389-398页

作者： Shanquan Chen Hui Zhang Yao Pan Qian Long Li Xiang Lan Yao Henry Lucas The Jockey Club School of Public Health and Primary care The Chinese University of Hong KongHong KongChina National Center for tb Control and Prevention China CDCBeijingPR China The Third Affiliated Hospital Sun Yat-sen UniversityGuangzhouChina Duke Global Health institute Duke UniversityDurhamNCUSA Global Health Research Center Duke Kunshan UniversityKunshanChina School of Medicine and Health Management Huazhong University of Science and TechnologyWuhanChina institute of Development Studies Sussex UniversityBrightonUK Chinese Center for Disease Control and Prevention BeijingPR China

Background:tuberculosis(tb)patients in China still face a number of barriers in seeking diagnosis and *** is evidence that the economic burden on tb patients and their households discourages treatment ***:A cross-sectional study was conducted in three cities of *** were selected using probability proportional to size(PPS)cluster sampling of rural townships or urban streets,followed by list sampling from a patient *** were collected using a questionnaire survey,key informant interviews and focus group discussions with tb patients to gain an understanding of the economic burden of tb and implications of this burden for treatment ***:A total of 797 tb patients were surveyed,of which 60 were interviewed in-depth following the *** than half had catastrophic health *** patients with higher household incomes were less likely to report non-compliance(OR 0.355,95%Ci 0.140–0.830)and patients who felt that the economic burden relating to tb treatment was high more likely to report non-compliance(OR 3.650,95%Ci 1.278–12.346).Those who had high costs for transportation,lodging and food were also more likely to report non-compliance(OR 4.150,95%Ci 1.804–21.999).The findings from the qualitative studies supported those from the ***:The economic burden associated with seeking diagnosis and treatment remains a barrier for tb patients in *** the cost of treatment and giving patients subsidies for transportation,lodging and food is likely to improve treatment *** doctors’salary system to cut off the revenue-oriented incentive,and expanding current insurance’s coverage can be helpful to reduce patients’actual burden or anticipated *** research on this issue is needed.

关键词： tuberculosis Economic burden Catastrophic expenditure Compliance China

implementing a new tuberculosis surveillance system in Zhejiang,Jilin and Ningxia:improvements,challenges and implications for China’s National Health information System

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infectious Diseases of Poverty 2021年第2期10卷 104-104页

作者： Wei-Xi Jiang Fei Huang Sheng-Lan Tang Ni Wang Xin Du Hui Zhang Yan-Lin Zhao 不详 National Center for tuberculosis Control and Prevention China CDCNo.155 Changbai RoadChangping DistrictBeijing 102206China

Background:China is still faced with the public health challenge of tuberculosis(tb),and a robust surveillance system is critical for developing evidence-based tb control *** tuberculosis information Management System(tbiMS),an independent system launched in 2005,has encountered several challenges in meeting the current needs oftb *** Chinese government also planned to establish the National Health information System(NHiS)aggregating data in different *** China National Health Commission-Gates tb project Phase iii launched a new tb surveillance system to address these challenges and also as a pilot for the countrywide implementation of the *** commentary highlights the improvements and challenges in implementing the newtb system and also discusses the implications for the roll-out of the NHiS.

关键词： Disease surveillance system tuberculosis implementation science

Out-of-pocket payments and economic consequences from tuberculosis care in eastern China:income inequality

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infectious Diseases of Poverty 2020年第1期9卷 26-35页

作者： Yan Liu Cai-Hong Xu Xiao-Mo Wang Zhen-Yu Wang Yan-Hong Wang Hui Zhang Li Wang Department of Epidemiology and Biostatistics Institute of Basic Medical Sciences Chinese Academy of Medical SciencesSchool of Basic Medicine Peking Union Medical CollegeBeijing 100005China Department of Critical care Medicine The Second People’s Hospital of Shenzhen&First Affiliated Hospital of Shenzhen UniversityHealth Science CenterShenzhen 518035China National Center for tuberculosis Control and Prevention China Center for Disease ControlBeijing 100226China

Background:Despite the availability of free tuberculosis(tb)diagnosis and treatment,tb care still generates substantial costs that push people into *** investigated out-of-pocket(OOP)payments for tb care and assessed the resulting economic burden and economic consequences for those with varying levels of household income in eastern ***:A cross-sectional study was conducted among tb patients in the national tb programme networks in eastern ***-related direct OOP costs,time loss,and coping strategies were investigated across households in different economic *** of Variance was used to examine the differences in various costs,and Kruskal-Wallis tests were used to compare the difference in total costs as a percentage of annual household ***:Among 435 patients,the mean OOP total costs of tb care were USD *** the lower-income quartile,OOP payments were lower,but costs as a percentage of reported annual household income were *** costs and costs prior to treatment accounted for 66.4 and 48.9%of the total costs,*** lower the household income was,the higher the proportion of medical costs to total costs before tb treatment,but the lower the proportion of medical costs patients spent in the intensive *** care caused 25.8%of tb-affected households to fall below the poverty line and caused the poverty gap(PG)to increase by United States Dollar(USD)*** in the poorest households had the highest poverty headcount ratio(70.2%)and PG(USD 236.1),but those in moderately poor households had the largest increase in the poverty headcount ratio(36.2%)and PG(USD 177.8)due to tb *** from poor households were more likely to borrow money to cope with the costs of tb care;however,there were fewer social consequences,except for food insecurity,in poor ***:Medical and pretreatment costs lead to high costs of tb care,especially among patients from the poorest *** is nec

关键词： Out-of-pocket payment tuberculosis impoverishment Coping strategy Eastern China

The correlation of drug resistance and virulence in Mycobacterium tuberculosis

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Biosafety and Health 2020年第1期2卷 18-24页

作者： Zhan Lingjun Wang Jie Wang Liang Qin Chuan institute of Laboratory Animal Science Chinese Academy of Medical Sciences(CAMS)Beijing 100021China Key Laboratory of Human Diseases Animal Model State Administration of Traditional Chinese MedicineBeijing 100021China Key Laboratory of Human Disease Comparative Medicine Ministry of HealthBeijing Key Laboratory for Animal Models of Emerging and Reemerging InfectiousBeijing 100021China Beijing Engineering Research Center for Experimental Animal Models of Human Critical Diseases Beijing 100021China tuberculosis(tb)Center Chinese Academy of Medical SciencesBeijing 100021China Department of Bioinformatics School of Medical Informatics and EngineeringXuzhou Medical UniversityXuzhou 221000China

The low success rates in the treatment of multidrug-resistant tuberculosis(MDR-tb)and extensively drug-resistant tb(XDR-tb),which account for 55%and 34%respectively,led the WHO to conclude that MDR/XDR-tb is a serious public health ***,the virulence of MDR/XDR-Mycobacterium tuberculosis(Mtb)has not been analyzed in details,which could provide a specific guidance for the control and *** this review,we discuss different aspects of MDR/XDR-Mtb virulence and its relationship to fitness cost by probing the following questions:(1)what mediates the virulence of MDR/XDR-Mtb?(What is the relationship between fitness and virulence of Mtb?(2)is it possible that drug-resistant Mtb(DR Mtb)can show higher fitness?(3)What is the definite effect on fitness of each drug-resistant mutant?(4)What other important factors affecting fitness in the mutant strain?(5)How to study the virulence of a large number of DR Mtb?And what prevention and control measures will be taken in the future,especially for the high virulent DR Mtb?We therefore summarized the congruent relationship between drug resistance and fitness from the global response-related genes to antibiotic resistance-contributing mutation,provided methods to explore the virulence of DR *** review may offer some critical information and concise guide to creating strategies for the prevention and control of drug-resistant Mtb.

关键词： tuberculosis Drug resistance Mutation Global response-related gene Virulence Fitness Correlation

An epidemiological study of resistant tuberculosis in Chongqing,China

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Journal of Medical Colleges of PLA(China) 2011年第3期26卷 158-173页

作者： Xiang Ying Ying Li Liu Jie Su Qian Shen Jing Zhan Jian Xu Rufu Xiong Hongyan Lin Hui Department of Epidemiology College of Military Preventive Medicine Third Military Medical University Chongqing 400038 China Department of Social Medicine and Health Service Management College of Military Preventive Medicine Third Military Medical University Chongqing 400038 China institute of tuberculosis Prevention and Treatment of C. hongqing Chongqing 400050 China

Background The epidemiological characteristics of drug-resistant tuberculosis （DR-tb） is fundamental to improving the prevention and control of DR-tb. Mutations in katG315 is thought to be the most predictive molecule markers for isoniazid （iNH） resistance in Mycobacterium tuberculosis （Mtb）. However, mutations to these genes have not been thoroughly studied in China, and epidemiological evidence of their expression levels are especially lacking in the southwest of China, which has a high tb burden within the population. Methods Mtb isolates were obtained from patients with active pulmonary tuberculosis at the tb dispensary and Chest hospital in Chongqing city between June 2003 and June 2006. Proportion methods were used to test the sensitivity to iNH, RFP, SM and EMB of cultured Mtb. A total of 100 Mtb isolates were also randomly selected for analysis of the molecular mutation spectrum of katG by DNA sequencing. Results Totally 1 089 Mtb isolates that completed positive sputum cultures and evaluated for their sensitivity to the four first-line drugs among 2 777 patients with tb. The prevalence of DR-tb and multi-drug resistant tuberculosis （MDR-tb） were 27.7% （302/1 089） and 7.3% （79/1 089）, respectively. The resistance to anti-tb drugs was found to be highest for SM （16.3%） and iNH （14.0%）. There was also a significant increase in the prevalence of resistance to RFP and EMB （P〈0.01）, and an increase in MDR-tb between June 2003 and June 2004 and between July 2005 and June 2006. The total mutation rate of katG315 was 75＂5% （37/49） in iNH-resistant Mtb, and mutation sites included $315T, $315N and $315i with mutation rates of 81.1% （30/37）, 13.5% （5/37） and 5.4% （2/37）, respectively No katG315 mutants were found in any of the 48 iNH-sensitive Mtb. Our preliminary diagnostic results suggest that mutations in katG315 may potentially serve as molecular markers that can be used to diagnose the resistance to anti-tb drug of iNH. Conclusion in the Chongqing, DR-tb and MDR-

关键词： Pulmonary tuberculosis Drug resistant katG315 Mutation isoniazid

Framework of behavioral indicators evaluating tb health promotion outcomes: a modified Delphi study of tb policymakers and health workers

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infectious Diseases of Poverty 2015年第1期4卷 447-459页

作者： Ying Li John Ehiri Daiyu Hu Eyal Oren Jia Cao Department of Social Medicine and Health Service Management Third Military Medical UniversityNo.30 Gaotanyan RoadShapingba districtChongqingChina Department of Health Promotion Sciences Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonUSA Chongqing institute of tb Prevention and Treatment Jiulongpo districtChongqingChina Department of Epidemiology&Biostatistics Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonUSA institute of Toxicology Third Military Medical UniversityNo.30 Gaotanyan RoadShapingba districtChongqingChina

Background:Although tb health promotion directed at policy makers and healthcare workers(HCWs)is considered important to tuberculosis(tb)control,no indicators currently assess the impact of such promotional *** article is the second in a series of papers that seek to establish a framework of behavioral indicators for outcome evaluation of tb health promotion,using the Delphi *** the first article,we sought to establish a framework of behavioral indicators for outcome evaluation of tb health promotion among tb suspects and *** objective of this second article is to present an indicator framework that can be used to assess behavioral outcomes of tb health promotion directed at policy makers and ***:A two-round,modified Delphi method was used to establish the *** experts who were knowledgeable and experienced in the field of tb control were consulted in Delphi surveys.A questionnaire was developed following 4 steps,and involved ranking indicators on a five-point Likert *** consensus level was 70%.Median,mode,and Coefficient of variation(CV)were used to describe expert *** authority coefficient(Cr)was used to assess the degree of each expert’s ***:Consensus was achieved following the two survey rounds and several iterations among the *** tb health-promotion activities directed at policymakers,the experts reached consensus on 2 domains(“Resource inputs”and“Policymaking and monitoring behaviors”),4 subdomains(“Human resources”among others),and 13 indicators(“Human resources per 100,000 person”among others).For tb health-promotion activities directed at HCWs,the experts reached consensus on 5 domains(“Self-protective behaviors”among others),6 sub-domains(“Preventing infection”among others),and 15 indicators(“Average hours of daily workplace disinfection by ultraviolet radiation”among others).Conclusions:This study identified a conceptual framework of core behavioral indicators to evalua

关键词： Health promotion Evaluation Policymakers tb healthcare workers tb HCWs indicator Delphi method