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Asian Pacific Journal of Tropical Medicine 2009年第6期2卷 48-51页

作者： Singhal S Quazi Z MahajanSN Diwan SK Gaidhane A Department of Chest and tuberculosis Acharya Vinoba Bhave Rural HospitalDMIMSSawangi(M)WardhaMaharashtraIndia Department of Community Medicine Acharya Vinoba Bhave Rural HospitalDMIMSSawangi(M)WardhaMaharashtraIndia Department of Medicine Acharya Vinoba Bhave Rural HospitalDMIMSSawangi(M)WardhaMaharashtraIndia

Objective:To judge for reasons of interrupting the treatment as told by patient himself/herself and see for adherence to therapy and treatment outcome after ***:All patients with history of interrupting the treatment presenting to chest OPD were included in this *** was done by medical officer on first interaction and by health care worker(as guidance of medical officer) *** for interrupting the treatment were *** and their relatives were counselled about the urgent need for strict adherence to therapy with special focus on reasons for which that particular patient had ***:Total 56 patients were included in the study during First Quarter of year *** outcomes of 40 patients were available.6 out of them had interrupted the treatment(15%)(national figures;19%and Maharashtra: 21%),13 patients died during the treatment(5 of them were Cat 2 defaulters).Multiple reasons for interrupting the treatment were *** common reasons were alcoholism and feeling of relief with treatment (46.4%).Conclusion:There is an urgent need for stressing upon counselling during Revised national tuberculosis control programme(RNTCP) sensitization and *** officers can play an important role in reducing the defaulter rate by counselling of patient and their relatives.

关键词： Defaulter RNTCP Treatment interruption Counselling

Validation of the clinical tuberculosis screening algorithm used in Nigerian national tuberculosis control programme for screening people living with HIV

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Health 2013年第11期5卷 1737-1741页

作者： Emmanuel N. Aguwa Chika N. Onwasigwe Joseph N. Chukwu Daniel C. Oshi Charles C. Nwafor Babatunde I. Omotowo Anne C. Ndu Anthony O. Meka Osa-Eloka C. Ekwueme Nwachukwu C. Ugwunna Moses C. Anyim Department of Community Medicine University of Nigeria Nsukka Nigeria Department of Community Medicine University of Nigeria Nsukka Nigeria German Leprosy and tuberculosis Relief Association Enugu Nigeria

Background: In high HIV prevalence, tuberculosis diagnosis is challenging. Some countries hence use clinical algorithms to screen for tuberculosis in People Living with HIV (PLHIV). Objectives: The aim of the study was to validate the national algorithm for clinical tuberculosis screening of persons living with HIV who attend comprehensive HIV clinics. Methods: A cross-sectional study of PLHIV who presented with cough of at least 2 weeks duration between 2009 and 2011 at St Patrick’s Hospital, Ebonyi State, Nigeria. Sputum smear microscopy for acid fast bacilli was obtained from the participants. Results: Three hundred and twelve PLHIV were studied: 146 (46.8%) males and 166 (53.2%) females. Only 55 (17.6%) of the participants had smear positive pulmonary tuberculosis. Weight loss (c2 = 2.33;P = 0.127), hemoptysis (c2 = 0.03;P = 0.864), night sweats (c2 = 1.52;P = 0.218), fever (c2 = 3.49;P = 0.06), anorexia (c2 = 0.49;P = 0.484), chest pain (c2 = 2.48;P = 0.115), breathlessness (c2 = 0.63;P = 0.426) were not significant in PLHWA with/without pulmonary tuberculosis. Cough, fever, night sweat and weight loss combined gave a sensitivity of 97.0%, specificity of 10.9%, negative predictive value (NPV) of 93.3% and positive predictive value (PPV) of 21.8%. Conclusion: Findings suggest that though national screening algorithm is a valid tool to screen for tuberculosis in PLHIV, it will lead to many false positive results.

关键词： HIV tuberculosis PLHIV Screening Tool Validation

Toward tuberculosis elimination by understanding epidemiologic characteristics and risk factors in Hainan Province, China

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Infectious Diseases of Poverty 2024年第1期13卷 107-108页

作者： Changqiang Zhou Tao Li Jian Du Dapeng Yin Xiujun Li Shixue Li Department of Biostatistics School of Public Health Cheeloo College of Medicine Shandong University Jinan People’s Republic of China national Center for tuberculosis control and Prevention Chinese Center for Disease Control and Prevention Beijing People’s Republic of China Clinical Center On TB control Beijing Chest Hospital Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing People’s Republic of China Hainan Center for Disease control and Prevention Haikou People’s Republic of China Research Center for tuberculosis control Shandong University Jinan People’s Republic of China

Background The disease burden of tuberculosis(TB)was heavy in Hainan Province,China,and the information on transmission patterns was limited with few *** atudy aims to further explore the epidemiological charac-teristics and influencing factors of TB in Hainan Province,and thereby contribute valuable scientific evidences for TB elimination in Hainan *** The TB notification data in Hainan Province from 2013 to 2022 were collected from the Chinese national Disease control Information System tuberculosis Surveillance System,along with socio-economic *** spatial-temporal and population distributions were analyzed,and spatial autocorrelation analysis was conducted to explore TB notification rate *** addition,the epidemiological characteristics of the cases among in-country migrants were described,and the delay pattern in seeking medical care was ***,a geographically and tem-porally weighted regression(GTWR)model was adopted to analyze the relationship between TB notification rate and socio-economic *** tailored control suggestions in different regions for TB elimination was provided by understanding epidemiological characteristics and risk factors obtained by *** From 2013 to 2022,64,042 cases of TB were notified in Hainan *** estimated annual percent-age change of TB notification rate in Hainan Province from 2013 to 2020 was-6.88%[95%confidence interval(CI):-5.30%,-3.69%],with higher rates in central and southern *** majority of patients were males(76.33%)and farmers(67.80%).Cases among in-country migrants primarily originated from Sichuan(369 cases),Heilongjiang(267 cases),Hunan(236 cases),Guangdong(174 cases),and Guangxi(139 cases),accounting for 53%.The majority(98.83%)of TB cases were notified through passive case finding approaches,with delay in seeking *** GTWR analysis showed that gross domestic product per capita,the number of medical institutions and health personnel

关键词： tuberculosis Elimination Hainan Province China Epidemiological characteristics Geographically Temporally weighted regression

Diagnosis and Management of Childhood tuberculosis: A Cross-Sectional Study of Practices in Gilgit Baltistan, Pakistan

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Journal of tuberculosis Research 2024年第2期12卷 57-72页

作者： Khalid Mahmood Razia Fatima Aashifa Yaqoob Faheem Jan Zia Samad Mahboob Ul Haq national tuberculosis control Program Islamabad Pakistan

Background: tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. tuberculosis in children remained a low public health priority with limited epidemiologic studies. Struggles for TB control in children need to be enhanced as children are providing the reservoir for future cases to develop. Objectives: The study evaluated diagnostic and treatment practices related to childhood pulmonary tuberculosis in Gilgit Baltistan (GB), Pakistan. Methods: A descriptive, cross-sectional study based on retrospective record review of childhood Pulmonary tuberculosis patients registered in the year 2020 with self-administered questionnaire. Results: Data of 557 childhood cases were collected. Most childhood cases were in age group 1 - 4 years (54%) with male predominance. More than 90% were diagnosed and treated at public sector facilities. 99% of the cases were clinically diagnosed with passive case finding. Cough was considered as a symptom of childhood tuberculosis (TB) by 94% of physicians. Other important features included failure to thrive (13%), contact with a family history of TB (15%), Malnutrition(24%) and respiratory signs (21%). 99% physicians advised chest X-ray, Complete blood count (CBC) (95%) and Erythrocytes sedimentation rate (ESR) (72%) for diagnosis and fewer physicians (2%) used sputum smear microscopy and induced sputum (0.1%). Combining data on dosage, frequency and duration for drugs, 99% of the cases were found receiving correct regimen. The treatment outcomes of the cases were cured 4 (0.8%), treatment completed 551 (99.3%) and died 2 (0.4%) with no lost to follow up. Conclusions: The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among physicians in public and private sectors of Gilgit Baltistan. Most of the cases are managed by general practitioners with no

关键词： Childhood tuberculosis Management Respiratory Signs

Inferring Mycobacterium tuberculosis Drug Resistance and Transmission using Whole-genome Sequencing in a High TB-burden Setting in China

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Biomedical and Environmental Sciences 2024年第2期37卷 157-169页

作者： FAN Yu Feng LIU Dong Xin CHEN Yi Wang OU Xi Chao MAO Qi Zhi YANG Ting Ting WANG Xi Jiang HE Wen Cong ZHAO Bing LIU Zhen Jiang ABULIMITI Maiweilanjiang AIHEMUTI Maimaitiaili GAO Qian ZHAO Yan Lin Key Laboratory of Medical Molecular Virology(MOE/NHC/CAMS) School of Basic Medical SciencesShanghai Medical CollegeFudan UniversityShanghai 200032China national tuberculosis Reference Laboratory Chinese Center for Disease Control and PreventionBeijing 102206China Hangzhou Red Cross Hospital Hangzhou 310005ZhejiangChina Xinjiang Uygur Autonomous Region Center for Disease control and Prevention Urumqi 830026XinjiangChina tuberculosis Dispensary of Kashgar Prefecture Kashgar 844099XinjiangChina

Objective China is among the 30 countries with a high burden of tuberculosis(TB)worldwide,and TB remains a public health *** Prefecture in the southern Xinjiang Autonomous Region is considered as one of the highest TB burden regions in ***,molecular epidemiological studies of Kashgar are *** A population-based retrospective study was conducted using whole-genome sequencing(WGS)to determine the characteristics of drug resistance and the transmission *** A total of 1,668 isolates collected in 2020 were classified into lineages 2(46.0%),3(27.5%),and 4(26.5%).The drug resistance rates revealed by WGS showed that the top three drugs in terms of the resistance rate were isoniazid(7.4%,124/1,668),streptomycin(6.0%,100/1,668),and rifampicin(3.3%,55/1,668).The rate of rifampicin resistance was 1.8%(23/1,290)in the new cases and 9.4%(32/340)in the previously treated *** resistance mutations were detected more frequently in lineage 2 strains than in lineage 3 or 4 strains,respectively:18.6%vs.8.7 or 9%,Ptuberculosis(DR-TB),78.4%(171/218)were attributed to the transmission of DR-TB *** Our results suggest that drug-resistant strains are more transmissible than susceptible strains and that transmission is the major driving force of the current DR-TB epidemic in Kashgar.

关键词： Mycobacterium tuberculosis Whole-genome sequencing(WGS) Transmission Drug resistance Xinjiang

An Outbreak of Serogroup Y Meningococcal Meningitis in a Private Secondary Vocational School-Guangzhou City,Guangdong Province,China,2023

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China CDC weekly 2024年第12期6卷 242-246,I0005页

作者： Xiang Zeng Qing He Yilan Li Yong Zhou Xiaoping Shao Pei Hu Jian Liang Yudan Song Chao Ma Lijie Zhang Limei Sun Lei Luo Chinese Field Epidemiology Training Program Chinese Center for Disease Control and PreventionBeijingChina Zhuhai Center for Disease control and Prevention Zhuhai CityGuangdong ProvinceChina Guangdong Center for Disease control and Prevention Guangzhou CityGuangdong ProvinceChina Guangzhou Center for Disease control and Prevention Guangzhou CityGuangdong ProvinceChina Institute of Public Health Guangzhou Medical University&Guangzhou Center for Disease Control and PreventionGuangzhou CityGuangdong ProvinceChina Department of the national Immunization programme Chinese Center for Disease Control and PreventionBeijingChina

What is already known about this topic?The inclusion of meningococcal vaccines in the national Immunization Program(NIP)over several years has significantly reduced the incidence of meningococcal meningitis in China to historic ***,there has been a diversification of meningococcal serogroups,leading to a shift in dominant serogroups in China from serogroup A to serogroups C and B,accompanied by a rise in reports of serogroups Y and *** is added by this report?An outbreak of serogroup Y Neisseria meningitidis(Nm)in a secondary vocational school involved a single confirmed severe case and 24 individuals with laboratory-confirmed Nm *** investigation revealed that the outbreak was localized to the classroom of the confirmed *** close contact within a confined space was identified as a significant risk factor for Nm *** genotype sequence identified was type 1655(ST-1655),which is categorized under clonal complex 23(CC-23)and bears resemblance to 8 previously confirmed cases of serogroup Y meningococcal meningitis within Guangdong *** suggests that serogroup Y infections continue to sporadically emerge and have become prevalent *** are the implications for public health practice?This outbreak underscores the critical need to enhance surveillance of meningococcal serogroups and population carrier,and advocate for vaccination with MenY-containing vaccines.

关键词： break Secondary Guangdong

Prevalence of Vitamin A Deficiency in Children Aged 6 to 17 Years—Western and Central Rural Areas,China,2012–2021

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China CDC weekly 2024年第3期6卷 51-55页

作者： Peipei Xu Juan Xu Wei Cao Titi Yang Qian Gan Hongliang Wang Ruihe Luo Hui Pan Qian Zhang national Institute for Nutrition and Health Chinese Center for Disease Control and PreventionBeijingChina

What is already known about this topic?Vitamin A deficiency(VAD)is a leading global nutritional concern,ranking among the top four major nutritional deficiencies *** prevalence of VAD is unevenly distributed across various regions,both within China and *** is added by this report?The report adds valuable insights into the vitamin A nutritional status of rural students aged 6–17 years who participated in the Nutrition Improvement programme for Rural Compulsory Education Students(NIPRCES).Over the decade from 2012 to 2021,there was a modest improvement in vitamin A *** prevalence of VAD and sub-clinical VAD(SVAD)declined as the students *** the majority of the survey years,the incidence of VAD was higher among males and western regions compared to females and central regions,*** are the implications for public health practice?A comprehensive approach,incorporating dietary diversification,nutrition education,and food fortification,should be implemented to prevent VAD and SVAD especially in males,younger children and children in western areas.

关键词： vitamin Rural younger

Epidemiological Characteristics of Human Parainfluenza Viruses Infections-China,2019-2023

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China CDC weekly 2024年第12期6卷 235-241,I0003,I0004页

作者： Yixuan Gao Yingwei Ma Daxing Feng Feng Zhang Biao Wang Xiaoqing Liu Bing Zhu Hui Xie Linqing Zhao Xiaoru Long Ying Chen Bing Wang Jie Jiang Zhen Zhu Yan Zhang Aili Cui Baicheng Xia Naiying Mao national Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases National Institute for Viral Disease Control and PreventionChinese Center for Disease Control and PreventionBeijingChina Precision Medicine Research Center Children’s Hospital of ChangchunChangchun CityJilin ProvinceChina Henan Provincial Center for Disease control and Prevention Zhengzhou CityHenan ProvinceChina Laboratory of Viral Diseases Qingdao Municipal Centre for Disease Control and PreventionQingdao CityShandong ProvinceChina Virus Laboratory Gansu Provincial Center for Disease Control and PreventionLanzhou CityGansu ProvinceChina Jiangxi Provincial Center for Disease control and Prevention Nanchang CityGansu ProvinceChina Virus Laboratory Guangzhou Women and Children’s Medical CenterGuangzhou Medical UniversityGuangzhou CityGuangdong ProvinceChina Institute for Immunization and Prevention Beijing Center for Disease Prevention and ControlAcademy for Preventive MedicineInstitute of Tuberculosis Control Research and PreventionBeijingChina Laboratory of Virology Beijing Key Laboratory of Etiology of Viral Diseases in ChildrenCapital Institute of PediatricsBeijingChina Department of Infection Children’s Hospital of Chongqing Medical UniversityChongqingChina Inner Mongolia Autonomous Region Comprehensive Center for Disease control and Prevention Hohhot CityInner Mongolia Autonomous RegionChina Shenyang Prefecture Center for Disease control and Prevention Shenyang CityLiaoning ProvinceChina

Introduction:A retrospective study based on sentinel surveillance was conducted in 10 provinciallevel administrative divisions(PLADs)in China to enhance the understanding of the epidemiological characteristics of human parainfluenza viruses(HPIVs).Methods:From January 2019 to June 2023,respiratory specimens were collected from individuals with acute respiratory infections(ARIs)and screened for four HPIVs serotypes and other common respiratory viruses using multiplex real-time polymerase chain reaction(PCR).This study analyzed the association of HPIVs infections with seasonal patterns,geographical distribution,demographic profiles,clinical features,and co-infection ***:During the study period,a total of 12,866 ARIs were *** overall detection rate of HPIVs was 6.15%,varying from 5.04%in 2022 to 9.70%in *** median age of HPIVs-infected patients was 3 ***2 was more prevalent among individuals aged 5–17 years(42.57%),while HPIV4 was more common in those over 65 years(12.24%).HPIV3(54.16%)and HPIV1(27.18%)were the predominant serotypes,and their prevalence exhibited significant seasonal fluctuations postcoronavirus disease 2019(COVID-19)*** peak of HPIV3 shifted three months later in 2020 compared to 2019 and returned to a summer peak *** peaks of HPIV1 were observed in 2021 following the peak of ***,coinfections were frequent in HPIVs cases(overall rate:22.12%),with human rhinovirus being the most common co-infecting ***:The prevalence of HPIVs in China was predominantly due to HPIV3 and HPIV1,and their seasonal patterns were altered by pandemic ***,continuous surveillance of HPIVs is essential.

关键词： prevalence seasonal Human

Need for operational simplicity and timely disbursal of benefits—a qualitative exploration of the implementation of a direct benefit transfer scheme for persons with tuberculosis in India

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贫困所致传染病(英文) 2024年第3期13卷 1-15页

作者： Mohan Malu Thangaraj Jeromie W. V. Pandey Sumit Priya G. Sri Lakshmi Arunachalam Sivavallinathan Sharma Rahul Shewade Hemant Deepak Aishwarya B. Afeeq K. Khatoon Afsana Gokulvijay B. Sireesha Gude Chandra Kavita Nandhakumar S. Samuel Prince Viswanathan C. Nanditha Shanmugasundaram Devika Rao Raghuram Murhekar Manoj V. Jeyashree Kathiresan Indian Council of Medical Research-national Institute of Epidemiology R-127 TNHB Ayapakkam Chennai Tamil Nadu India TB Support Network WHO Country Office for India New Delhi India Central tuberculosis Division Government of India New Delhi India

Background Ni-kshay Poshan Yojana (NPY) is a direct benefit transfer scheme of the Government of India introduced in 2018 to support the additional nutritional requirements of persons with TB (PwTB). Our recent nationwide evaluation of implementation and utilization of NPY using programmatic data of PwTB from nine randomly selected Indian states, reported a 70% coverage and high median delay in benefit credit. We undertook a qualitative study between January and July 2023, to understand the detailed implementation process of NPY and explore the enablers and barriers to effective implementation and utilization of the NPY *** We followed a grounded theory approach to inductively develop theoretical explanations for social phenomena through data generated from multiple sources. We conducted 36 in-depth interviews of national, district and field-level staff of the national tuberculosis Elimination programme (NTEP) and NPY beneficiaries from 30 districts across nine states of India, selected using theoretical sampling. An analytical framework developed through inductive coding of a set of six interviews, guided the coding of the subsequent interviews. Categories and themes emerged through constant comparison and the data collection continued until theoretical *** Stakeholders perceived NPY as a beneficial initiative. Strong political commitment from the state administration, mainstreaming of NTEP work with the district public healthcare delivery system, availability of good geographic and internet connectivity and state-specific grievance redressal mechanisms and innovations were identified as enablers of implementation. However, the complex, multi-level benefit approval process, difficulties in accessing banking services, perceived inadequacy of benefits and overworked human resources in the NTEP were identified as barriers to implementation and *** The optimal utilization of NPY is enabled by strong political commitment and

关键词： national tuberculosis Elimination programme Nutritional status Direct benefit transfer Ni-kshay Poshan Yojana Implementation Cash transfer scheme Grounded theory India

The virulence regulator AbsR in avian pathogenic Escherichia coli has pleiotropic effects on bacterial physiology

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Journal of Integrative Agriculture 2024年第2期23卷 649-668页

作者： Dongfang Zhao Haobo Zhang Xinyang Zhang Fengwei Jiang Yijing Li Wentong Cai Ganwu Li State Key Laboratory for Animal Disease control and Prevention Harbin Veterinary Research InstituteChinese Academy of Agricultural SciencesHarbin 150069China College of Veterinary Medicine Northeast Agricultural UniversityHarbin 150038China national Animal tuberculosis Reference Laboratory Division of Zoonoses SurveillanceChina Animal Health and Epidemiology CenterQingdao 266032China Department of Veterinary Diagnostic and Production Animal Medicine College of Veterinary MedicineIowa State UniversityAmesIowa 50011-1134the United States

Avian pathogenic Escherichia coli(APEC)belonging to extraintestinal pathogenic ***(ExPEC)can cause severe infections in extraintestinal tissues in birds and humans,such as the lungs and ***(microcin production regulation,locus A,herein renamed AbsR,a blood survival regulator),a member of the MarR(multiple antibiotic resistance regulator)transcriptional regulator family,governs the expression of capsule biosynthetic genes in human ExPEC and represents a promising druggable target for ***,a deep understanding of the AbsR regulatory mechanism as well as its regulon is *** this study,we present a systems-level analysis of the APEC AbsR regulon using ChIP-Seq(chromatin immunoprecipitation sequencing)and RNA-Seq(RNA sequencing)*** found that AbsR directly regulates 99 genes and indirectly regulates 667 ***,we showed that:1)AbsR contributes to antiphagocytotic effects by macrophages and virulence in a mouse model for systemic infection by directly activating the capsular gene cluster;2)AbsR positively impacts biofilm formation via direct regulation of the T2SS(type II secretion system)but plays a marginal role in virulence;and 3)AbsR directly upregulates the acid tolerance signaling system EvgAS to withstand acid stress but is dispensable in ExPEC ***,our data indicate that the role of AbsR in virulence gene regulation is relatively conserved in ExPEC ***,this study provides a comprehensive analysis of the AbsR regulon and regulatory mechanism,and our data suggest that AbsR likely influences virulence primarily through the control of capsule ***,we found that AbsR severely represses the expression of the type I-F CRISPR(clustered regularly interspaced short palindromic repeats)-Cas(CRISPR associated)systems,which could have implications in CRISPR biology and application.

关键词： avian pathogenic Escherichia coli(APEC) extraintestinal pathogenic Escherichia coli(ExPEC) AbsR RNA-Seq ChIP-Seq gene regulation