Investigation of 3-year inpatient TB cases in Zunyi, China: Increased TB burden but improved bacteriological diagnosis

Abstract

BackgroundAs one of the top three high tuberculosis (TB) burden countries, China is a country where the overall TB incidence continues to decline. However, due to its large population and area, the increased TB burden exists in regional areas.MethodsThis retrospective study analyzed local inpatient pulmonary TB cases in the Affiliated Hospital of Zunyi Medical University (AHZMU) from January 2016 to December 2018 in a high TB incidence and economically-less-developed area of China. Four methods, acid-fast bacilli stain, culture, Xpert and LAMP, were used to detect Mycobacterium tuberculosis (M.tb), while proportional method and Xpert were used to identify rifampicin-resistant TB (RR-TB). Case number, treatment history, M.tb confirmed TB and rifampicin resistant proportion were analyzed to investigate the local TB epidemic.ResultsTotal 3,910 local inpatient cases with pulmonary TB were admitted to AHZMU during this study period. The annual numbers of total TB cases increased 26.4% (from 1,173 to 1,483), while new cases increased 29.6% (from 936 to 1,213) and RR-TB cases increased 2.7 times (from 31 to 84). Meanwhile, the percentage of previously treated cases declined from 20.2 to 18.2% and the M.tb confirmed TB proportion increased from 34.7 to 49.7%.ConclusionThe elevated M.tb confirmed TB proportion and the declined percentage of previously treated cases indicated the improved TB diagnosis and treatment of AHZMU. However, the increasing number of total TB cases, new and RR-TB cases showed an upward trend and increased TB burden in a relatively underdeveloped area of China.

Changes in the balance of Th17/Treg cells and oxidative stress markers in patients with HIV‑associated pulmonary tuberculosis who develop IRIS

“…The participants were aged 18-84 years old, the male to female ratio is ~1.45:1. Pulmonary TB was confirmed according to the diagnostic criteria of pulmonary TB in the health industry standards of China (WS 288-2008 and WS 288-2017) ( 30 ): i) nucleic acid test shows a positive result for M. tuberculosis and ii) chest radiological imaging shows typical clinical symptoms of active TB infection. HIV infection was confirmed according to the diagnostic criteria based on the Chinese Guidelines for Diagnosis and Treatment of HIV/AIDS (2018) ( 31 ): Nucleic acid test shows a positive result for HIV.…”

Trends of Drug-Resistant Tuberculosis in an Urban and a Rural Area in China: A 10-Year Population-Based Molecular Epidemiological Study

“…11 Since this survey, China has made a concerted effort to improve the control of drug-resistant TB. Although the trends in the prevalence of drugresistant TB have been evaluated in several individual regions of China, including Beijing, Zhejiang, Henan, and Guizhou, [12][13][14][15][16][17] most of these studies were based on hospitalized TB patients and therefore the reported prevalence of drug resistance may have been higher than would be found in population-based studies.…”