| Health of human being is seriously treatened by tuberculosis (TB). Because of some reasons, such as the prevalence of HIV/AIDS, the transmission of anti-drugs Mycobacterium tuberculosis (MTB), etc., tuberculosis has become a global problem of public health. In China, the situation of TB prevalence is very serious too. China is the second to India among the 22 countries with high burden of TB. According to the 2000 Nationwide Random Survey for the Epidemiology of TB in China (except Taiwan, Hong Kong and Macao), the infection rate was 44.5%, and 550 million people were infected with (MTB), which was much higher than the mean of one third in the world. So one of the most important tasks of the public health in China is controlling the occurring and prevalence of TB. The national epidemic survey of TB done in 2000 showed that almost half of the population nationwide (550 million) were infected by TB bacteria, which is higher than the average in the world. It is estimated that there are 1.45 million of new active pulmonary tuberculosis occurred every year by World Health Organization, including 0.65 million of smear positive cases. To control TB is one of the most important missions of public health in China. It is a key to utilize the fast, simple and sensitive method to make diagnosis of TB for TB control.The research was a cross-sectional design by means of random sampling methods. Four countirs/districts of Nanchang City in Jiangxi province was selected for this investigation. From Jan. to June,2009, the patients suspected with TB was investigated with uniform epidemiological questionnaire, and three sputum samples (on-spot sputum, evening sputum and morning sputum) from each patient were collected to examine mycobaterium, of which. The patient was diagnosed by the smear spositive or/and culture positive of any among the the three sputume samples. The mycobacterium pecies including MTB, Mycobacterium bovis (M bovis) and non-tuberculosi mycobacterium (NTM) was identified by means of the PNB/TCH distinguishable culture medium to learn the infectious situation of MTB, M. bovis, and NTM in the region. The proportion method were used to test the susceptibility of the clinical isolates to 4 anti-TB drugs, isoniazid (INH), rifampicin (RFP), streptomycin (SM), and ethambutol (EMB). Statistic analyses of the results were performed with EXCEL2003, SPSS 15.0 software and.Chi-square test. There was significant difference between two groups when P value is<0.05.Of the 442 suspected TB patients investigated,315 (71.3%) were male and 127 ones (28.7%) were female. The ratio of male to female was 2.48 to 1. Among the patients, the youngest was 12 years old and the oldest was 80 years old, the number of the patients above 60-year old was most, the second was 41～60 years old group, accounting for 31.67%,, the third was 21-40 year-old group, accounting for 26.70%, and the lowest was under 20-year old group, accounting for 6.3% According to this study, the prevalence of TB in the rural area was significant:the number (322cases, accounting for 72.85%) of the patients was much more than that (120 cases, accounting for 27.15%) of the patients in the urban area. Ananlysis on the professional population, of the patients, the dominant were those from peasants, accounting for 272 (61.54%), and floating population, accounting for 66 (14.93%) which were much more than that from the other professional population. According to this research, of the patients, there were 55 (12.44%) retreatment cases, and 43 (9.72%) had been treated with irregular drug-taking history from a few days to a few years.59 (13.35%) of the patients had been contacted TB patients before they got sick, in which 22 (4.98%) had the history of tightly close to TB patients.289 (65.38%) of the patient had never gained any health education about TB before they had the disease. Only 203 (45.93%) of the patients knew the transmission of TB.164 (37%) patients firstly went to anti-TB institute seeing the doctors.In this study 1296 sputum samples collected from 432 suspected TB patients of four countirs/districts of Nanchang City in Jiangxi province were made for the bacteriological examination by means of sputum smear microscopy and Mycobacterium culture method. With Acid-Fast Bacilli (AFB), the positive rate was 27.93%(362/1296) and the negative rate was 72.07%(934/1296), among 432 suspected patients with TB, 162 cases were positive and 270 were negative, of which the positive rate was 37.50% and negative rate was 62.50%. With culture method, the positive rate was 29.48% (382/1296) and the negative rate was 72.07%(914/1296), among 432 suspected patients with TB,159 cases were culture positive and 273 were culture negative, of which the positive rate was 36.81% and negative rate was 63.19%.The positive rate (40.97%) of AFB associated with bacteria culture method was much higher than that of AFA and bacteria culture method respectively.The mycobacterium pecies was identified by means of the PNB/TCH distinguishable culture medium with that we had got 120 clinical Mycobacterium isolates from 120 patients respectively. Of the 120 isolates,108 (90%) were MTB,1 (0.83%) was M. bovis and 11 (9.17%) were NTM.Drug susceptibility testing were conducted with the proportion method. Of 108 MTB isolates,97(89.81%) strains were sensitive to the four first-line anti-TB drugs (SM, RFP, INH and EMB), and 11 (10.19%) strains were drug-resistance including 7 (6.48%) single drug-resistance and 4 (3.70%) multi-drug resistance.According to the results of 442 suspected TB patients by means of field epidemiological investigation, the number of male and in the rural area was much more than of female and in the urban area respectively; the middle-and old-age people, peasants and floating population are high risk population of TB; there was phenomena of irregular drug-taking history for TB therapy, accounting for 9.72%; the health education of TB control and treatment must be enhanced in the area, because 289 (65.38%) of the patient had never gained any health education about TB before they had the disease.The result of bacteriological examination shewed the agent of TB in the area was complex, including MTB, M. bovis, and NTM. Specially NTM accounted for 9.17%, to which is needed peying more attention. The rate of MTB drug-resistance against the four first-line anti-TB drugs (SM, RFP, INH and EMB) was 10.19% including 6.48% single drug-resistance and 3.70% multi-drug resistance.The positive rate can be increased by using AFB associated with culture method to examine one sputum sample at the same time.In some instances this research described the epidemic trend of TB in the area, which is important epidemiological significance and providing valid basic scientific data for TB control and prevention... |
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