The Epidemiological Study On Tuberculosis In Jiangsu Provence

Observe: To explore the risk factors of pulmonary tuberculosis among rural dweller in jiangsu province, to determine the status of drug resistance and study the character of genetic diversity of jiangsu's mycobacterium tuberculosis (M.tb) strains based on variable numbers of tandem repeats (VNTR).Methods:(1)Using paired-matched case-control study, 318cases and 318 controls were interviewed ,data were analyzed by conditional logistic regression model. (2) 304 strains were isolated and identified. Drug resistence was tested with indirect proportion method. In which four first line anti-tuberculosis drugs (rifamycins, isoniaizid, streptomycin, ethambutol) were performed. (3) Using muti-loci VNTR assay (MLVA) to analyze for the polymorphism and clustering of VNTR among 67 strains by PCR, 2% agarose electrophoresis and the BioNumerics (version3.0) software.Results (1) Single-variable analysis showed that capita-income, type of house, housing area per member, nourishment(meat, egg), fatigue after working, heavy economic burden, negative events, catching relevant disease, smoking, prior exposure to PTB were associated with incidence of PTB, with ORs of 0.726,0.649,0.823,0.913,0.906,1.849,2.027,3.867,2.355,1.389,3.599,all P<0.05,but all factors except for smoking, type of house, housing area per member entered into multiple regression model. (2) 90.3% drug-resistant strains were determined in non-mycobacterium tuberculosis which account for 7.2%. 62.1% M.tb resisted at least one of four drugs, 59.6% drug-resistant strains were showed in new cases, 68.1% in retreatment cases. The rate of drugs resistance was no statistical significant difference among the three areas, so did it between female and male cases, between city and rural cases. Non-regularly treated case showed much risk in drug-resistance than regularly-treated cases. (3) 15 VNTR-locus form the genome of M.tb were selected,The distribution of 67 strains showed definite polymorphism, 8 different genotypes were finally classified in which 32.6% strains were clustered to one genotype, the others were scattered.Conclusion It is suggest that the epidemic situation of PTB would be controlled with well-managed PTB and measures against other risk factors. Cases were cured with drugs selected by drug-resistance examination. The VNTR loci in M.tb isolated from Jiangsu showed marked polymorphism, the MLVA is an available one for epidemiological survey.