BACKGROUND: Indonesia is among countries with a high incidence of multi drug-resistant tuberculosis (MDR-TB) globally. In this study, we aim to determine the prevalence of silico-tuberculosis among TB patients and to investigate the association of radiographic silicosis and the role of drug supervisor as well as other socio-clinical factors, in the development of MDR-TB in Indonesia. METHODS: A hospital-based study in West Java among 148 MDR-TB patients (case) and 164 drug-sensitive/DS-TB patients (control) was conducted. Chest x-rays were evaluated by two radiologists and one NIOSH B reader according to the ILO Classification. Face-to-face interviews were conducted using structured questionnaires to collect patients' information, including the task of drug supervisor. RESULTS: Findings indicate that supportive drug supervisor reduces the risk of developing MDR-TB, but silicosis showed no significant association. Nevertheless, in this study we found that 17 cases (5.4%) had silico-tuberculosis mostly exhibited as ILO profusion 3; predominated by q shape, 52.9% with large opacities and dominated by size A. Other factors significantly associated with the risk of developing MDR-TB were marital status, low income, longer traveling time to hospital, unsuccessful previous treatment and suffering drug side effects. CONCLUSION This study reveals that one of preventive healthcare strategy to protect TB patients from developing MDR-TB is supportive drug supervisor. While, the development of MDR-TB was not significantly influenced by silicosis; however, there is a notable prevalence of silicosis as determined by chest radiography, highlighting the critical need for dust control, occupational hygiene, and health screening for high-risk populations.
Indonesia/epidemiology* ; Humans ; Silicosis/diagnostic imaging* ; Male ; Tuberculosis, Multidrug-Resistant/etiology* ; Middle Aged ; Adult ; Female ; Prevalence ; Risk Factors ; Aged ; Antitubercular Agents/therapeutic use*

Objective: To analyze the epidemic characteristics and drug resistance of pulmonary tuberculosis among the floating population in Beijing and to provide a scientific basis for formulating strategies for the prevention and control of tuberculosis among the floating population. Methods: Data of tuberculosis patients who were positive for Mycobacterium tuberculosis culture was collected from 16 districts and one municipal institution of tuberculosis control and prevention in Beijing in 2019. The strain samples were tested for drug sensitivity by the proportional method. According to household registration location, patients were divided into the floating population and Beijing registration. SPSS 19.0 software analyzed tuberculosis patients' epidemic characteristics and drug resistance in the floating population. Results: In 2019, there were 1 171 culture-positive tuberculosis patients in Beijing, among the floating population, 593 (50.64%) patients were identified, with a male-to-female sex ratio of 2.2∶1 (409∶184). Compared to patients under household registration as Beijing residents, a higher proportion of young adults aged 20-39 years (65.09%,386/593) were noticed, with 55.65% (330/593) reported from the urban areas and 96.80% (574/593) were reported the first time. The differences were statistically significant (all P<0.05). After completing the drug sensitivity test, 37 cases were with multiple drug-resistant tuberculosis, accounting for 6.24% (37/593). The rates of isoniazid resistance (42.11%,8/19) and multidrug resistance (21.05%,4/19) in floating population patients after retreatment were significantly higher than those in newly treated patients (11.67%, 67/574 and 5.75%, 33/574), and the differences were statistically significant (all P<0.05). Conclusions: Most patients with tuberculosis in the floating population in Beijing in 2019 were young males aged 20-39 years. The reporting areas were urban areas and the newly treated patients mainly. The patients with tuberculosis in the re-treated floating population were more likely to suffer from multidrug and drug resistance, which should be taken as the key population for prevention and control.
Young Adult ; Humans ; Female ; Male ; Beijing/epidemiology* ; Tuberculosis ; Tuberculosis, Pulmonary/epidemiology* ; Tuberculosis, Multidrug-Resistant/epidemiology* ; Drug Resistance

OBJECTIVE: This study aims to estimate the cost-effectiveness of the combined chemotherapy regimen containing Bedaquiline (BR) and the conventional treatment regimen (CR, not containing Bedaquiline) for the treatment of adults with multidrug-resistant tuberculosis (MDR-TB) in China. METHODS: A combination of a decision tree and a Markov model was developed to estimate the cost and effects of MDR patients in BR and CR within ten years. The model parameter data were synthesized from the literature, the national TB surveillance information system, and consultation with experts. The incremental cost-effectiveness ratio (ICER) of BR vs. CR was determined. RESULTS: BR ( vs. CR) had a higher sputum culture conversion rate and cure rate and prevented many premature deaths (decreased by 12.8%), thereby obtaining more quality-adjusted life years (QALYs) (increased by 2.31 years). The per capita cost in BR was as high as 138,000 yuan, roughly double that of CR. The ICER for BR was 33,700 yuan/QALY, which was lower than China's 1× per capita Gross Domestic Product (GDP) in 2020 (72,400 yuan). CONCLUSION BR is shown to be cost effective. When the unit price of Bedaquiline reaches or falls below 57.21 yuan per unit, BR is expected to be the dominant strategy in China over CR.
Adult ; Humans ; Antitubercular Agents/therapeutic use* ; Cost-Effectiveness Analysis ; Cost-Benefit Analysis ; Tuberculosis, Multidrug-Resistant/drug therapy* ; China/epidemiology*

Antitubercular Agents/therapeutic use* ; China/epidemiology* ; Drug Resistance, Multiple, Bacterial ; Extensively Drug-Resistant Tuberculosis ; Humans ; Kanamycin Resistance ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis ; Ofloxacin/pharmacology* ; Tuberculosis, Multidrug-Resistant/epidemiology*

China/epidemiology* ; Humans ; Minisatellite Repeats ; Molecular Typing ; Mycobacterium tuberculosis/genetics* ; Polymerase Chain Reaction ; Tuberculosis, Multidrug-Resistant/transmission*

A retrospective analysis was performed in two major HIV/AIDS referral hospitals in Beijing to evaluate the prevalence of Mycobacterium tuberculosis (MTB) and non-tuberculous mycobacterial (NTM) infections in HIV-infected patients. A total of 627 patients' data were reviewed, and 102 (16.3%) patients were diagnosed with culture-confirmed mycobacterial infection, including 84 with MTB, 16 with NTM, and 2 with both MTB and NTM. The most frequent clinical complication by mycobacterial infection was pulmonary infection (48/102, 47.1%). The overall rates of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) were 11.9% and 3.4%, respectively. This study underlines the urgent need to intensify screening for mycobacteria coinfection with HIV and to prevent the spread of drug-resistant TB among HIV-infected patients.
AIDS-Related Opportunistic Infections ; epidemiology ; microbiology ; Adult ; Beijing ; Coinfection ; Extensively Drug-Resistant Tuberculosis ; epidemiology ; microbiology ; Female ; HIV Infections ; epidemiology ; microbiology ; Hospitals, Urban ; Humans ; Male ; Mycobacterium Infections, Nontuberculous ; epidemiology ; microbiology ; Mycobacterium tuberculosis ; isolation & purification ; Nontuberculous Mycobacteria ; isolation & purification ; Prevalence ; Retrospective Studies ; Sputum ; microbiology ; Tuberculosis, Multidrug-Resistant ; epidemiology ; microbiology ; Tuberculosis, Pulmonary ; epidemiology ; microbiology

Tuberculosis (TB) has remained an ongoing concern in China. The national scale-up of the Directly Observed Treatment, Short Course (DOTS) program has accelerated the fight against TB in China. Nevertheless, many challenges still remain, including the spread of drug-resistant strains, high disease burden in rural areas, and enormous rural-to-urban migrations. Whether incident active TB represents recent transmission or endogenous reactivation has helped to prioritize the strategies for TB control. Evidence from molecular epidemiology studies has delineated the recent transmission of Mycobacterium tuberculosis (M. tuberculosis) strains in many settings. However, the transmission patterns of TB in most areas of China are still not clear. Studies carried out to date could not capture the real burden of recent transmission of the disease in China because of the retrospective study design, incomplete sampling, and use of low-resolution genotyping methods. We reviewed the implementations of molecular epidemiology of TB in China, the estimated disease burden due to recent transmission of M. tuberculosis strains, the primary transmission of drug-resistant TB, and the evaluation of a feasible genotyping method of M. tuberculosis strains in circulation.
China ; epidemiology ; Genotyping Techniques ; Humans ; Molecular Epidemiology ; Mycobacterium tuberculosis ; genetics ; Tuberculosis, Multidrug-Resistant ; epidemiology ; transmission ; Whole Genome Sequencing

Investigations on the genetic diversity of Mycobacterium tuberculosis in China have shown that Beijing genotype strains play a dominant role. To study the association between the M. tuberculosis Beijing genotype and the drug-resistance phenotype, 1286 M. tuberculosis clinical isolates together with epidemiological and clinical information of patients were collected from the center for tuberculosis (TB) prevention and control or TB hospitals in Beijing municipality and nine provinces or autonomous regions in China. Drug resistance testing was conducted on all the isolates to the four first-line anti-TB drugs (isoniazid, rifampicin, streptomycin, and ethambutol). A total of 585 strains were found to be resistant to at least one of the four anti-TB drugs. The Beijing family strains consisted of 499 (53.20%) drug-sensitive strains and 439 (46.80%) drug-resistant strains, whereas the non-Beijing family strains comprised 202 (58.05%) drug-sensitive strains and 146 (41.95%) drug-resistant strains. No significant difference was observed in prevalence (χ= 2.41, P > 0.05) between the drug-resistant and drugsensitive strains among the Beijing family strains. Analysis of monoresistance, multidrug-resistant TB, and geographic distribution of drug resistance did not find any relationships between the M. tuberculosis Beijing genotype and drug-resistance phenotype in China. Results confirmed that the Beijing genotype, the predominant M. tuberculosis genotype in China, was not associated with drug resistance.
Antitubercular Agents ; therapeutic use ; China ; epidemiology ; Drug Resistance, Multiple, Bacterial ; Genetic Variation ; Genotype ; Humans ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis ; genetics ; isolation & purification ; Phenotype ; Tuberculosis, Multidrug-Resistant ; drug therapy ; epidemiology

Objective: Drug-resistant tuberculosis (TB) may be resistant to one or multiple anti-TB drugs. We used generalized estimation equations to analysis the risk factors of drug-resistant TB and provide information for the establishment of a warning model for these non-independent data. Methods: The drug susceptibility test and questionnaire survey were performed in sputum positive TB patients from 30 anti TB drug-resistance surveillance sites in Zhejiang province. The generalized estimation model was established by the GENMOD module of SAS, with resistance to 13 kinds of anti-TB drugs as dependent variables and possible influencing factors, such as age, having insurance, HBV infection status, and history of anti-TB drug intake, as independent variables. Results: In this study, the probability of drug resistance at baseline level was 20.26%. Age, insurance, whether being co-infected with HBV, and treatment history or treatment withdrawal were statistically significantly correlated with anti-TB drug resistance. The prediction equation was established according to the influence degree of the factors mentioned above on drug resistance. Conclusion: The generalized estimation equations can effectively and robustly analyze the correlated binary outcomes, and thus provide more comprehensive information for drug resistance risk factor evaluation and warning model establishment.
Antitubercular Agents/therapeutic use* ; Drug Resistance, Multiple, Bacterial ; Humans ; Models, Statistical ; Mycobacterium tuberculosis/drug effects* ; Risk Factors ; Sputum/microbiology* ; Surveys and Questionnaires ; Tuberculosis/epidemiology* ; Tuberculosis, Multidrug-Resistant

China has a double burden of diabetes mellitus and tuberculosis, and many studies have been carried out on the mutual impact of these two diseases. This paper systematically reviewed studies conducted in China covering the mutual impact of epidemics of diabetes and tuberculosis, the impact of diabetes on multi-drug resistant tuberculosis and on the tuberculosis clinical manifestation and treatment outcome, the yields of bi-directional screening, and economic evaluation for tuberculosis screening among diabetes patients.
China ; epidemiology ; Coinfection ; epidemiology ; etiology ; microbiology ; Diabetes Mellitus ; epidemiology ; etiology ; Epidemics ; Mass Screening ; economics ; Prevalence ; Tuberculosis ; epidemiology ; microbiology ; Tuberculosis, Multidrug-Resistant ; epidemiology ; microbiology