ObjectiveTo analyze the reported incidence rate of pulmonary tuberculosis and diagnosis and treatment of pulmonary tuberculosis patients in Jing’an District, Shanghai from 2018 to 2023, and to provide a reference basis for the prevention and treatment of pulmonary tuberculosis. MethodsMedical records, including demographic information, diagnosis and treatment information, laboratory testing results, treatment outcomes, patient prognoses, and etc., of all the patients registered for first-time management, with the disease type of pulmonary tuberculosis in Jing’an District from January 1, 2018 to December 31, 2023 were extracted from the Tuberculosis Management Information System of China’s Disease Control and Prevention Information System.The reported incidence rate of pulmonary tuberculosis from 2018 to 2023 was analyzed. Additionally, the delay rate for medical consultation, diagnostic delay rate, prevalence of pulmonary cavity, rate of sputum smear-positive, sputum conversion rate of smear-positive patients after 2 months, proportion of deaths attributable to pulmonary tuberculosis or other causes, and the proportion of patients with treatment duration >1 year in 2018‒2019, 2020‒2022, and 2023 were compared, respectively. ResultsA total of 1 378 pulmonary tuberculosis patients were registered for management in Jing’an District in 2018‒2023, with a reported incidence rate of 25.97/100 000, 25.72/100 000, 23.93/100 000, 22.36/100 000, 18.18/100 000, and 22.32/100 000, respectively. Meanwhile, the overall reported incidence rates in 2018‒2019, 2020‒2022, and 2023 were 25.84/100 000, 21.53/100 000, and 22.32/100 000, respectively. The median age of the patients was 56 (33, 67) years, with a male-to-female ratio of 1.94∶1. The patients with a household registration of Shanghai accounted for 70.75%, among whom those aged between 61‒<71 years were the majority. Whereas, those aged between 31‒<41 years accounted for a higher proportion in the long-term resident population. The median delay times of patient’s medical consultation, diagnosis, and case-finding were 25 (19, 33) days, 29 (21, 43) days, and 41 (32, 66) days, respectively. The delay rate for medical consultation was higher in 2020‒2022 (47.99%) and 2023 (46.89%), but lower in 2018‒2019 (31.02%). In 2018‒2019, 2020‒2022, and 2023, the diagnostic delay rate was 12.41% (68/548), 13.53% (84/621), and 16.75% (35/209), respectively. Besides, during the same time the delay rate in case-finding was 19.53%, 27.05% and 34.45%, respectively, all exhibited an increasing trend. Furthermore, the rate of patients with pulmonary cavity was 16.06%, 14.98%, and 11.00%, respectively, showing a decreasing trend. Furthermore, the rate of sputum smear-positive was 27.19%, 33.33% and 32.54%, while the sputum conversion rate of smear-positive patients after 2 months was 81.21%, 85.02% and 89.71%. The mortality rates due to tuberculosis and other causes were 3.10%, 5.64%, and 3.83%, respectively. The proportion of patients with a treatment duration of ≥365 days was 44.27% in 2018‒2019, 39.93% in 2020‒2022 and 26.60% in 2023. ConclusionThe overall reported incidence rate of pulmonary tuberculosis in Jing’an District showed a decline trend from 2018‒2022, with a slight rebound in 2023. Targeted interventions should be prioritized for the elderly with local household registration and young permanent residents without Shanghai household registration.

Tuberculosis （TB） and human immunodeficiency virus infection / acquired immune deficiency syndrome （HIV/AIDS） are both serious global public health threats. Early detection of infected persons and/or patients through TB/HIV bi-directional screening is crucial for prevention and control strategy in China and globally. In recent years， with the promotion and application of new TB and HIV detection technologies worldwide， TB/HIV bi-directional screening technologies and strategies have made remarkable changes. This expert consensus introduces the significance and challenges of TB/HIV bi-directional screening， summarizes important progress of research and applications， and makes recommendations on screening measures and procedures to further strengthen TB/HIV bi-directional screening in China.

ObjectiveTo determine the quality of life among HIV-infected individuals and risk factors in Jing’an District of Shanghai. MethodsThis is a cross-sectional study. Cluster sampling strategy was used to select HIV-infected individuals who were registered with the national HIV/AIDS case reporting system in eight community health service centers in Jing’an District of Shanghai. The short form 36 （SF-36） scale， self-rating anxiety scale （SAS）， social support scale （SSS） and specifically designed questionnaires were used to collect information. Logistic regression was used to determine the factors associated with quality of life. ResultsIn total， 365 HIV-infected individuals were included in the study. The total average score of quality of life was 79.5±10.4. The scores in general health， vitality and emotional well-being were lower than the norm， whereas the scores in other dimensions were higher than the norm. Multivariable logistic regression indicated that age of 45‒ years （vs age of 18‒ years： OR=0.23， 95%CI： 0.08‒0.68） was significantly associated with the quality of life. Furthermore， smoking （OR=2.18， 95%CI： 1.22‒3.90）， lower CD4⁺T cell counts （<350 cell·μL^-1， OR=2.89， 95%CI： 1.54‒5.40）， comorbidity （≥2 kinds， OR=3.40， 95%CI： 1.15‒10.04） and anxiety （OR=1.09， 95%CI： 1.05‒1.14） were risk factors associated with declining quality of life. ConclusionIt warrants more attention to those HIV-infected individuals with poor psychological status， smoking， low CD4⁺T cell counts and comorbidities. Targeted health care and social support could effectively improve the quality of life among HIV-infected individuals.

Objective To evaluate the relationship between CD4+ T lymphocyte count and results of enzyme-linked immunospot (ELISPOT) assay in human immunodeficiency virus (HIV)-Mycobacterium tuberculosis (M.tb) coinfected patients.Methods A total of 193 HIV-infected individuals in Yunnan Province and Shanghai were enrolled.T-SPOT.TB assay was employed to detect M.tb specific T lymphocyte in the peripheral blood mononuclear cells (PBMC).CD4+ T lymphocyte in PBMC from the enrolled subjects was detected by flow cytometry.Data were analyzed using t test.ResultsThe incidence of latent tuberculosis in HIV-infected individuals was 30.6％.The CD4+ T lymphocyte counts in HIV-infected individuals with active tuberculosis were 190×106/L,which were significantly lower than those in HIV-infected individuals with latent tuberculosis (484×106/L; t=6.665,P＜0.01).The HIV-infected individuals were stratified according to CD4+ T lymphocyte counts of ＞500×106/L,200×106-500×106/L,and ＜200×106/L and the constituent ratios of active tuberculosis/latent tuberculosis were 1∶16.2,1∶1.3 and 5.6∶1,respectively.Among 79 subjects with positive T-SPOT.TB results,20 were coinfected with active tuberculosis,in which 14 had CD4+ T lymphocyte counts of ＜200 ×106/L,5 had 200×105-500×106/L and 1 had ＞500×106/L.Fifty-two in 59 HIV/latent tuberculosis patients individuals had CD4+ T lymphocyte counts of ＞200×106/L.ConclusionsThe prevalence of latent tuberculosis in HIV-infected individuals is high in China.Cellular immunity in HIV-infected individuals with active tuberculosis is severely impaired.With the decrease of CD4 ′ T lymphocyte counts,patients with latent tuberculosis are prone to develop active tuberculosis in HIV-infected individuals.The negative predictive value of T-SPOT.TB is significantly diminished in patient with low CD4+ T lymphocyte counts,especially less than 200×106/L.

Objective To analyze the situation of inquirer in Shanghai Jing'an district AIDS voluntary coun-seling and testing(VCT). Methods Inquirer were serviced by trained counselors before and after HIV antibody tes-ring,each inquirer were asked to complete a "Advisory Cases Registration Form". Results Inquirer were male-domi-nated,accounting for 85.7%. And inquirer's age were mainly 25 ～ 34 years old, which accounting for 55.8%. The types of inquirer were mainly because of male non-married heterosexual sexual contact, female non-married heterosex-ual contact, male homosexual sexual sexual contact, which accounted for 77.4%, 11.8% and 3.7%, respectively. For the total of three categories accounted for 92.9%. Inquirer aged 25 ～ 34 years old in 2007 were more than 2006 ,and inquirer because of male non-married heterosexual sexual contact in 2007 were more than 2006. There were 2 infectors because of male homosexual sexual contact in 3 positive infectors who were screened in 2007. Conclusion VCT played more and more important role in AIDS prevention and control, and it should be further strengthened and ex-panded.