Acceptance of Chemo-prophylaxis for Latent Tuberculosis Infection among High School/College Student Contacts of Tuberculosis Patients in Shanghai, China

Student contacts of tuberculosis（TB）cases are susceptible to latent tuberculosis infection（LTBI）,and chemo-prophylaxis can reduce the risk of active TB among them.This study aimed to assess the acceptance of chemo-prophylaxis for LTBI among students, and their concerns regarding TB and its preventive treatment.

Treatment quality and outcome for multidrug-resistant tuberculosis patients in four regions of China: a cohort study

Background:China incurs an extremely low treatment coverage of multidrug-resistant tuberculosis(MDR-TB).This study aimed to understand the experience of MDR-TB patients on quality of health care,and the clinical impact through an up to six-year follow-up.Methods:Cohorts of MDR-TB patients were built in TB/MDR-TB designated hospitals in four regions of China from 2014 to 2015.Patients were followed up during treatment course,and yearly confirmation afterward until 2019.Delay in MDR-TB diagnosis and treatment was calculated upon bacteriological confirmation and treatment initiation.Risk factors for unfavourable outcomes were identified by multivariate logistic regression.Results:Among 1168 bacteriological-positive TB patients identified from a 12-million population,58(5.0%)MDR-TB cases were detected.The median delay for MDR-TB diagnosis was 90.0 days,with 13.8%having a delay above 180.0 days.MDR-TB treatment was only recommended to 19(32.8%)participants,while the rest continued with regimen for drug-susceptible TB.In MDR-TB treatment group,36.8%achieved treatment success,while the others had incomplete treatment(21.1%),loss to follow-up(36.8%)and TB relapse(5.3%).For non-MDR-TB treatment group,33.3%succeeded,25.6%relapsed,2.6%failed,23.1%died,and 15.4%were lost to follow-up.Overall,only 35.7%(20/56)of detected MDR-TB patients had favourable outcomes and higher education level was positively associated with it(adjusted odds ratio[aOR]:3.60,95%confidence interval[CI]:1.04-12.5).Conclusions:A large proportion of patients did not receive MDR-TB treatment and had unfavourable outcomes.Delayed MDR-TB diagnosis resulted in poor quality of MDR-TB care.Rapid diagnosis,regulated patient management and high-quality MDR-TB treatment should be enhanced in China.

Diverse bacterial populations of PM_(2.5) in urban and suburb Shanghai,China

Airborne bacteria play key roles in terrestrial and marine ecosystems and human health,yet our understanding of bacterial communities and their response to the environmental variables lags significantly behind that of other components of PM_(2.5).Here,atmospheric fine particles obtained from urban and suburb Shanghai were analyzed by using the qPCR and Illumina Miseq sequencing.The bacteria with an average concentration of 2.12× 10^(3 )cells/m^(3),were dominated by Sphingomonas,Curvibacter,Acinetobacter,Bradyrhizobium,Methylobacterium,Halomonas,Aliihoeflea,and Phyllobacterium,which were related to the nitrogen,carbon,sulfur cycling and human health risk.Our results provide a global survey of bacterial community across urban,suburb,and high-altitude sites.In Shanghai(China),urban PM2.5 harbour more diverse and dynamic bacterial populations than that in the suburb.The structural equation model explained about 27%,41%,and 20%^78%of the variance found in bacteria diversity,concentration,and discrepant genera among urban and suburb sites.This work furthered the knowledge of diverse bacteria in a coastal Megacity in the Yangtze river delta and emphasized the potential impact of environmental variables on bacterial community structure.

Post-2015,why delay to seek healthcare?Perceptions and field experiences from TB healthcare providers in northern Malawi:a qualitative study

Background:Malawi is a low-income country with high Tuberculosis(TB)burden.TB diagnosis delay and untimely initiation of treatment is still a major problem in Malawi which could increase the risk of tuberculosis transmission in the communities.This study investigated factors related to the diagnostic delay of tuberculosis from TB healthcare providers in the northern region of Malawi.Methods:Nine focus group discussions were conducted with 57 participants in total.The participants were healthcare cadres including district TB officers,clinical officers,TB nurses,laboratory technicians and Health Surveillance Assistants(HSAs).NVivo(11.0)software was used for data analysis.Results:The factors related to diagnostic delay were categorized into three themes:client factors,institutional factors and healthcare provider related factors.Client’s stigma and fear for HIV test,resource shortage within healthcare institutions and the healthcare workers’poor attitude against potential patients were among the most influential factors behind the TB diagnostic delay.Conclusions:The TB control strategies should aim to reduce HIV stigma,improve resource supply and improve TB healthcare workers’morale in order to achieve timely TB diagnosis.