Study On The Evaluation Of TB Patients Screening Effect In People Living With HIV/AIDS In Yunnan And The Risk Factors Of Anti-tuberculosis Treatment Outcome

Objective To evaluate the effect of TB patients screening in people living with HIV/AIDS in Yunnan province during2010and2011, with or without Global Fund (GF).Analyze the epidemiology characteristics and anti-tuberculosis treatment outcome of TB/HIV co-infection patients in7counties, explore the risk factors on TB treatment of patients co-infected with TB/HIV disease, much guidance will be provided for further improving the efficiency of TB/HIV co-infection case finding and anti-tuberculosis treatment success. To learn and analyze the awareness of TB/HIV co-infection knowledge, as a basis for health promotion and health education of TB/HIV co-infection in the future. Inquire the social support state in patients with TB/HIV and its influence factors.Methods TB/HIV data collected through annual paper reports and China Information System for Disease Control TB Information System between2010and2011, calculated the TB screening rates and TB examining rates in HIV/AIDS, compared the case finding difference between GF counties and non-GF counties. Used China Information System for Disease Control TB Information System of access to medical record information, on-site verification the treatment related information and questionnaire investigation. Obtained the treatment outcome and treatment success rate of the7counties registration confirmed patients, analyzed the influence of of different demographic characteristics, treatment relevant information on treatment success. Got the awareness of TB/HIV co-infection knowledge and social support condition of these patients. The statistic methods used in this study included statistic description, Chi-square test, rank sum test, variance analysis, multivariate unconditional logistic regression.Results1By the end of2011,TB screening rates and examining rates among HIV/AIDS were higher than2010(P<0.001), TB screening rates and TB examining rates in GF counties were significantly higher than non-GF counties (P<0.001); In non-GF counties, bigger number of critically ill patients was found and diagnosis-delay was much longer than GF counties.2There were445TB/HIV patients started anti-tuberculosis treatment in7project counties during January2010to June2012, anti-tuberculosis treatment success rate was89.21%. The risk factor of Anti-TB treatment effect is:4-7TB suspicious symptoms at first visit (OR=2.208), from HIV/AIDS detection (OR=5.856), severe tuberculosis (OR=4.607),intensify phase direct pattern (OR=4.129)/whole processing management (OR=8.09) and interrupt anti-TB drugs (OR=21.517).3The awareness level of TB/HIV knowledge of patients in7project counties is relatively high, at82.33%.The awareness of the highest is free policy of TB and HIV/AIDS (93.27%), and the TB clinic location awareness the lowest (65.47%). Patients without health insurance awareness level is lower than those who had a care;4The average social support score in TB/HIV patients is (30.78+7.278), lower than the general population and TB patients; male, unemployed, person in custody, unmarried, divorced and widowed and nonlocal patients got lower social support score.Sex,marriage status and census register were the mainly influence factors of social support.ConclusionEarly detection of TB cases among people living with HIV and gave properly treatment management in time could enhance the life quality of TB/HIV patients. The work pattern of TB/HIV co-infection control achieved excellent effects in Yunnan province by the support of GF, and should be generalized in Yunnan province. The number of TB suspicious symptoms at first visit, case finding source of patients, severe tuberculosis, treatment management pattern and interrupt anti-TB drugs were the influence factors of therapeutic effect. The awareness level of TB/HIV knowledge of patients in7project counties is relatively high. Daily work of the health education has achieved good effect in these regions. The average social support score in TB/HIV patients were lower than the general population and TB patients, we need to focus on mental health of TB/HIV patients.