| Objective To study the epidemic characteristics and treatment outcome of tuberculosis (TB) patients in Tianjin Prison System from2000to2009, and analyses the factors associated with the treatment outcome of TB, in order to provide more effective strategies for TB control in Tianjin Prison System.Methods TB control work of the prison system was included in the Tianjin tuberculosis control program, which was organized and implemented by Tianjin Bureau of Prisons and technically supported by Tianjin TB Control Center. All of1811tuberculosis cases of Tianjin prison system registered from2000to2009in Tianjin TB Control Center, who were found by census and symptom based case-finding, took the directly observed treatment of short course strategy and the effect of treatment was evaluated.Results Of1811active patients,1780(98%) were male, and31(2%) were female. The male to female ratio was57.42:1. The minimum age of the patients was18years, the maximum70years, average37.8years. The registration rates of TB patients diagnosed by census in Tianjin prison system decresde from2236.84/100000in2000to251.19/100000in2009. Of1811TB patients, there were1678cases of pulmonary TB and133cases of tuberculous pleurisy. Of1678pulmonary TB patients,176(10.5%) cases were smear-positive and1502(89.5%) cases were smear-negative:1508(83%) cases of initial treatment and303(16.7%) cases of retreatment cases.Three ways were taken to find cases.343cases were diagnosed by the way of physical examination,956cases were confirmed by census, and512cases were found due to clinical symptoms. Of1811patients,45.6%had typic tuberculosis symptoms, i.e. had cough and cough up sputum for≥2weeks and emptysis,12.8%had cough and cough up sputum for <2weeks,15.3%had other symptoms such as chest tightness, chest pain, fever, night sweats, fatigue, loss of appetite and26.3%were asymptomatic. The results of X-ray examination showed that85%(1531/1811) of patients had lesions in1-2lung fields, and15.46%(280/1811) had lesions in3-6lung fields.9%(156/1811) of patients with X-ray examination showed empty in lung field.From2000to2009,176cases of smear-positive pulmonary TB patients in Tianjin prison system were treated and managed, of which129cases were cured, the cure rate was73.30%. The cure rates were79.63%in new smear positive cases and63.24%in retreated smear positive cases, respectively. The difference was statistically significant (χ2=5.73, P=0.0167). No significant upward or downward trend of cure rates of smear-positive TB patients during2000to2009(P>0.05). In addition,23cases were treatment failure,4cases died, one case had adverse reactions and19cases were lost in smear positive cases.Of1635cases of smear-negative pulmonary TB and tuberculosis pleurisy,1448cases completed the course of treatment; the rate of treatment completion was88.6%. The rates of treatment completion were89.0%and86.0%in new and reteated patients respectively, but the difference was not statistically significant (χ2=1.8390, P=0.1751). The rates of treatment completion was rising during2000to2009(P=0.0353). A total of187cases of smear-negative pulmonary TB and tuberculosis pleurisy patients did not complete the therapy. Among them,19cases were treatment failure,18cases died,4cases had adverse reactions and136cases were lost.Conclusions Tuberculosis control program in Tianjin prison system during2000to2009had achieved good effect on the finding and management of TB patients. The results of the present study may lay a good foundation for exploring more effective tuberculosis control model in Tianjin prison system. |
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