Epidemiological Characteristics Which Extra Pulmonary Tuberculosis(tuberculosis Of Bone And Joint)in The Prison System Of Tianjin

Objective:To study the epidemic characteristics and treatment outcome of extrapulmonary tuberculosis(Osteoarticular tuberculosis)among prisoners in TiaIljin Prison System from 2000 to 2014,and to understand the epidemic rule of extrapulmonary tuberculosis in Tianjin Prison System and factors associated with the treatment outcome of it;and to study the epidemic characteristics and treatment outcome of pulmonary tuberculosis in TiaIljin Prison System from 2000 to 2014,analyzing the influence to prevalence of extrapulmonary tuberculosis(Osteoarticular tuberculosis)through the census of tuberculosis and directly under the interview of DOTS,in order to provide basis for more effective tuberculosis control strategy and control mode in prison system.Methods:Through the statistic screening and follow-up visit of inpatients and outpatients in Tianjin prison center hospital(Xinsheng hospital)and another ten prison hospitals in fifteen years from 2000 to 2014,taking the 148 diagnosed Osteoarticular tuberculosis patients,other 184 extrapulmonary tuberculosis patients,with a total of 332 cases as the study object,analyzing and summarizing their disease characteristics and treatment outcome;and summarizing 2656 pulmonary tuberculosis patients who are diagnosed and registrated in Tianjin prison system from 2000 to 2014,understanding its epidemic rule.In addition,comparing the epidemiological characteristics of extrapulmonary and pulmonary tuberculosis patients in ten prisons for 15 years,in order to know whether there is a correlation between them.Results:There are 2656 pulmonary tuberculosis and 332 extrapulmonary tuberculosis who are registrated during 2000-2000,of which the number of Osteoarticular tuberculosis is 148(44.58%);and among the 148 cases,there are 142 men and 6 women.Patients from 25 to 34 are most(40.54%),of which there are 37 cases(25%)having clear evidence of tuberculosis infection in lungs.The number of patients combing drug abuse is 33 cases(22.30%),and the number of patients with HIV is 9(6.08%).The median time from entering the prison to the onse tis 47.5 months.Of the Osteoarticular tuberculosis,the number of spinal tuberculosis is the most(119,80.41%),followed by pelvic tuberculosis with a number of 6(4.05%);of the spinal tuberculosis,the number of thoracic tuberculosis is the most(53,44.54%),followed by lumbar tuberculosis with a number of 52(43.70%),and the number of cervical vertebra tuberculosis is the least(14,11.76%),of which 12 thoracic12 lumbar 1 vertebral bodies(thoracic lumbar segment)are easiest to be attacked,and there are 61 cases with two sections involved(51.3%),in addition,the number of patients with vertebral abscess is 52(51.3%),of which thoracic is the most(50.94%).What's more,there are 30 cases accepting surgical treatment,and the rest getting conservative treatment by anti-tuberculosis drugs,of which 27 cases are clinical cured,93 cases are improved,and 13 cases opened during the treatment process,4 cases of are released,and 10 cases are not cured,1 case with drug abuse and HIV died for a heart attack.The total detection rate of pulmonary tuberculosis in Tianjin prison system from 2000 to 2014 is 906.03/105,falling from 1741.49/105 in 2000 to 777.22/105 in 2014;The total detection rate of extrapulmonary tuberculosis is 129.99/105,falling from 301.86/105 in 2000 to 76.09/105 in 2014;The total detection rate of Osteoarticular tuberculosis is 57.95/105,falling from 116.10/105 in 2000 to 21.74/105 in 2014.By doing rank correlation analysis to the detection rate of pulmonary and extrapulmonary and Osteoarticular tuberculosis among the number of 15 years,we find that the detection rate of pulmonary and extrapulmonary tuberculosis is positively related(rs = 0.604,P = 0.017),and the detection rate of extrapulmonary and Osteoarticular tuberculosis is positively related(rs = 0.864,P = 0.000),and there is no relation between Osteoarticular tuberculosis and pulmonary tuberculosis(rs = 0.364,P = 0.182).Conclusion:By implementing modern tuberculosis control strategy of tuberculosis in Tianjin prison system,the detection rate of pulmonary tuberculosis,extrapulmonary tuberculosis,Osteoarticular tuberculosis are all reduced.the trend of tuberculosis epidemic is on the decline.By doing rank correlation analysis to the detection rate of pulmonary and extrapulmonary and Osteoarticular tuberculosis among the number of 15 years,we find that the detection rate of pulmonary and extrapulmonary tuberculosis is positively related,and the detection rate of extrapulmonary and Osteoarticular tuberculosis is positively related,and there is no relation between Osteoarticular tuberculosis and pulmonary tuberculosis.Therefore,we think,To reduce the incidence of pulmonary tuberculosis can reduce the incidence of extrapulmonary tuberculosis.Osteoarticular tuberculosis incidence is more complicated,Now we are lack of multi-center large sample research.It is recommended to bringing extrapulmonary tuberculosis into the modern TB control system.