Tuberculosis in China often resistant to most drugs: researchers sound the alarm

by Michael Woodhead
The emergence of strains of tuberculosis that show multiple resistance to almost all available anti-TB drugs is causing great concern among Chinese clinicians.
A  study of more than 200 patients with tuberculosis in Harbin has found that one in four patients had tuberculosis that was resistant to at least one drug, and more than one in twenty had extensively drug resistant tuberculosis (XDR-TB) that was untreatable by commonly used anti-TB drugs such as isoniazid, rifampin, ethambutol, streptomycin, ofloxacin, and kanamycin.
Dr Yang Ying and colleagues from Harbin University of Science and Technology found that 26.3% of tuberculosis patients had isolates that showed resistance to at least one drug, while multidrug-resistant TB (MDR-TB) was seen in 6.8%of patients (3% of newly diagnosed patients and 22% of previously treated cases).
"The results of this analysis of drug resistance in Mycobacterium tuberculosis reflect the situation in a local hospital and indicate that the morbidity related to TB, especially MDR-TB, is still a serious health problem. Thus, the timely detection of drug resistance is of great importance to optimize treatment and to direct infection control measures to block the transmission of MDR-TB."
The results are published in the International Journal of Infectious Diseases.

Doctor bludgeoned to death by "revenge killer" former patient angry over nose job

by Michael Woodhead
The head of the ENT department at Qiqihar Beigang Hospital in Heilongjiang has been bludgeoned to death by an 18-year old youth who was dissatisfied with the treatment he received from the doctor.
According to Chinese media reports the young man surnamed Qi entered the hospital brandishing a 50cm steel pipe, which he used to bash in the face of Dr Sun Dongtao. A doctor who witnessed the attack said the young man bashed Dr Sun so violently in the face and throat that he was not recognisable. Despite receiving immediate treatment the 45-year old doctor died. The suspect was apprehended by police, who found he was a local high school student who had recently undergone treatment on his nose by Dr Sun but was dissatisfied. Police said he developed a deep feeling of resentment against Dr Sun and sought revenge.

Public health workers unprepared for emergencies

Public health workers in north east China are poorly prepared for emergency situations, a study has found.

A survey of 368 public health inspectors from 17 public health areas in Heilongjiang found that most staff believed they had adequate skills and compensation to manage in a crisis. However the study also found that competency and preparedness were lacking. Lack of explicit national job requirements, overlapping responsibilities and poor collaboration among agencies, together with poor knowledge and skills level of personnel, led to an ambiguity of responsibility, and hindered the preparedness competency of public health staff, according to the study in BMJ Open.

China medical research in the journals

No increase in obesity among rural children

There are no signs of an obesity epidemic among rural Chinese children, a study from has shown

Researchers from the Capital Institute of Paediatrics, Beijing, monitored overweight and obesity rates in more than 280,000 children from eight counties in Jiangsu and Zhejiang between 1998 and 2005. They found that the prevalence of overweight was barely changed from 3.7% in 1998 to 3.9% in 2005 and there was no increase in the 0.5% prevalence of obesity.  An increase in overweight/obesity was more likely in boys than girls, especially among those aged over three years. The study also found that the prevalence of stunting decreased dramatically.

Full study: Public Health

IVF conception for 1% of Chinese babies

About one in a hundred Chinese babies is born to women undergoing IVF or other assisted reproductive technology, Beijing researchers have shown. Dr Yang Xiaokui and co-researchers from the Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital analysed rates of ART among 112,403 deliveries from 14 provinces and 39 hospitals. They found the proportion of infants born as a result of ART in China was about 1.013% in 2011, compared to 4% in developed countries. Their study also found an increased maternal complications such as multiple gestation, higher cesarean section rate, low birth weight infants, higher infant mortality in women who conceived with the help of ART, compared with spontaneously pregnant women.
Full study: Fertility and Sterility

Urgent action needed on liver fluke infections in Heilongjiang

Liver fluke infestations are a common and increasing problem in China’s north east province of Heilonjiang, a study from Harbin Medical University has shown.

The infections, which are caused by eating undercooked fish,  were  seen commonly throughout Heilongjiang Province and mainly along the Songhua River, according to Dr Han Su and colleagues from the university. In a review of 4951 outpatients with suspected liver fluke infections the overall prevalence of clonorchiasis was 26%.  Rates of infection increased from 22.5% in 2009 to 34% in 2012. Farm labourers accounted for two thirds of cases and consumption of freshwater fish was the strongest risk factor. Cases of re-infection were common.

“The present study revealed that clonorchiasis remains widespread and prevalent in Heilongjiang Province. An integrated control programme is urgently needed to reduce the public health impact of clonorchiasis in this endemic area.”

Full study: PLOS One

Benzodiazepine use linked to benign brain tumours

Benzodiazepines may increase the risk of benign brain tumours, according to Taiwanese researchers. In a review of  62,186 patients who had been prescribed benzodiazepines, they found that rates of benign brain tumours were more than three times higher in patients using benzodiazepines. The risk of benign brain tumours was dose dependent and increased over time with increasing exposure to benzodiazepines. There was no increase seen in risk of malignant brain tumours, but this may have been due to the low number of such tumours in the study group.

Full study: Journal ofthe Neurological Sciences

SMS reminders improve allergy medication compliance

For patients with allergic rhinitis, a daily SMS reminder is an effective way to improve adherence with intranasal corticosteroid treatment medication and treatment outcomes, according to researchers from the Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital.

In a study of 50 patients with allergic rhinitis they showed that adherence to medication was 60% in the SMS group and 28% in the control group. Clinic attendance and allergy symptoms scores were also better for patients who received SMS reminders.

Full study: International Archives of Allergy and Immunology

Urgent action needed on HIV in Heilongjiang

by Michael Woodhead

A HIV epidemic in Heilongjiang has shown explosive growth since 2009 and homosexual contact has become the dominant route of HIV transmission, research shows.

Dr Shao Bin and co-researchers at the Public Health College of Harbin Medical University says action is urgently needed to curb the HIV outbreak in the northeast.

Analysing data from the provincial surveillance system for HIV infections, they found there had been 3062 HIV-infections in the area up to 2012, with 426 deaths. Since 2007, homosexual transmission has increased and become the dominant route of HIV transmission, accounting for 58% of cases during 2009–2010, and 69% during 2011–2012.

Gay men with HIV infections tended to be younger (21–30), unmarried, urban residents and have college or higher education.

“The current existing prevention strategy is not enough to prevent new infections. … Urgent intervention is needed to recognize and target this population, ,” the researchers said

Full study: Journal of Infection