TB in China, participants also discussed the country’s MDR and XDR TB regimens, the treatment of MDR TB in hospitals, the role of HIV infection, and diabetes as a comorbidity in TB patients.
Mingting Chen, Vice Director and Researcher, National Center for Tuberculosis Control and Prevention, China CDC, described survey information on China’s MDR TB prevalence and treatment and prevention approaches.
Results from the 2010 Fifth Nationwide TB Prevalence Survey in China show that all types of TB declined to 459 per 100,000 in 2010, compared with 466 per 100,000 in 2000. Smear-positive TB declined from 169 per 100,000 in 2000 to 66 per 100,000 in 2010—a “remarkable decrease” of about 61 percent, said Mingting Chen. Bacteriologically confirmed TB fell from 216 per 100,000 in 2000 to 119 per 100,000 a decade later, a decrease of 45 percent. China has 100 percent coverage of Directly Observed Treatment-Short course (DOTS), its case detection rate of new TB cases is 80 percent, and its cure rate for new TB cases is above 90 percent. More than 4.5 million smear-positive patients were cured from 2001 to 2010, and China achieved its millennium development goal for TB control 5 years ahead of schedule.
Chen laid out the steps necessary to prevent MDR and XDR TB. First, the quality of basic DOTS needs to be enhanced by consolidating a strong government commitment, improving the TB laboratory services network, and improving identification and care of TB patients in vulnerable groups. In addition, the recording and reporting system for TB needs to be strengthened, the quality of FLDs and SLDs needs to be improved, standard operating procedures in drug supply and management systems need to be implemented, and cooperation between public health institutions (such as China CDC) and hospitals needs to be intensified.
China has undertaken technical support for the treatment of MDR and XDR TB patients, providing national guidelines for the management of DR TB, issued in 2012 by China CDC; a manual for management of SLDs; guidelines for infection control; guidelines for adverse reactions to DR TB chemotherapy; and standard operating procedures for culture and DST. China also has launched a pilot project for the programmatic treatment and management of MDR and XDR TB patients (PMDRT). This initiative includes the formulation of a national framework and working plan for the PMDRT, as well as a gradual increase in the number of pilot
1 This section is based on the presentation by Mingting Chen, Vice Director and Researcher, National Center for Tuberculosis Control and Prevention, China CDC.