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      Promising of Multidrug-resistant Tuberculosis Screening among New Tuberculosis Patients in China

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      Chinese Medical Journal
      Medknow Publications & Media Pvt Ltd

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          Abstract

          Peng et al.[1] reported that the MDR-TB burden among the new tuberculosis (TB) patients accounted for more than 1/4th of all multidrug-resistant TB (MDR-TB) cases in the past 5 years in Zhejiang province, although the identified rate of MDR-TB among 9830 new TB cases was only 2.0%. Drug-resistant TB, especially MDR-TB, is a major threat to the control of TB worldwide. However, due to high cost and limited budget, screening on MDR-TB has not been implemented among all TB cases by now. A Chinese survey indicated that the prevalence of MDR-TB was 5.7% in the new TB cases and 25.6% in the previously treated cases in 2007. In the period of 2011–2015, MDR-TB screening has been provided for the patients who are at high risk of drug-resistant TB in the National TB Control Program (NTP) implementation. It was estimated that there were 57,000 MDR/rifampicin-resistant (MDR/RR)-TB cases among the notified pulmonary TB cases in 2015 in China, but only 9662 MDR/RR cases were identified, this figure was much lower in comparison with the estimated cases. Clearly, most MDR-TB cases have been lost due to limited coverage of drug-resistant screening. Fortunately, this situation will be changed sooner with the development of technologies and economy in China. The technologies of MDR-TB tests developed rapidly in the recent years, such as GeneXpert® recommended by the WHO, substantially reduced the time needed for diagnosis. The “13th Five-Year Plan” of China NTP promised that all suspected pulmonary TB patients will be provided for sputum smear and culture examination and drug-resistance will be of course screened for etiologically positive pulmonary TB patients, including both new TB and those at high risk of MDR-TB. The county-level hospitals will take the important roles to diagnose TB cases and screening MDR-TB timely. This is an undoubtedly ambitious plan for screening MDR-TB among one million TB cases, of which more than 85% are new TB cases. However, the preliminary study of Peng et al. presented a promising and encouraging perspective for this plan, and we truly expect and indeed believe that the “13th Five-Year Plan” will bring a different contribution to control TB in China. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

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          Multidrug-resistant Tuberculosis Burden among the New Tuberculosis Patients in Zhejiang Province: An Observational Study, 2009–2013

          Background: Screening on multidrug-resistant tuberculosis (MDR-TB) has been limited to the serious TB subpopulations excluding the new TB patients. This study aimed to examine MDR-TB burden among the new TB patients. Methods: We conducted a study in Zhejiang Province during 2009–2013 to screen for MDR-TB patients among the low MDR-TB risk patients and five subpopulations of high MDR-TB risk patients. The number, prevalence, and trend of MDR-TB were compared while the logistic regression model was used to examine risk factors related to MDR-TB. Results: A total of 200 and 791 MDR-TB cases were, respectively, identified from the 9830 new TB cases and 2372 high-risk suspects who took MDR-TB screening from 2009 to 2013. The MDR-TB rates went down in both of the new TB patients and five MDR-TB high-risk groups over the study time, but the percentage of MDR-TB patients identified from the new TB patients in all diagnosed MDR-TB cases kept stable from 28.3% in 2011 to 27.0% in 2012 to 26.0% in 2013. Conclusions: The study indicated that MDR-TB burden among new TB patients was high, thus screening for MDR-TB among the new TB patients should be recommended in China as well as in the similar situation worldwide.
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            Author and article information

            Journal
            Chin Med J (Engl)
            Chin. Med. J
            CMJ
            Chinese Medical Journal
            Medknow Publications & Media Pvt Ltd (India )
            0366-6999
            05 September 2017
            : 130
            : 17
            : 2142
            Affiliations
            [1 ]National Center for Tuberculosis Prevention and Control, Chinese Center For Disease Control And Prevention, Beijing 102206, China
            [2 ]National Institute of Drug Dependence, Peking University, Beijing 100191, China
            Author notes
            Address for correspondence: Dr. Hui Zhang, National Center for Tuberculosis Prevention and Control, Chinese Center For Disease Control and Prevention, No.155 Changbai Road, Changping District, Beijing 102206, China E-Mail: zhanghui@ 123456chinatb.org
            Article
            CMJ-130-2142
            10.4103/0366-6999.213433
            5586195
            28836569
            c8cdce22-781a-4742-bae2-d2e0728f243f
            Copyright: © 2017 Chinese Medical Journal

            This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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            : 13 July 2017
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