Tuberculosis control in China

Lin, H.H., Wang, L., Zhang, H., Ruan, Y., Chin, D.P. and Dye, C., 2015. Tuberculosis control in China: use of modelling to develop targets and policies. Bulletin of the World Health Organization, 93, pp.790-798.

  • MDR tuberculosis often results from person-to-person transmission, not just unsuccessful hospital treatments.
  • China likely cannot meet the current global targets for tuberculosis control.
  • By 2010, China achieved older global targets of halving tuberculosis prevalence and mortality between 1990 and 2015.
  • This success was driven by shifting tuberculosis treatment from hospitals to Chinese CDC public health centers.
  • Future reductions in tuberculosis incidence and mortality are expected to be much slower.
  • The most optimistic scenario predicts only an 18% reduction in incidence and a 28% reduction in mortality between 2015 and 2025.
  • Current targets will not be met by 2025 with passive surveillance alone.
  • Active and enhanced surveillance may accelerate declines in tuberculosis but with unclear individual and community benefits.
  • The global tuberculosis targets for 2035 (90% reduction in incidence, 95% reduction in mortality) appear even less attainable.
  • Achieving the 2035 targets may require a new vaccine or prophylactic treatment for latent infections.
  • Reducing MDR tuberculosis prevalence could be achieved by improving treatment of drug-susceptible tuberculosis or enhancing MDR tuberculosis diagnosis and treatment.
  • A combination of both interventions could lead to the greatest impact, with an estimated 75% decline in MDR tuberculosis prevalence over the decade starting in 2015. 
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