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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