SUNDAY, JUNE 24, 2018

China successfully halves national TB prevalence

A study recently published in The Lancet found that China exceeded its directly observed, short-course strategy for fighting tuberculosis five years before its target date, which may serve as a model for TB reduction strategies.

"One of the key global TB targets set by the Stop TB Partnership aims to reduce tuberculosis prevalence by 50 percent between 1990 and 2015," Study Leader Dr. Yu Wang said. "This study in China is the first to show the feasibility of achieving such a target, and China achieved this 5 years earlier than the target date."

Through implementing a more broad range prevention treatment plan, China was able to decrease its national TB prevalence by 57 percent and increase successful TB treatment by 87 percent. It achieved this by implementing the DOTS program across the nation and making health services available in every province of the country.

"The DOTS program has been much more effective in reducing the prevalence of tuberculosis in known cases than in new cases," the study's authors said. "Because the prevalence in known cases is already very low, future reduction in tuberculosis prevalence is likely to slow substantially unless control efforts in addition to the DOTS strategy are implemented, especially in earlier case detection and treatment and use of new instruments."

Director of the World Health Organization's Collaborating Centre for Tuberculosis and Lung Disease in Italy Giovanni Battista said the DOTS strategy is effective in developing countries, but to eradicate TB worldwide, a more intense strategy must be implemented.

"Long-term, rapid reduction in the tuberculosis burden leading to tuberculosis elimination will need additional efforts, including adoption of new instruments in diagnosis (rapid molecular testing for drug-susceptible and drug-resistant tuberculosis) and treatment (new drugs effective against drug-resistant cases), systematic diagnosis and treatment of latent tuberculosis infection, and better access to care by high-risk populations (including free diagnosis and treatment, and social protection mechanisms preventing income loss)," Battista said.