More than 10% of China’s annual tuberculosis cases are multi-drug resistant (MDR), according to a national TB survey published Thursday in The New England Journal of Medicine which “pulls no punches” in describing China’s subpar record of detection and treatment of the disease. From NPR:
And still worse, most of these resistant cases are being passed from patient to patient. So drug-resistant forms of TB are circulating in the community, they’re not just being created one patient at a time when an individual doesn’t get a full course of the right drugs (although that’s happening too).
“The results of this nationwide survey in China confirm that the country has a serious epidemic of drug-resistant tuberculosis,” write study authors, who mostly work at the Chinese Center for Disease Control and Prevention, a government agency.
Writing in the New England Journal of Medicine, the researchers report that a third of new TB cases and half of patients with previously treated TB have drug-resistant forms.
“China has the highest annual number of MDR tuberculosis in the world — a quarter of the cases worldwide,” the Chinese experts note in a forthright statement that bears no trace of muting the problem for the sake of national pride.
“The situation is already pretty dire,” Daniel Chin, a TB Program officer at Bill & Melinda Gates Foundation in Beijing and a co-author of the study, said in an interview. “We have no reason at all to believe that the situation has gotten any better in the intervening time. Once you go into the country- side, TB is everywhere and is one of the major infectious diseases still afflicting the Chinese population.”
About 44 percent of patients with multi-drug resistant TB who had received previous treatment had not completed their last course, which means more continuity of care is needed, the researchers said.
The survey involved 10 of China’s 31 provinces that have 1.36 billion of the country’s population. Some data in the study had been reported to the World Health Organization and published in its report.
The generic medicines rifampin and isoniazid are used to treat TB, and when drug-resistant bacteria are involved, patients need to take multi-therapy combinations or newer, expensive antibiotics.