Sino-Singapore Health | Sino-Singapore disease control expert: my country’s tuberculosis epidemic presents the characteristics of “three excess and one serious”

　　China News Service, Beijing, March 24 (Reporter Zhang Ni) If asked "whether there are any tuberculosis patients around me", many people may answer "never heard of it". However, in reality, as one of the oldest infectious diseases in the world, tuberculosis is still a stubborn disease plaguing the world to this day.

　　"Compared with the world, my country's tuberculosis epidemic burden is relatively heavy, ranking third in the world, and the number of infected people is also larger." Zhao Yanlin, director of the Tuberculosis Control Center of the Chinese Center for Disease Control and Prevention, revealed in Beijing a few days ago that my country's tuberculosis epidemic situation is "more than three percent" "One heavy" feature.

The current situation of the epidemic situation of “three excesses and one seriousness”

　　The "Global Tuberculosis Report 2023" released by the World Health Organization shows that in 2022, the estimated number of new tuberculosis patients in my country is 748,000 (780,000 in 2021), and the estimated incidence of tuberculosis is 52/100,000 (55/10 in 2021). Ten thousand). Among the 30 countries with high tuberculosis burden, my country ranks third in the estimated incidence of tuberculosis, accounting for 7.1% of the global incidence.

　　"The current situation of my country's tuberculosis epidemic can be summarized as 'heavy burden, many infections, many incidences, and many reports'."

　　Recently, Zhao Yanlin said this at the theme salon of "Technological Upgrading to Accelerate the End of the Tuberculosis Epidemic in my country" held by the Social Media Research Center of Peking University.

　　He further explained that because our country has a large population base and many infected people, both the number of cases and the number of reported patients ranks second among Class A and B infectious diseases in my country.

　　At the same time, like many countries, "seeking treatment for symptoms" is currently the main way to detect tuberculosis patients in my country. "The main difficulty facing tuberculosis prevention and control at present is early detection. Tuberculosis is somewhat hidden, and about 20% of suspected cases are asymptomatic."

　　Zhao Yanlin said that from the perspective of the incidence and spread of tuberculosis, subclinical tuberculosis patients (with lesions in the body but no clinical manifestations, which can be detected with current medical methods) and active tuberculosis patients are two very important groups. If we can Moving forward, identifying these two types of tuberculosis patients as early as possible and intervening to block the infection can reduce their spread in the community.

　　To block the spread of these two groups, screening and early intervention of high-risk groups is particularly important. This is also the core measure to upgrade the prevention and control strategy from the technical level.

To avoid “returning to poverty due to tuberculosis”, local practices are worth learning from

　　The reporter learned at the meeting that the full treatment cost for an ordinary non-drug-resistant tuberculosis patient is almost 15,000 yuan, while the cost for a drug-resistant patient may reach 200,000 yuan, posing a heavy disease burden. In order to interrupt the spread of the epidemic and prevent "return to poverty due to tuberculosis", local disease control departments are also exploring their own paths.

　　For example, in Yunnan, 80% of poor tuberculosis patients are concentrated in 57 rural revitalization assistance counties, which account for only 40% of the province's population. According to Xu Lin, director of the Tuberculosis Prevention and Control Institute of the Yunnan Provincial Center for Disease Control and Prevention, targeting key groups It is the most cost-effective method of screening for tuberculosis.

　　Yunnan has incorporated tuberculosis screening into basic public services for key groups such as the elderly and diabetic patients. In 2023, chest X-ray examinations for people aged 65 and above will be included in the annual physical examination. At the same time, incentives will be clearly defined to provide treatment to patients with suspected tuberculosis. Recommended to primary medical institutions in designated medical hospitals for subsidies.

　　With the combined effect of these measures, the tuberculosis screening rate among key populations in Yunnan has reached 80%, and the standardized management rate and successful treatment rate have both reached 90%.

　　Zhu Limei, director of the Chronic Infectious Disease Prevention and Control Institute of the Jiangsu Provincial Center for Disease Control and Prevention, said that as early as 2021, Jiangsu Province established a provincial health cloud imaging platform. Jiangsu Province installed an AI artificial intelligence film reading system on the cloud imaging platform at the end of last year. In the future, it is expected to achieve early detection of lung diseases including tuberculosis through artificial intelligence-assisted film reading across the province.

　　In addition, Jiangsu Province provides all second-line drugs of Group A and Group B, including bedaquiline, free of charge to all drug-resistant patients. The successful treatment rate for drug resistance reaches 85.6%, ranking first in the country and much higher than the global average. 63 %.

　　In Zhejiang, tuberculosis-free communities are the main focus of strengthening proactive screening and preventive treatment. Chen Bin, director of the Tuberculosis Prevention and Control Institute of the Zhejiang Provincial Center for Disease Control and Prevention, said that Zhejiang Province has proposed to build "tuberculosis-free communities" with full provincial coverage and promote the implementation of tuberculosis-free communities in Zhejiang from top to bottom at the government level. Thanks to policy and mechanism guarantees and multi-channel financing methods, Zhejiang Province has achieved very positive linkages in the process of building tuberculosis-free communities.

　　Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, once said, "Today, we have the knowledge and tools they have dreamed of. We have the political commitment, and we have an opportunity unprecedented in human history: the opportunity to write the last chapter of the tuberculosis story."

　　Today, it is imperative to seize this opportunity. (over)