Early screening, treatment key to putting end to tuberculosis

Despite advances, concerted efforts still needed to overcome bacterial disease

Although China has made exceptional progress in reducing tuberculosis in recent years, health experts said the sheer number of TB infections in the country remains large and concerted efforts in expanding early screening, subsidizing treatment and developing novel testing tools are needed to tackle the disease.

This Friday marks the 28th World Tuberculosis Day, which aims to raise public awareness about the infectious disease that claimed 1.6 million lives globally in 2021.

It is caused by a bacterium that usually attacks the lungs and can spread between people through tiny droplets exhaled by an infected person.

Peng Liyuan, wife of Chinese President Xi Jinping and the World Health Organization goodwill ambassador for TB and HIV/AIDS, said in a written speech on Wednesday that China has been actively promoting new diagnostic techniques, therapies and management tools, and as a result, the cure rate for TB patients has been maintained above 90 percent.

However, she added that TB remains a global public health issue and there is still a long way to go to end TB globally.

Zhao Yanlin, director of the TB prevention and control center at the Chinese Center for Disease Control and Prevention, said that TB domestically has been declining consistently in recent years, with the incidence rate falling from 104 per 100,000 people in 2001 to 55 per 100,000 people last year.

"The death rate has also been kept under 2.1 per 100,000 people, paralleling that in developed countries," he said in an interview this month.

Despite the notable progress, Zhao said China still has the world's third-largest TB burden after India and Indonesia. "Each day, about 2,000 new TB cases are reported in the country," he said.

Zhao said a serious challenge is to counter the rising rate of drug-resistant TB, which is usually caused by poor compliance with standard treatment regimens and is much harder and more expensive to treat.

"The key is detecting regular TB patients as early as possible and delivering standard treatment to prevent the disease from becoming resistant to medicines," he said.

To this end, Zhao said that special attention should be paid to key groups, such as students and close contacts of patients, as well as key venues such as schools, elderly care homes and crowded factories. "Meanwhile, health examinations required for school enrollment and employment can also be leveraged to identify TB cases," he said.

Lin Minggui, head of the infectious disease department at Beijing Tsinghua Changgung Hospital, said that he has always attached great significance to educating patients on strictly complying with treatment regimens that last at least two weeks.

"Persuading patients to increase their adherence to prescriptions and take drugs for a long period without suspension is vital to containing the occurrence of drug-resistant forms of TB," he said.

Lin added that new medicines and therapies should be administered promptly to patients infected with drug-resistant TB to control their symptoms and reduce the risk of transmission.

On Feb 23, the National Administration of Disease Prevention and Control released a circular aimed at strengthening the control of drug-resistant TB.

The document calls for enhanced communication and cooperation among hospitals, disease control centers and grassroots medical institutions to increase the compliance of TB patients and ensure their seamless management. It also requires all TB-designated hospitals at the district or county level to be capable of conducting convenient diagnostic tests for drug-resistant TB in the next three years.

Zhang Wenhong, head of the infectious disease department at Fudan University Huashan Hospital and a national political adviser, suggested setting up multipronged insurance policies for TB patients.

During this year's two sessions that concluded on March 13, he said that many patients stopped taking medicines due to financial strain. As a result, he suggested rolling out free treatment policies at the national level such as including all standard anti-TB drugs to the reimbursement list, as well as providing special assistance for TB patients from low-income or impoverished families and exempting medical expenses for drug-resistant TB cases.

Dong Xiaoping, chief virologist at the China CDC and a national political adviser, said that homegrown diagnostic kits for TB have not reached a first-rate level yet globally.

To end the disease, new technologies that can facilitate the detection of TB patients at an early stage and evaluate outcomes of treatment are important, he added.