China sharply curbs TB

Beijing, March 18: In what can be seen as having important lessons for India and other developing countries, China has sharply cut its tuberculosis (TB) prevalence in just 20 years.

Between 1990 and 2010, TB prevalence in the country fell from 170 to 59 per 1 lakh population.

Expansion of the directly observed, short-course (DOTS) strategy, from half the population in the 1990s to the entire country after 2000, has helped it achieve the uncommon feat, analysis of national survey data showed.

“Marked improvement in tuberculosis treatment, driven by a major shift in treatment from hospitals to the public health centres (that implemented the DOTS strategy) was largely responsible for this epidemiological effect,” the study showed.

DOTS is at the heart of the Stop TB Strategy developed by the World Health Organisation.

The Stop TB Strategy aims to reduce tuberculosis prevalence by 50 percent between 1990 and 2015.

“This study in China is the first to show the feasibility of achieving such a target, and China achieved this five years earlier than the target date,” said Yu Wang from the Chinese Center for Disease Control and Prevention in Beijing.

To assess the effect of the nationwide expansion of the DOTS programme after 2000, a survey was done in 2010.

Nearly 253,000 individuals aged 15 years and older were surveyed in 2010 at 176 investigation points chosen from all 31 provinces.

The results showed that between 2000 and 2010, national TB prevalence fell by 57 percent — tripling the reduction of the previous decade.

During this time, 87 percent of the total decrease in prevalence was among cases already diagnosed with TB before the survey.

“The DOTS programme has been much more effective in reducing the prevalence of tuberculosis in known cases than in new cases,” the study showed.

The findings of the study appeared in medical journal The Lancet.