Development and Application of a Multidrug-Resistant Tuberculosis Case Management System—Yunnan Province,China,2017–2020

Introduction:Treatment and case management of multidrug-resistant tuberculosis(MDR-TB)is a significant challenge in tuberculosis(TB)control and prevention.This pilot study aims to apply and test a new electronic information system in order to help bolster case management of MDR-TB.Methods:The MDR-TB Case Management System(CMS)was developed and piloted in the Yunnan Tuberculosis Clinical Center(TCC)in 2017.Next,5 sites in Yunnan were randomly selected and sampled as pilots in 2018.The real-time regular follow-up rate(RFUR)was calculated for pilot sites.Loss to follow-up(LTFU)rates of MDR-TB treatment cohorts between pilot and non-pilot sites were compared by a chi-square test.LTFU for MDR-TB treatment cohorts was then assessed by univariate and multivariate binary logistic regression.Results:The average regular follow-up rate was 90.7%in TCC and 73.7%in five other pilot sites of Yunnan Province respectively.The average LTFU rate for pilot sites(9.0%)was lower than non-pilot sites(20.6%,P<0.01).The risk of LTFU during MDR-TB treatment reduced 61.7%in CMS pilot cases(adjusted odds ratio:0.38,95%confidence interval:0.23–0.60)compared with non-pilot cases.Conclusions:As a significant supplement to the Tuberculosis Information Management System,the CMS strengthened the collection,analysis,and utilization of strategic information for MDR-TB cases.The system improved case management by embedding it as a tool of the Comprehensive Supportive Care service model.

Uncovering the Impact of Control Strategies on the Transmission Pattern of SARS-CoV-2—Ruili City,Yunnan Province,China,February–March 2022

Introduction:The implementation of public health and social measures(PHSMs)was an effective option for controlling coronavirus disease 2019(COVID-19).However,evidence is needed to evaluate these PHSMs’effects on the recently emerged variant Omicron.Methods:This study investigated variant Omicron BA.2’s outbreak in Ruili City,Yunnan Province,China.The disease transmission dynamics,spatiotemporal interactions,and transmission networks were analyzed to illustrate the effect of PHSM strategies on Omicron spread.Results:A total of 387 cases were related to the outbreak.The time-varying reproduction number was synchronized with PHSM strategies.Spatiotemporal clustering strength presented heterogeneity and hotspots.Restricted strategies suppressed temporal and spatial relative risk compared with routine and upgraded strategies.The transmission network presented a steeper degree distribution and a heavier tail under upgraded strategies.Phase transformation and distinctive transmission patterns were observed from strategy-stratified subnetworks.Conclusions:The tightened response strategy contained reproduction of the virus,suppressed spatiotemporal clustering,and reshaped the networks of COVID-19 Omicron variant transmission.As such,PHSMs against Omicron are likely to benefit future responses as well.