Multicenter Evaluation of the Molecular Line Probe Assay for Multidrug Resistant Mycobacterium Tuberculosis Detection in China

In order to evaluate the performance of a molecular Hain line probe assay （Hain LPA） for rapid detection of rifampicin and isoniazid resistance of Mycobocterium tuberculosis in China, 1612 smear positive patients were consecutively enrolled in this study. Smear positive sputum specimens were collected for Hain LPA and conventional drug susceptibility testing （DST）. The sensitivity and specificity of Hain LPA were analyzed by using conventional DST as golden reference. The sensitivity, specificity, positive predictive value {PPV） and negative predictive value （NPV） for rifampicin resistance detection were 88.33%, 97.66%, 81.54%, and 98.62%, respectively. The sensitivity, specificity, PPV and NPV for isoniazid resistance detection were 80.25%, 98.07%, 87.25%, and 96.78%, respectively. These findings suggested that Hain LPA can be an effective method worthy of broader use in China.

Access to and affordability of healthcare for TB patients in China: issues and challenges

This paper introduces the background,aim and objectives of the project entitled“China—the Gates Foundation Collaboration on TB Control in China”that has been underway for many years.It also summarizes the key findings of the nine papers included in this special issue,which used data from the baseline survey of Phase II of the project.Data were collected from the survey of TB and MDR-TB patients,from designated hospitals,health insurance agencies and the routine health information systems,as well as key informant interviews and focus group discussions with relevant key stakeholders.Key issues discussed in this series of papers include the uses of TB services and anti-TB medicines and their determining factors related to socio-economic and health systems development;expenditures on TB care and the financial burden incurred on TB patients;and the impact of health insurance schemes implemented in China on financial protection.

Effectiveness of the Integrated TB Surveillance System--China,2018-2019

What is already known about this topic?China’s national health information system provides important support and means for deepening the country’s medical and health reform,for improving relevant delivery services,for enhancing the level of scientific management of health,and for promoting the goal of basic medical and health services for everyone in China.What is added by this report?To further the construction of the national health information system,the National Center for Tuberculosis Control and Prevention of China CDC,started a pilot project for a new tuberculosis(TB)integrated health(iHealth)surveillance system,which was integrated with regional health information platforms.The goal was to explore automatic data exchange between hospitals and disease control facilities to reduce the workload of data-entry.What are the implications for public health practice?This pilot proved that data sharing and automatic exchanges between different information systems can be achieved through a unified surveillance dataset,which could provide a reference point for the construction of surveillance systems for other infectious diseases or for the entire public health information system.

Use of anti-tuberculosis drugs among newly diagnosed pulmonary tuberculosis inpatients in China: a retrospective study

Background:China’s national tuberculosis control program(NTP)provides free,first-line anti-tuberculosis(TB)drugs to pulmonary TB patients.This treatment regimen follows the World Health Organization’s(WHO)guideline.The objective of this paper is to evaluate the current status of anti-TB drug use for newly diagnosed pulmonary TB inpatients treated in prefecture-and county-level designated hospitals.Methods:Three prefecture-level hospitals and nine county-level hospitals were selected for the study.All newly diagnosed pulmonary TB inpatient medical records from 2012 were reviewed and doubly examined by two national senior physicians.The rational use of anti-TB drugs was evaluated based on criteria in line with WHO’s guideline.Results:Of the 2,060 total treatment regimens for TB,53.1%were found to be rational(1093/2060).The percentages in prefecture-level and county-level hospitals were 50.3%(761/1513)and 60.7%(332/547),respectively.The difference between the two levels of hospitals was statistically significant(Chi-square value=17.44,P<0.01).The percentages of rational treatment regimens for first-time hospitalizations and for two or more hospitalizations were 59.5%(983/1653)and 27.0%(110/407),respectively,with a statistically significant difference(Chi-square value=138.00,P<0.01).The overall use of second-line drugs(SLD)was 54.9%(1131/2060).The percentages for prefecture-level and county-level hospitals were 50.6%(766/1513)and 66.7%(365/547),respectively.A statistically significant difference was found(Chi-square value=42.06,P<0.01).The use of SLD for inpatients hospitalized once and inpatients hospitalized twice or more was 58.4%(966/1653)and 40.5%(165/407),respectively,with a statistically significant difference(Chi-square value=42.26,P<0.01).Conclusions:Half of inpatients might be treated with irrational regimens,and the use of SLD was more appropriately dispensed in city-level hospitals than in county-level hospitals.Trainings and guidelines for health personnel,supervision led by health authorities and increased investment to designated hospitals may help to improve the rational use of anti-TB drugs.

Multichannel Financing Reduces Economic Burden and Improves the Medical Security Level for Tuberculosis Patients

Tuberculosis(TB)is one of the main infectious diseases to simultaneously cause poverty and be caused by poverty.Reducing the economic burden of TB patients in China is essential to improving patient compliance and reducing the impact of the TB epidemic.In accordance with the national reform of the medical and health system and the current status of the country’s TB prevention and treatment service system,representatives of the government proposed the concept of a multichannel financing mechanism.