China’s epidemic of drug-resistant tuberculosis is being worsened by inadequate treatment in the public health system and hospitals, according to the first nation-wide study of the disease.
One third of new cases and one half of people with previously treated TB in 2007 had a form of the disease that didn’t respond to medicine, according to research published in the New England Journal of Medicine today. At 5.7 percent, the presence of TB that was resistant to multiple therapies among new cases was almost twice the global average, the study said.
China had an estimated 110,000 cases of multi-drug resistant TB in 2007, the highest annual number of cases in the world, and the situation could be much worse today, the study authors wrote. A fourth of TB patients in the public health system are receiving inadequate treatment because they are first given medicines that don’t work against their form of the disease, the study indicated.
“The situation is already pretty dire,” Daniel Chin, a TB Program officer at Bill & Melinda Gates Foundation in Beijing and a co-author of the study, said in an interview. “We have no reason at all to believe that the situation has gotten any better in the intervening time. Once you go into the country-side, TB is everywhere and is one of the major infectious diseases still afflicting the Chinese population.”
About 44 percent of patients with multi-drug resistant TB who had received previous treatment had not completed their last course, which means more continuity of care is needed, the researchers said.
The survey involved 10 of China’s 31 provinces that have 1.36 billion of the country’s population. Some data in the study had been reported to the World Health Organization and published in its report.
The generic medicines rifampin and isoniazid are used to treat TB, and when drug-resistant bacteria are involved, patients need to take multi-therapy combinations or newer, expensive antibiotics.
About 8.8 million people fell ill with TB and 1.4 million people died from the disease in 2010, making it the second-biggest infectious disease killer behind HIV/AIDS, according to the WHO.
There were about 650,000 cases of the multi-drug resistant form, with about 150,000 people dying, the WHO said.