Background:In the underdeveloped multi-ethnic regions of China,high tuberculosis(TB)burden and regional inequity in access to healthcare service increase the challenge of achieving the End TB goals.Among all the provi...Background:In the underdeveloped multi-ethnic regions of China,high tuberculosis(TB)burden and regional inequity in access to healthcare service increase the challenge of achieving the End TB goals.Among all the provinces,the highest TB burden is reported in Xinjiang,where ethnic minorities and older people have suffered most.However,current case-finding strategy is inadequate given the complex social determinants and suboptimal case detection rates.Thus,we developed an integrated TB control program to improve case detection and conducted a pilot in Xinjiang from 2014 to 2015.In this case study,we summarized the activities and key findings.We also shared the experiences and challenges of implementing interventions and provided recommendations to inform the TB control program in the future.Case presentation:The pilot interventions were implemented in one selected town in Yining based on local TB control programs.By applying tailor-made educational materials,outreach TB educational activities were conducted in diverse ways.In 22 Masjids,the trained imams promoted TB education to the Muslims,covering 20,440 persontimes in 88 delivered preaching sessions.In seven schools,1944 students were educated by the teachers and contributed to educating 6929 family members.In the village communities,13,073 residents participated in household education and screening.Among them,12,292 people aged under 65 years were investigated for suspicious pulmonary TB symptoms,where six TB patients were diagnosed out of 89 TB suspects;781 older people were mobilized for screening directly by chest X-ray,where 10 patients were diagnosed out of 692 participants.Supportive healthcare system,multi-sectoral cooperation and multi-channel financing mechanism were the successful experiences of implementation.The interventions were proved to be more effective than the previous performance:the number of TB suspects consulting doctors and patients detected increased by 50%and 26%,respectively.The potential challenges,implications and recommendations should been taken into account for further program improvement.Conclusions:In underdeveloped multi-ethnic regions with high TB burden,improving case detection is necessary and the interventions can be feasible and effective within a supportive system.More intensive educational and training approaches,a high index of TB suspicion and prioritization of older people in screening are recommended.To sustain and scale up the program,the impacts,cost-effectiveness,feasibility and acceptability of interventions warrant further research and evaluation in each specific context.展开更多
INTRODUCTION Tuberculosis(TB)remains a widespread and serious infectious disease caused by the chronic pathogen Mycobacterium tuberculosis(Mtb),leading to approximately 10 million new cases and 1.5 million deaths annu...INTRODUCTION Tuberculosis(TB)remains a widespread and serious infectious disease caused by the chronic pathogen Mycobacterium tuberculosis(Mtb),leading to approximately 10 million new cases and 1.5 million deaths annually[1].Notably,the continuous emergence of drug-resistantMtb strains and co-infection with human immunodeficiency virus(HIV)further pose significant challenges to TB prevention and treatment,necessitating an innovative breakthrough in TB control.Vaccination is the most economical and effective approach to preventing and controlling infectious diseases.However,Bacillus Calmette-Guérin(BCG)is currently the only licensed vaccine available for TB,protecting meningeal and disseminated TB in children,but failing to protect adolescents and adults,who are the primary transmitters of TB.Moreover,BCG cannot prevent the progression of latent TB infection(LTBI)to active TB,and its protective efficacy wanes over time[2,3].Against this backdrop,efforts to develop more effective TB vaccines have been ongoing.展开更多
This paper addresses the World Tuberculosis(TB)Day 2025 theme,“Yes!We can end TB!Commit,Invest,Deliver”.Through comprehensive analysis of China’s TB epidemic landscape and associated challenges,we align with the“N...This paper addresses the World Tuberculosis(TB)Day 2025 theme,“Yes!We can end TB!Commit,Invest,Deliver”.Through comprehensive analysis of China’s TB epidemic landscape and associated challenges,we align with the“National TB Prevention and Control Plan(2024−2030)”which emphasizes that building Zero-TB communities through the integration of“active case finding”and“TB preventive treatment(TPT)”represents a viable pathway toward ending the TB epidemic.Active case finding serves as a critical intervention for early detection and transmission reduction,while TPT constitutes an essential strategy for decreasing latent TB infection incidence.By facilitating the rapid expansion of Zero-TB communities through governmental commitment,strategic resource allocation,and coordinated implementation,we anticipate achieving the ultimate goal of TB epidemic elimination.展开更多
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 findi...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.展开更多
基金The project was supported by the China-WHO Biennial Collaborative Projects 2014-2015 and TB control programs in Xinjiang Uygur Autonomous Region.
文摘Background:In the underdeveloped multi-ethnic regions of China,high tuberculosis(TB)burden and regional inequity in access to healthcare service increase the challenge of achieving the End TB goals.Among all the provinces,the highest TB burden is reported in Xinjiang,where ethnic minorities and older people have suffered most.However,current case-finding strategy is inadequate given the complex social determinants and suboptimal case detection rates.Thus,we developed an integrated TB control program to improve case detection and conducted a pilot in Xinjiang from 2014 to 2015.In this case study,we summarized the activities and key findings.We also shared the experiences and challenges of implementing interventions and provided recommendations to inform the TB control program in the future.Case presentation:The pilot interventions were implemented in one selected town in Yining based on local TB control programs.By applying tailor-made educational materials,outreach TB educational activities were conducted in diverse ways.In 22 Masjids,the trained imams promoted TB education to the Muslims,covering 20,440 persontimes in 88 delivered preaching sessions.In seven schools,1944 students were educated by the teachers and contributed to educating 6929 family members.In the village communities,13,073 residents participated in household education and screening.Among them,12,292 people aged under 65 years were investigated for suspicious pulmonary TB symptoms,where six TB patients were diagnosed out of 89 TB suspects;781 older people were mobilized for screening directly by chest X-ray,where 10 patients were diagnosed out of 692 participants.Supportive healthcare system,multi-sectoral cooperation and multi-channel financing mechanism were the successful experiences of implementation.The interventions were proved to be more effective than the previous performance:the number of TB suspects consulting doctors and patients detected increased by 50%and 26%,respectively.The potential challenges,implications and recommendations should been taken into account for further program improvement.Conclusions:In underdeveloped multi-ethnic regions with high TB burden,improving case detection is necessary and the interventions can be feasible and effective within a supportive system.More intensive educational and training approaches,a high index of TB suspicion and prioritization of older people in screening are recommended.To sustain and scale up the program,the impacts,cost-effectiveness,feasibility and acceptability of interventions warrant further research and evaluation in each specific context.
基金supported by the National Key Research and Development Program of China(2022YFC2302900 and 2021YFA1300200 to C.H.L.and J.W.)the National Natural Science Foundation of China(82330069 to C.H.L.and 82372653 to J.W.)+4 种基金the State Key Laboratory of Medical Proteomics(SKLPK202001,SKLPO202003,and SKLP-X202401 to C.H.L.)the CAS Project for Young Scientists in Basic Research(YSBR-010 to J.W.)Youth Innovation Promotion Association CAS(Y2022036 to J.W.)Shenzhen Medical Research Fund(B2302035 to C.H.L.)Guangzhou National Laboratory(GZNL2024A01023 to C.H.L.).
文摘INTRODUCTION Tuberculosis(TB)remains a widespread and serious infectious disease caused by the chronic pathogen Mycobacterium tuberculosis(Mtb),leading to approximately 10 million new cases and 1.5 million deaths annually[1].Notably,the continuous emergence of drug-resistantMtb strains and co-infection with human immunodeficiency virus(HIV)further pose significant challenges to TB prevention and treatment,necessitating an innovative breakthrough in TB control.Vaccination is the most economical and effective approach to preventing and controlling infectious diseases.However,Bacillus Calmette-Guérin(BCG)is currently the only licensed vaccine available for TB,protecting meningeal and disseminated TB in children,but failing to protect adolescents and adults,who are the primary transmitters of TB.Moreover,BCG cannot prevent the progression of latent TB infection(LTBI)to active TB,and its protective efficacy wanes over time[2,3].Against this backdrop,efforts to develop more effective TB vaccines have been ongoing.
文摘This paper addresses the World Tuberculosis(TB)Day 2025 theme,“Yes!We can end TB!Commit,Invest,Deliver”.Through comprehensive analysis of China’s TB epidemic landscape and associated challenges,we align with the“National TB Prevention and Control Plan(2024−2030)”which emphasizes that building Zero-TB communities through the integration of“active case finding”and“TB preventive treatment(TPT)”represents a viable pathway toward ending the TB epidemic.Active case finding serves as a critical intervention for early detection and transmission reduction,while TPT constitutes an essential strategy for decreasing latent TB infection incidence.By facilitating the rapid expansion of Zero-TB communities through governmental commitment,strategic resource allocation,and coordinated implementation,we anticipate achieving the ultimate goal of TB epidemic elimination.
基金The study based on which this paper was written is part of the program entitled“China National Health and Family Planning Commission and the Gates Foundation TB Project”-a collaboration between the Government of China and the Melinda and Bill Gates Foundation(Grant No.51914)implemented by the China Center of Disease Control and Prevention(CDC).
文摘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.
