China Reports Gains in Fighting Tuberculosis

http://www.nytimes.com/2014/03/25/health/china-reports-gains-in-fighting-tuberculosis.html

Version 0 of 1.

China has cut its rate of tuberculosis by more than half over the last 20 years, according to health officials there.

Its success shows that the tuberculosis-fighting strategy endorsed by the World Health Organization in 1995 works well if it is rigorously applied.

The strategy — called DOTS, for directly observed therapy, short course — requires that every case be diagnosed by sputum sample, and every patient be given a standard regimen of four antibiotics to take daily for about six months, and be watched taking the pills every day. The observer can be a nurse, a family member, a neighbor or any other trusted person.

According to a study done by the Chinese Center for Disease Control and Prevention and published last week by The Lancet, tuberculosis prevalence fell to 59 cases per 100,000 population, from 170 cases in 1990. The more provinces that adopted DOTS, the faster it fell.

The scientists compared vast numbers of samples taken in 1990, 2000 and 2010, including more than 250,000 patients at 176 clinics for the last one.

China still has a huge TB problem, with a million new cases every year, 11 percent of the world’s caseload. Before DOTS, most patients were identified by chest fluoroscopy, got various unmonitored drug regimens and were hospitalized if they fell seriously ill.

An editorial comment by W.H.O. experts said China’s success showed that the goal of halving global cases by 2025 is feasible. But, it said, the world needs new drugs against drug-resistant strains and must adopt the new diagnostic machines that rapidly detect such strains.