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Peng et al. reported that the MDR-TB burden among the new tuberculosis (TB) patients accounted for more than 1/4th of all multidrug-resistant TB (MDR-TB) cases in the past 5 years in Zhejiang province, although the identified rate of MDR-TB among 9830 new TB cases was only 2.0%. Drug-resistant TB, especially MDR-TB, is a major threat to the control of TB worldwide. However, due to high cost and limited budget, screening on MDR-TB has not been implemented among all TB cases by now.
A Chinese survey indicated that the prevalence of MDR-TB was 5.7% in the new TB cases and 25.6% in the previously treated cases in 2007. In the period of 2011–2015, MDR-TB screening has been provided for the patients who are at high risk of drug-resistant TB in the National TB Control Program (NTP) implementation. It was estimated that there were 57,000 MDR/rifampicin-resistant (MDR/RR)-TB cases among the notified pulmonary TB cases in 2015 in China, but only 9662 MDR/RR cases were identified, this figure was much lower in comparison with the estimated cases. Clearly, most MDR-TB cases have been lost due to limited coverage of drug-resistant screening.
Fortunately, this situation will be changed sooner with the development of technologies and economy in China. The technologies of MDR-TB tests developed rapidly in the recent years, such as GeneXpert® recommended by the WHO, substantially reduced the time needed for diagnosis. The “13th Five-Year Plan” of China NTP promised that all suspected pulmonary TB patients will be provided for sputum smear and culture examination and drug-resistance will be of course screened for etiologically positive pulmonary TB patients, including both new TB and those at high risk of MDR-TB. The county-level hospitals will take the important roles to diagnose TB cases and screening MDR-TB timely. This is an undoubtedly ambitious plan for screening MDR-TB among one million TB cases, of which more than 85% are new TB cases. However, the preliminary study of Peng et al. presented a promising and encouraging perspective for this plan, and we truly expect and indeed believe that the “13th Five-Year Plan” will bring a different contribution to control TB in China.
There are no conflicts of interest.
Edited by: Yi Cui