MDR-TB Prevalence in China Exceeds Global Averages, Study Says

Multi-drug resistant tuberculosis is nearly twice as common in China as in the rest of the world, likely because of insufficient treatment adherence and supervision, according to a study published Thursday in BMC Infectious Diseases, Bloomberg reports.

For the study, Chinese and Dutch researchers led by Guang Xue He of China's Center for Disease Control and Prevention reviewed surveys that were conducted between 1996 and 2004 in 10 Chinese provinces and involved more than 14,000 people with TB. According to the study, about 25% of all new TB cases in China and about 50% of all previously treated cases are resistant to at least one TB drug. China's Henan province reported the highest rates of MDR-TB, Bloomberg reports (Bennett, Bloomberg, 12/11). According to the study's findings, MDR-TB accounted for 9.3% of all TB cases in China, 5.4% of all new cases and 25.6% of all previously treated cases. These figures surpass average global rates for MDR-TB, which accounts for 4.8% of all TB cases, 3.1% of all new cases and 19.3% of all previously treated cases worldwide. In addition, the study found that about 20% of TB patients in China previously had been treated for the disease, compared with 11% worldwide.

According to the study, there are "[m]any possible explanations" for the high prevalence of drug-resistant TB in China, including inadequate use of TB medication in public hospitals, insufficient treatment supervision, ineffective drug management and a lack of infection control measures in hospitals. In addition, the availability of TB drugs without a prescription in some areas of China "may have contributed to the development of drug resistance," the researchers said. They added that the high MDR-TB prevalence could be attributed to other factors in different areas of the country (Tan, Reuters, 12/11).

According to a World Health Organization report published in February, China accounts for 25% of MDR-TB cases worldwide and has the second-highest prevalence of the strain after former Soviet Union nations such as Azerbaijan, Georgia, Kazakhstan and Uzbekistan. Pieter Van Maaren, TB adviser for WHO's Western Pacific Region, said the prevalence of drug-resistant TB in China has "been high for quite some time," adding that the "majority of cases are the result of not-so-good or poor TB control in the past" (Bloomberg, 12/11).

The study is available online (.pdf).