In China, 1 in 10 TB Cases are Drug-Resistant
BEIJING (AP) - One in 10 cases of tuberculosis in China cannot be treated by the most commonly-used drugs, driven by a lack of testing and misuse of medicine, according to a national survey that showed for the first time the size of the drug-resistant epidemic.
Researchers say the findings from the 2007 survey on drug-resistant TB, published Thursday in the New England Journal of Medicine, show that the government must invest more in public health services to better diagnose drug-resistant strains of the killer lung disease. Hospitals must also be prevented from routinely misusing drugs that worsen the problem, they say.
"For the first time, we have a representative, national survey of this problem in China. It shows that this is pretty serious," said Dr. Daniel Chin, a TB expert at the Bill & Melinda Gates Foundation in Beijing who is one of the study’s authors. "One in 10, by any standard globally, would be pretty high."
The proportion of drug-resistant TB found in the survey was in line with previous estimates that were based on provincial studies, the researchers said. While the survey was done in 2007, the researchers said it took time to culture and test samples from each patient.
The ancient and treatable lung disease is caused by germs that spread when a person with active TB coughs, sneezes or speaks. It has in recent years evolved into stronger forms: drug-resistant TB, which does not respond to two top drugs, and extensively drug-resistant TB, which is virtually untreatable. A handful of what’s been unofficially dubbed ’totally drug-resistant’ cases have also been identified, most recently in India.
TB is usually cured in six to nine months with a mixture of four antibiotics, but if that treatment is interrupted or the dose reduced, the bacteria mutate into a tougher strain that can no longer be killed by standard drugs. The drug-resistant form takes up to two years and thousands of dollars to treat.
The survey conducted by the Chinese Center for Disease Control and Prevention, or China CDC, also showed that 8 percent of patients with drug-resistant TB were actually extensively drug-resistant cases. The survey’s researchers tested 4,000 TB patients recruited through local TB clinics over nine months.