Hui Zhang1, Zhong-Wei Jia2. 1. National Center for Tuberculosis Prevention and Control, Chinese Center For Disease Control And Prevention, Beijing 102206, China. 2. National Institute of Drug Dependence, Peking University, Beijing 100191, China.
Peng et al.[1] 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.