Abstract
BackgroundChina has made progress in tuberculosis control, but this disease remains a burden in many regions of China. We performed time-series analysis to examine changes in the rates of newly notified and newly smear-positive cases of tuberculosis in different regions of China from 1997 to 2018 and assessed the effect of the current control program.MethodsNational and provincial notification data on tuberculosis from 1997 to 2018, which covers 31 provinces in the mainland of China, were extracted from the Chinese public health science data center. The annual percentage changes in newly notified and smear-positive cases were analyzed using a joinpoint regression method.ResultsThere were 18 646 672 newly notified tuberculosis cases from 1997 to 2018, with the greatest number in 2005. A total of 6 605 414 of these cases (35.42%) were smear-positive cases. The number of newly notified cases in China overall decreased (96.88–59.27 cases per 100 000) significantly during the most recent years. The decline during this period ranged from −3.9% (95% CI −5.7 to −2.9) in the western region to −4.3% (95% CI −4.8 to −3.7) in the eastern region. Most provinces had significant declines in newly notified and smear-positive cases, whereas the decline of newly smear-positive cases in Xinjiang was about half of that observed during the same period in China overall (−4.1% vs −9.9%). In addition to disparities in annual percentage changes, the rate of newly notified cases was higher in the western region than in the eastern and central regions.ConclusionsThe burden of tuberculosis has been on declining throughout China during recent years, but tuberculosis in western China continues to be a public health emergency that needs to be urgently addressed. Effective prevention and control strategies are needed for regions with high disease burdens and those with increasing or unchanging numbers of newly notified and smear-positive cases of tuberculosis.
Highlights
China has made progress in tuberculosis control, but this disease remains a burden in many regions of China
The current study aims to examine changes in newly notified and newly smearpositive cases of TB in different regions of China based on national routine surveillance data from 1997 to 2018, and to assess the effectiveness of the TB control program in China
We have contacted with National Center for Tuberculosis Control and Prevention to verify the data before analysis
Summary
China has made progress in tuberculosis control, but this disease remains a burden in many regions of China. We performed time-series analysis to examine changes in the rates of newly notified and newly smear-positive cases of tuberculosis in different regions of China from 1997 to 2018 and assessed the effect of the current control program. In an effort to end the TB epidemic within the generation, the first ever United Nations High Level Meeting (UNHLM) on TB convened during 2018. As the global community looks to meet ambitious targets for reduction and even elimination of TB by 2050 [6], the annual declines in incidence must be much greater [7]. More interventions with proven efficacies and investments in new strategies are needed to achieve the UNHLM targets and to eliminate TB by 2030
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