Evaluation of the tuberculosis programme in Ningxia Hui Autonomous region, the People's Republic of China: A retrospective case study

Date

2012

Authors

Yang, Yu Rong
McManus, Donald P
Gray, Darren
Wang, Xiao Ling
Yang, Shukun
Ross, Allen G
Williams, Gail
Ellis, Magda

Journal Title

Journal ISSN

Volume Title

Publisher

BioMed Central Ltd.

Abstract

Background: Tuberculosis is a devastating disease due to its rapid transmission and high rate of mortality. Ningxia Hui Autonomous Region (NHAR), located in the North-west, is one of the poorest provinces in China and national surveys have shown TB has been hyper endemic in NHAR for several decades. As no active surveys had been undertaken since the initiation of the DOTS control program across all of NHAR. Methods. A retrospective study was undertaken of all clinical records of TB patients registered from January 2005 to September 2009. Poisson regression was performed to investigate the change in incidence over time and accounted for age, sex and county. Length of time on treatment, disease severity and patient delay were assessed by county. Results: More than 30% of patients had been on treatment for over 12 months and 10% for over 3 years, reflecting drug-resistance or failure of DOTS. More than 93% of patients had grade III disease at time of diagnosis and >15% of patients had severe disease grade IV-V in some NHAR counties. Further, 8.8% of patients were not diagnosed for over 6 months from the onset of symptoms; this was as high as 20% in some counties. The reported incidence of TB is most likely grossly underestimated and the data indicate TB is a major public health concern in NHAR. Conclusions: It is clear that active surveillance is necessary to determine the full extent of the burden of TB in NHAR. New control and treatment strategies for TB are required that increase awareness in the health-care system and at the individual and community level.

Description

Keywords

Keywords: Communicable disease control; Directly observed treatment short course strategy; DOTS; Prevention and control

Citation

Source

BMC Public Health

Type

Journal article

Book Title

Entity type

Access Statement

Open Access

License Rights

DOI

10.1186/1471-2458-12-1110

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