Changes in newly notified cases and control of tuberculosis in China: time-series analysis of surveillance data

Abstract

Background 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. Methods National 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. Results There 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. Conclusions The 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.

Impact of immunization programs on 11 childhood vaccine-preventable diseases in China: 1950–2018

“… 28 Second, the passive nature of the surveillance system could have resulted in under-reporting and/or under-ascertainment of the true disease burden. 29 , 30 This is particularly true during periods when there was massive political, social, and/or economic chaos nationwide, such as during the Cultural Revolution (1966–1976). Indeed, this could explain the sudden drop in incidence rates seen in the late 1960s.…”

Spatiotemporal Changes in Pulmonary Tuberculosis Incidence in a Low-Epidemic Area of China in 2005-2020: Retrospective Spatiotemporal Analysis

“…During the 16-year period of 2005 to 2020, the PTB notification rates of Wuxi city decreased from 50.4 to 23.9 per 100,000 population at an average rate of –4.9% per year. The decline was higher than that in China (–3.8%) during the same period [ 8 ]. In addition to the implementation of national measures such as the DOTS strategy, national TB prevention strategies, control plans, and government commitments, 3 factors could have contributed to the difference.…”

“…Moreover, the government revised the Law of the People’s Republic of China on the Prevention and Treatment of Infectious Diseases, and the Chinese Center for Disease Control and Prevention developed the nationwide Notifiable Infectious Disease Reporting Information System, which is the largest internet-based disease reporting system after the severe acute respiratory syndrome outbreak [ 7 ]. With the implementation of various TB prevention and control measures, the morbidity and mortality of TB in China have decreased dramatically [ 8 , 9 ]. The incidence of PTB and smear-positive TB in China dropped from 611 and 170 per 100,000 population in 1990 to 442 and 59 per 100,000 population in 2010, respectively [ 6 ].…”

“…The incidence of PTB and smear-positive TB in China dropped from 611 and 170 per 100,000 population in 1990 to 442 and 59 per 100,000 population in 2010, respectively [ 6 ]. However, due to differences in the population, climate, and socioeconomic factors, the prevalence of PTB in China has significant spatial heterogeneity [ 8 , 10 , 11 ]. According to the fifth national TB epidemiological survey in 2010, the prevalence of PTB in the eastern, central, and western regions of China was 291, 463, and 695 per 100,000 population, respectively [ 12 ].…”

Triggering Receptor Expressed on Myeloid Cells 2 Mediates the Involvement of M2-Type Macrophages in Pulmonary Tuberculosis Infection

“… 2 In recent years, with the efforts of the Chinese government, the burden of TB epidemic has shown a downward trend throughout the country, but it’s still the top priority in the western region of China. 3 Therefore, the research of tuberculosis still needs the efforts of more scholars.…”