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4 Drug-Resistant TB in China
Pages 31-44

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From page 31...
... Participants discussed the results of a drug-resistance surveillance released in 2012, which provided crucial information that is being used to shape the country's programmatic management of MDR TB. As they sought to explore multiple aspects and characteristics of the epidemiology of MDR 31
From page 32...
... China has undertaken technical support for the treatment of MDR and XDR TB patients, providing national guidelines for the management of DR TB, issued in 2012 by China CDC; a manual for management of SLDs; guidelines for infection control; guidelines for adverse reactions to DR TB chemotherapy; and standard operating procedures for culture and DST. China also has launched a pilot project for the programmatic treatment and management of MDR and XDR TB patients (PMDRT)
From page 33...
... China has established a model of cooperation between hospitals and public health centers, Mingting Chen said. Hospitals have responsibility for diagnosis, treatment, and side effects for MDR TB patients.
From page 34...
... Mingting Chen added in conclusion that legislation is important to govern the isolation and travel of MDR TB patients. Also important is evaluation of China's efforts to control and prevent MDR TB.
From page 35...
... Furthermore, among new cases, 1.8 percent of patients with MDR TB were already resistant to ofloxacin or kanamycin, as were 8.5 percent of previously treated patients. According to Mingting Chen, the survey results indicate that China has the second-largest MDR TB burden among 27 HBCs.
From page 36...
... 36 FIGURE 4-1  The majority of MDR TB patients who completed treatment did so at China CDC facilities. SOURCE: From the New England Journal of Medicine, Zhao, Y., S
From page 37...
... The fact that one-third of MDR TB cases have quinolone resistance may limit the use of new regimens for MDR TB. Yanlin Zhao is involved with an effort to collect and sequence strains of the bacterium, which makes it possible to do cluster analysis of cases.
From page 38...
... . These grim data highlight the importance of detecting MDR TB so that these patients are not given the standard DOTS regimen, which can augment the evolution of MDR and XDR TB, Wenhong Zhang said.
From page 39...
... Wenhong Zhang also commented on the new policy in China, effective in 2010, providing that the China CDC would no longer treat patients but would provide management, supervision, and follow-up. He noted that lack of awareness that a patient should be followed up by China CDC is another MDR TB risk factor.
From page 40...
... All patients have been treated with the Global Fund MDR TB treatment regimen. From July 2008 through December 2012, 800 TB cases were treated, with 183 having MDR TB and 19 having XDR TB.
From page 41...
... All 12 of the MDR TB patients were younger than 45 years old. Among the 117 M.tb.
From page 42...
... Among these TB patients, 1,090 with diabetes were identified, including 227 in whom diabetes was newly diagnosed. According to these numbers, if the screening were scaled up nationally, 124,000 additional patients with diabetes would be referred for care.
From page 43...
... . In Indonesia, a 6-month sputum culture was positive in 22 percent of TB patients with diabetes and in 6.9 percent of controls (Alisjahbana et al., 2007)


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