The underdeveloped central and western regions have the highest tuberculosis epidemic, which is twice as high as the economically developed eastern coastal provinces. The rural population activity and the prevalence rate of smear-positive pulmonary tuberculosis were 397/65438+ 10,000 and 13 1/65438+ 10,000, respectively, which were higher than those in cities and towns. At present, about 80% of tuberculosis patients in China come from rural areas; The incidence of tuberculosis increases with age, especially in the age group over 45. Before the age of 35, the prevalence rate of pulmonary tuberculosis in men and women was similar, and after the age of 35, the prevalence rate of male was higher than that of female.
Drug resistance is the key issue to be concerned about in tuberculosis control in China in the future. At present, the initial drug resistance rate is 18.6%, and the acquired drug resistance rate is 46.5%. It is estimated that there are 420,000 drug-resistant smear-positive pulmonary tuberculosis patients in China. According to the results of drug resistance monitoring in four provinces, the rates of multidrug-resistant tuberculosis in Guangdong and Shandong provinces where DOTS was implemented were 2.8% and 2.9% respectively. In the provinces where DOTS is not implemented, namely Henan and Zhejiang, it is 10.8% and 4.5% respectively. In the survey of drug resistance in 53 countries around the world, the drug resistance rate of primary multidrug-resistant tuberculosis in Henan Province ranks second.
The possible tuberculosis/AIDS co-infection epidemic will aggravate the tuberculosis epidemic in China and increase the difficulty of tuberculosis work. According to experts' estimation, about 850,000 people in China were infected with HIV in 2002. If not controlled, this figure will reach 6,543,800,000 by 2065.438+00. It is estimated that half of TB/HIV co-infected patients eventually develop active TB. As a country with serious tuberculosis epidemic and the second highest tuberculosis burden in the world, the quality of tuberculosis control in China directly affects the global tuberculosis control work. Therefore, the world is extremely concerned about the tuberculosis control work in China, and some countries and organizations have given some support.
At present, the huge TB control project in China mainly has the following international support:
1. China World Bank Loan/UK Grant Tuberculosis Control Project. This project is a brand-new financing model designed by China government in consultation with the World Bank and the British Department for International Development, and it is the largest tuberculosis control project in the world so far. The project is to reduce the loan interest rate of the World Bank by using the grant from the British government, and the loan of * * * is $654.38+0.4 billion for tuberculosis control in China. Covering 16 provinces, municipalities and autonomous regions, it lasted for 7 years and is expected to be completed on 12 in 2009.
2. Tuberculosis control in Sino-Japanese aid projects. With the assistance of the World Health Organization and other international organizations, the government of China applied for the China Tuberculosis Control-Japanese Aid Project, which was carried out in 0/2 provinces (autonomous regions) such as Guizhou, Shaanxi, Guangxi, Yunnan, Qinghai, Jiangxi, Anhui, Henan, Shanxi, Inner Mongolia, Sichuan (some counties) and Tibet. The Japanese government provides anti-tuberculosis drugs and microscopes to infectious tuberculosis patients in the project implementation area every year.
3. China China WHO Tuberculosis Control Project. The Canadian government invests $780,000 annually in Shandong, Jiangsu and Zhejiang through CIDA, and supports such fields as patient discovery and reporting fees, treatment management fees, IEC and supervision.
4. Belgian Damien Foundation supported the project. Belgium Damian Foundation has provided financial assistance, medicines and partial financial support for tuberculosis prevention and control in some counties and cities in Tibet and Inner Mongolia Autonomous Region since 20001,and will increase its support for Qinghai from 2003.
5. Global Fund for AIDS, Tuberculosis and Malaria. From 2002 to 2006, the Global Fund for AIDS, Tuberculosis and Malaria initially allocated $48 million for tuberculosis control in China. The main areas of support are: providing drugs, free diagnosis fees, reporting fees, patient management fees, training, information, education and publicity, planning management, practical research and sociological evaluation, and necessary equipment.