Tuberculosis in China - Epidemiology

Epidemiology

In China, tuberculosis has been the number 1 cause of death from infectious disease in adults. In 1990, 360,000 people in China died from tuberculosis.

Tuberculosis is one of China's major public health problems. According to WHO estimates, China has the world's second largest tuberculosis epidemic, behind only India, with more than 1.3 million new cases of tuberculosis every year. Of the 37 notifiable communicable diseases in China, tuberculosis ranks first in terms of notified cases and deaths. Despite the serious nature of this disease, the country's progress in tuberculosis control was slow during the 1990s and early part of the new millennium. The estimated proportion of new cases of sputum smear-positive tuberculosis that were diagnosed and treated by the public health program - a key indicator of efforts to control tuberculosis - had stagnated at around 30%, far below the 70% target set by the WHO.

In 2003, an epidemic of severe acute respiratory syndrome (SARS) broke out in China. (See Progress of the SARS outbreak.) The spread of SARS brought to light substantial weaknesses in the country's public health system. After the SARS epidemic was brought under control, the Chinese government implemented a series of measures to strengthen its public health system. This effort coincided with acceleration in efforts to control tuberculosis. Within 3 years, implementation of the WHO-recommended DOTS (Directly Observed Therapy, Shortcourse) strategy to control tuberculosis increased from 68% to 100% of counties and the detection of cases of smear-positive tuberculosis by the public health system more than doubled, from 30% of new cases to 80%. Together with a tuberculosis treatment success rate of more than 90%, China achieved the 2005 global targets for tuberculosis control.