Caixin Weekly | Salvaging Tuberculosis Patients (AI Translation)

财新周刊｜打捞结核病人

[para. 1] In Shenzhen's Nanshan District, at the intersection of a busy district, an important site for tuberculosis prevention exists at the Nanshan District Chronic Disease Prevention and Treatment Center. Annually, about 500 new tuberculosis (TB) cases are confirmed among the area's 1.81 million residents, indicating that tuberculosis still poses a significant challenge even in wealthier parts of China.

[para. 2] Despite its economic prosperity, Nanshan District, like other areas in China, faces challenges in combating TB. Wealthy districts host major companies yet still confront this ancient disease.

[para. 3] In May, a local chronic disease hospital initiated a proactive TB screening program targeting senior citizens over 65 and diabetes patients. The screenings included questionnaires, chest X-rays, and blood and sputum tests. Results revealed higher TB infection rates in these groups.

[para. 4][para. 5] A nearby hospital treated a severely ill patient found by police after nearly drowning; he was diagnosed with advanced tuberculosis. Many similar cases exist among migrant workers who aren't often screened or covered by health checks, leading to potential hidden TB carriers due to their high mobility and lack of healthcare coverage.

[para. 6] TB patients remain hidden in developed cities, undetected and untreated. WHO estimates over 700,000 TB cases in China annually, but only about 500,000 are officially recorded, suggesting significant underreporting, with 20% of new cases slipping through the healthcare system unnoticed.

[para. 7][para. 8] Many patients don't seek medical help in time, contributing to TB's spread. Research indicates that 50%-70% of TB transmission occurs before patients seek medical attention. TB primarily affects the lungs and can spread through droplets when an infected person coughs or breathes.

[para. 9][para. 11] The "Expert Consensus on the Estimation of National Latent Tuberculosis Infection Rates" suggests 18.08% of people aged five and older are latently infected with TB in China, possibly developing into active TB. Despite China's efforts, patients are often detected through passive methods, with many not recognizing symptoms like fatigue or weight loss as indicators of lung disease.

[para. 11][para. 12] The Chinese government has recognized that proactive measures and new technologies are needed. In November, a plan was issued to enhance TB prevention and control. It acknowledged the disease's incidence rate has dropped but remains a serious threat. Efforts are uneven across regions, with a need to strengthen proactive patient screening.

[para. 13][para. 14] Various regions in China have been exploring proactive TB screening by combining symptom-based methods with chest imaging, particularly for high-risk groups like the elderly and diabetics. Regional differences must be accounted for in detecting and managing TB cases while leveraging new technologies for better diagnostics.

[para. 15] Screening, a key strategy to discover TB patients, requires significant investment. In Yunnan and Guangdong, TB incidence has seen significant declines due to enhanced proactive detection strategies. Implementations like mobile X-ray vans have been instrumental in some areas, aiding in early screening.

[para. 16][para. 17] New technologies like molecular diagnostics have improved rapid diagnosis rates; however, high equipment and reagent costs still hinder widespread implementation. Despite the availability of advancements like convenient tongue swabs, limited resources mean practical and cost-effective technology application remains constrained.

[para. 18] Globally, TB prevention efforts struggle with financial constraints, highlighting China's progress and emphasizing the need for tailored regional strategies considering economic capabilities.

[para. 19][para. 20][para. 21] China's system is well-positioned to eliminate TB, but challenges persist. Financial support, accurate screening, further public participation, and modernized strategies remain integral to the fight against TB. China aims for realistic, achievable goals to curb the epidemic by 2030, differing from more ambitious global targets set by WHO.