Availability of second-line drugs and anti-tuberculosis drug susceptibility testing in China: a situational analysis
Abstract:OBJECTIVE: To assess the availability of second-line drugs (SLDs) and the use of drug susceptibility testing (DST) results for the treatment of tuberculosis (TB) in China.
DESIGN: Cross-sectional survey in 4675 health care facilities, 1960 of which have a dedicated TB clinic, in 12 provinces in China.
RESULTS: More than 70% of TB clinics at the provincial and prefecture levels had at least one SLD available compared to 41.8% of facilities at the county/district level. The proportion of facilities at provincial, prefecture and county levels with any fluoroquinolone was respectively 74.1%, 64.9% and 34.5%. Sputum culture was performed at 6.0% of TB clinics at the county level, 37.5% at the prefecture and 59.3% at the provincial levels, while DST was performed only at the prefecture (28.6%) and provincial (44.4%) levels. Only 18% of the facilities that used SLDs for the treatment of multidrug-resistant TB (MDR-TB) based treatment regimens on DST results.
CONCLUSION: SLDs are widely available in China for the treatment of both TB and other infectious diseases. To prevent the development of Mycobacterium tuberculosis resistance to SLDs, the availability of SLDs should be limited and they should be used with caution in the treatment of MDR-TB.
Document Type: Regular Paper
Affiliations: 1: National Center for TB Control and Prevention, China Center for Disease Control and Prevention, Beijing, China; Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 2: Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; and KNCV Tuberculosis Foundation, The Netherlands 3: Center for Infection and Immunity Amsterdam, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 4: National Center for TB Control and Prevention, China Center for Disease Control and Prevention, Beijing, China 5: China Office, International Union Against Tuberculosis and Lung Disease, Beijing, China
Publication date: 2010-07-01
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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