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Hospitals in firing line for resistant TB


13:23, June 08, 2012

One in 10 cases of tuberculosis in China cannot be treated by the most commonly-used drugs, driven by a lack of testing and misuse of medicine, according to a national survey.

Researchers say the findings from the 2007 survey on drug-resistant TB, published in the New England Journal of Medicine yesterday, show that the government must invest more in public health services to better diagnose drug-resistant strains of the killer lung disease. Hospitals must also be prevented from routinely misusing drugs that worsen the problem.

"For the first time, we have a representative, national survey of this problem in China. It shows that this is pretty serious," said Dr Daniel Chin, a TB expert at the Bill & Melinda Gates Foundation in Beijing, who is one of the study's authors.

The proportion of drug-resistant TB found in the survey was in line with previous estimates based on provincial studies, researchers said. While the survey was done in 2007, it took time to culture and test samples from each patient.

TB is usually cured in six to nine months with a mixture of four antibiotics, but if treatment is interrupted or the dose reduced, the bacteria mutate into a tougher strain that can no longer be killed by standard drugs.

The survey, by the Chinese Center for Disease Control and Prevention, tested 4,000 TB patients recruited over nine months.

In the past decade, China has made marked progress in fighting tuberculosis. But many state-run facilities still don't have the resources to test patients for drug-resistant strains in order to give them the right drugs, and many are unable to track patients to ensure drug regimens are followed.

The survey also showed that patients who were last treated in a tuberculosis hospital were 13 times as likely to have drug-resistant TB as those treated elsewhere. They likely became infected in the hospitals or were given the wrong drugs. The overuse and misuse of antibiotics is common in China.

"The hospital is clearly a major culprit in this, even what we call tuberculosis hospitals which are supposed to be specialized in the treatment of drug-resistant TB, they are actually perhaps, as this study has implicated, contributing to drug-resistant TB," Chin said.


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