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    Home > Medical News > Latest Medical News > Ending the "white plague" may be useful to learn from the experience of fighting the new crown

    Ending the "white plague" may be useful to learn from the experience of fighting the new crown

    • Last Update: 2020-12-11
    • Source: Internet
    • Author: User
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    a new outbreak of coronary pneumonia that has raised awareness of the power of infectious diseases, and the same outbreak, which has neglected other infectious diseases, such as tuberculosis, known as the "white plague". In fact, this ancient and
    respiratory infectious disease has never been far away from us.
    , which many believe is only present in ancient costume dramas, is still one of the top ten causes of death in the world and the leading cause of death from a single infectious disease. Some experts pointed out that according to the existing rate of decline in TB incidence and death, if there is no major breakthrough in diagnostic technology, drugs, vaccines and protection strategies, it may be difficult to achieve the World Health Organization 2030 goal of eliminating tuberculosis., the World Health Organization released the 2020 Global Tuberculosis Report. According to the report, about 10 million new cases of TB will occur globally in 2019, and about 1.4 million people will die from TB, which remains the world's number one infectious disease killer. China is one of the world's highest burden countries for tuberculosis, with about 833,000 cases in 2019, of which 33,000 died.
    note that the report shows that for the first time, the TB mortality rate in our country has fallen to the last of the 30 high-burden countries.
    WHO Office in China, viral hepatitis, sexually transmitted infections, tuberculosis technology
    Chen Zhongdan believes that this is due to the international tuberculosis strategy that China has pioneered over the past 20 years, which has enabled china to make significant progress in TB control and prevention, achieving and exceeding the TB Millennium Development Goals five years ahead of schedule, including halving TB infection and reducing mortality by 80% between 1990 and 2010. Between 2000 and 2019, the incidence rate decreased by 45.7 per cent, of which the incidence rate decreased by 10.8 per cent between 2015 and 2019.
    same time, our country has made progress in the detection and treatment of drug-resistant tuberculosis. According to Chen Zhongdan, the proportion of TB patients diagnosed with pathogens who received the test of olifossing and the proportion of patients diagnosed with drug-resistant TB who started second-line treatment increased from 45% and 46% in 2017 to 81% and 74% in 2019, respectively., although China's TB mortality rate fell to the last high-burden country, but China's TB disease burden is still heavy, especially drug-resistant tuberculosis.
    drug-resistant TB is so concerned? The reason is not difficult to find, one is that its treatment is difficult, and the other is its high burden of disease. A significant proportion of TB patients face a heavy financial burden, which is an important factor restricting the diagnosis, timely treatment, standardized treatment and success of treatment. Chen Zhongdan points out that the current global catastrophic expenditure on tuberculosis is 49%, but the situation is very different from that faced by TB patients, with 44% of sensitive TB patients facing catastrophic spending and 80% of drug-resistant TB patients facing catastrophic spending.
    china is the "heavy disaster area" of drug-resistant tuberculosis. Compared with ordinary tuberculosis, drug-resistant tuberculosis treatment cycle is longer, patients are more burdened with disease. However, public attention to TB is not high enough.
    understand that sensitive TB patients as long as on-time treatment, cure rate is very high, but TB is not the only one, drug-resistant TB patients treatment rate and cure rate is not high. According to the World Health Organization, about 500,000 new drug-resistant TB patients worldwide will be treated in 2019, with only 38 percent of drug-resistant TB patients treated and only 57 percent cured, and drug-resistant TB remains a public health crisis.
    " drug-resistant TB testing usually needs to find bacteria through pathogenic means, confirm TB patients, and then carry out drug-resistant testing, however, in China, drug-resistant TB currently exists a major problem, is that the proportion of TB patients with pathogen diagnosis is not high. Chen Zhongdan said that 57% of TB patients worldwide are diagnosed with pathogens, while in high-income Countries in Europe and the United States, 84% of TB cases are diagnosed through pathogens, but in China, the figure is less than 50%. Therefore, there is an urgent need to further strengthen quality control and increase the proportion of TB pathogen diagnosis, so as to improve prevention and diagnosis, especially the detection and treatment of patients with drug-resistant tuberculosis.
    , medical expenses are also an important factor affecting the treatment of drug-resistant TB patients. According to Chen Zhongdan, in 2019, the World Health Organization based on 89 countries reported MDR-TB patients per capita medical expenditure analysis, China's current treatment program cost about 60,000 to 70,000 yuan for the entire course of treatment. With the inclusion of new drugs and the renewal of treatment options, the cost will increase significantly, up to 200,000 to 300,000 yuan or more. Currently, TB diagnosis and treatment is not completely free of charge, especially for the diagnosis of drug-resistant TB, drug treatment and treatment monitoring services, which are not fully covered by health insurance and national tuberculosis projects. Different studies have shown that tuberculosis and MDR-TB are one of the major diseases that cause poverty and return to poverty due to illness. The good news is that the development and spread of new TB drugs is accelerating in the treatment of drug-resistant TB.
    Li Liang, deputy director of Beijing Chest Hospital, said recently that after the introduction of two new drugs, Bedaquine and Dramani, some drug-resistant patients have begun to use, and achieved good results. At present, there are nearly 1500 patients in the country who use bedaquinine free of charge, with a cure rate of up to 85%. Moreover, both Bedaquine and Dlamani were included in Medicare Class B at the end of last year, with patients paying only a portion of their own money. Li Liang expressed the hope that these new drugs can enter the Class A catalog as soon as possible, so that more patients can afford these new drugs, good medicines. In fact, it's not just betaquine and dramanis, the World Health Organization reports that as of August 2020, 22 drugs, a variety of different anti-tuberculosis drug programs and 14 vaccine candidates are undergoing clinical trials. In addition, new testing techniques and products make TB testing easier and more accurate.need to emphasize that the world's tuberculosis prevention and control is facing high disease burden, insufficient financial investment and other issues. Although TB has saved 60 million lives globally since 2000, progress remains slow and investment and action are far below the need to end the TB epidemic. Moreover, the outbreak of neo-crown pneumonia has had a significant negative impact on TB prevention and treatment.
    the outbreak, not only disrupted medical services for some TB patients, but also made it more difficult to detect TB patients. A new study by the China Centers for Disease Control and Prevention on the impact of TB shows a marked decline in TB detection in the first quarter of this year compared with the previous three years. In addition, there has been a significant decrease in the number of follow-up visits in diagnosed patients. According to the World Health Organization, the number of TB patients who have been disrupted, detected and treated in TB services has fallen by 25 to 50 per cent in just three months, with the global number of TB deaths likely to increase by 200,000 to 400,000 by 2020 alone. Chen Zhongdan also noted that data from several high-burden TB countries show a sharp decline in TB cases reported between January and June 2020.
    experts called for continued increased investment in TB, promotion of TB research and innovation, and the goal of ending TB.As Dr. Tan Desai, Director-General of the World Health Organization, said at the 51st International Association for the Prevention of Pneumonia Global Lung Health Conference, the new crown pneumonia epidemic should not be an excuse for the suspension of tuberculosis diagnosis and control services, on the contrary, the new crown pneumonia epidemic should become an effective grasper to promote the development of various public health undertakings, including tuberculosis prevention and control, through innovative and efficient remote digital medical treatment, home isolation treatment and other resources at hand, to complete the prevention and control objectives.
    li Liang believes that Internet medical treatment is very suitable for respiratory infections such as tuberculosis, and this outbreak also provides an opportunity to improve the existing diagnostic and treatment system, so that we can use telemedican, Internet medicine this new form to improve the prevention and control system.
    , the same as respiratory infectious diseases, the management model of patients with neo-crown pneumonia also provides a reference for tuberculosis prevention and control. Li Liang said, to control respiratory infections, the first is to find the source of infection, the second is to cut off the transmission route, isolation of the source of infection, the third is to protect susceptible people. China's new crown pneumonia prevention and control has made significant progress, lies in early detection, early isolation, early treatment. In the past, we have mainly adopted a "non-hospital" approach to the management of tuberculosis, a chronic infectious disease. While non-hospitalization can avoid infections between patients and patients, patients and health care providers, as well as the use of medical resources, at the same time, this management approach increases the risk of TB transmission. Li Liang believes that after the outbreak of neo-crown pneumonia, perhaps we should re-examine the measures and policies of non-hospitalization. "China is very big, the conditions are different, it is not possible to be one-size-fits-all, but I think if the conditions are right, infectious disease TB patients can be hospitalized." Li Liang said.
    Li Liang also stressed that at present, China found that TB patients are still mainly "due to the disease", that is, patients with symptoms to the hospital after screening out, but in fact, half of TB patients do not have any clinical symptoms, then these people are likely not to be found and cause a wider spread. Therefore, there must be major breakthroughs in testing and technology, such as the ability to actively screen key populations.
    5, vigorously advancing research and innovation to achieve the goal of ending TB
    This year's World Health Organization report also sends a worrying signal that both the 2020 milestone set by the Stop TB Strategy and the global targets set by the United Nations High-level Meeting on Tuberculosis are challenging to meet on time. Dr. Minghui Ren, Assistant Director-General for Infectious and Noncommunicable Diseases of the World Health Organization, said at the 51st International Association for the Prevention of Tuberculosis Global Lung Health Conference that the number of TB cases and deaths has been declining in recent years, but not fast enough to reach our goal of eliminating TB on time.
    researchers at Harvard University agree that it has become very difficult to achieve the goal of eliminating TB by 2030, and that achieving the target of a 90 percent reduction in TB mortality and an 80 percent reduction in morbidity by 2015 is likely to be achieved by 2045. It would also mean $3 trillion more in global economic losses, while 5 million more people would die from tuberculosis than originally planned.
    , for example, if we are to achieve the World Health Organization's goal of ending TB, that is, by 2035, the incidence of TB will fall from 60 per 100,000 today to less than 10 per 100,000. Li Liang said that in the past 10 years, China's TB decline rate of about 2% to 3% per year, even according to the highest 3%, to fall below 10/100,000 will take a long time, a long way from the 2035 target. If there are no major breakthroughs in diagnostic techniques, drugs, vaccines, and protection strategies, it will be very difficult to achieve this goal.
    chen Zhongdan said that prevention and treatment among people at high risk of TB must be vigorously promoted, while relying on scientific and technological progress, strengthening the level of diagnosis and treatment, strengthening drug research and development, so that patients can access more rapid, accurate, convenient and affordable diagnostic treatment and care services.
    addition, in the new crown pneumonia pandemic, people are most concerned about the progress of vaccine research and development, there are already many countries in the new crown vaccine clinical research. At the 51st International Association for the Prevention of Tuberculosis Global Lung Health Conference, many experts also called for attention to the development of TB vaccine. Although TB is a traditional infectious disease, the critical situation of its global spread requires a sense of urgency to advance measures to end TB. "If we have a good vaccine in the future, we won't get TB from an earlier level, and we're closer to the goal of ending TB." Li Liang said. TB patients in the late stages of physical thinning, malnutrition, anaemia led to pale skin, so TB is also known as the "white plague." In an era of lack of medical care, tuberculosis is incurable and almost terminal.
    because the disease is mainly transmitted through the respiratory tract, and 80% occur in the lungs, so in many people's eyes, tuberculosis is equivalent to tuberculosis, which is commonly known as "pneumoconiosis." In fact, TB can occur in any organ except hair and nails, but mainly infringing on the lungs. Tuberculosis is tuberculosis, which occurs in the lung tissue, trachea, bronchitis and thoracic membranes, and is strictly a form of tuberculosis, with only the infection and the site of onset concentrated in the respiratory system.
    new progress in TB research and development diagnostics in recent
    serious underfunding has hindered progress in ending TB. Chen Zhongdan pointed out that the commitment to TB diagnostic treatment care is underfunded. By 2020, the commitment to TB prevention, diagnosis, treatment and care will be $6.5 billion, half of the $13 billion target agreed by countries in the
    united Nations political declaration on tuberculosis. In addition, the target includes $2 billion a year in research and development investment, a figure of 900 million in 2018, which shows that the funding gap for TB control remains large.
    's lack of investment doesn't mean it doesn't matter, by comparing the number of deaths and the corresponding funding from 2008 to 2018, it can be seen that TB deaths far exceed
    deaths and malaria deaths, but TB spending is the lowest of the three diseases, which shows that TB funding and disease burden are not consistent.
    limited funding, but in recent years, TB research and development, diagnosis has made a lot of progress. Chen Zhongdan said that as of August 2020, a total of 11 treatment technologies have been approved by the World Health Organization, in addition to 19 are under evaluation. In terms of TB drugs, a total of 22 drugs are in the first, second and third phases of clinical trials, 16 of which are in clinical phase III, and some progress has been made in vaccine development. people because of this new crown pneumonia outbreak, changed a lot of health and living habits. Maria Van Kerkhove, an infectious disease epidemiologist at the World Health Organization and technical director of new crown pneumonia, says that over the past few months, many people have gradually changed their behaviour, keeping social distance, wearing masks and paying attention to hand cleaning, which has helped many areas recover from the outbreak.
    Li Liang pointed out that even if there is no new crown, these habits should be adhered to, because wearing a mask not only to prevent new crown pneumonia, but also to prevent tuberculosis, but also to prevent other respiratory infections.
    on hand hygiene, Li Liang believes that in addition to washing hands, there are many other hand hygiene needs to be paid attention to
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