Rising challenge of multidrug-resistant tuberculosis in China:a predictive study using Markov modeling

查看全文 作　　者：Bing-Ying [1,2]Li;Wen-Pei [1,2]Shi;Chang-Ming [1,3]Zhou;Qi [1,2]Zhao;Vinod K [4]Diwan;Xu-Bin [1,2]Zheng;Yang [1,5]Li;Sven [4]Hoffner;Biao [1,2,4]Xu

机构地区：[1]School of Public Health,Fudan University,Shanghai,China;[2]Key Lab of Health Technology Assessment(Fudan University),National Health Commission,Shanghai,China;[3]Department of Cancer prevention,Fudan University Shanghai Cancer Center,Shanghai,China;[4]Department of Public Health Sciences(Global Health/IHCAR),Karolinska Institutet,Stockholm,Sweden;[5]Department of Nephrology,Zhongshan Hospital,Fudan University,Shanghai,China

出　　处：《Infectious Diseases of Poverty》索引2020年第9卷第3期,共8页

基　　金：The study was supported by the Swedish Research Council(No.540–2013-8797 to SH);the National Natural Science Foundation of China(No.81361138019 to BX)joint project(VR-NSFC);the National Science and Technology Major Project of China(No.2018ZX10715012–4 to BX). 摘　　要：Background:Multidrug-resistant tuberculosis(MDR-TB)is on the rise in China.This study used a dynamic Markov model to predict the longitudinal trends of MDR-TB in China by 2050 and to assess the effects of alternative control measures.Methods:Eight states of tuberculosis transmission were set up in the Markov model using a hypothetical cohort of 100000 people.The prevalence of MDR-TB and bacteriologically confirmed drug-susceptible tuberculosis(DS-TB+)were simulated and MDR-TB was stratified into whether the disease was treated with the recommended regimen or not.Results:Without any intervention changes to current conditions,the prevalence of DS-TB+was projected to decline 67.7%by 2050,decreasing to 20 per 100000 people,whereas that of MDR-TB was expected to triple to 58/100000.Furthermore,86.2%of the MDR-TB cases would be left untreated by the year of 2050.In the case where MDR-TB detection rate reaches 50%or 70%at 5%per year,the decline in prevalence of MDR-TB would be 25.9 and 36.2%respectively.In the case where treatment coverage was improved to 70%or 100%at 5%per year,MDR-TB prevalence in 2050 would decrease by 13.8 and 24.1%,respectively.If both detection rate and treatment coverage reach 70%,the prevalence of MDR-TB by 2050 would be reduced to 28/100000 by a 51.7%reduction.Conclusions:MDR-TB,especially untreated MDR-TB,would rise rapidly under China’s current MDR-TB control strategies.Interventions designed to promote effective detection and treatment of MDR-TB are imperative in the fights against MDR-TB epidemics. 关键词：Multidrug-resistant tuberculosis Markov chains PREVALENCE Prevention and control

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Rising challenge of multidrug-resistant tuberculosis in China:a predictive study using Markov modeling

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