Fei Huang, Yinyin Xia, Hui Chen, Ni Wang, Xin Du, Wei Chen, Tao Li, Shitong Huan, Miaomiao Sun, Mingting Chen, Keshavjee Salmaan, Yanlin Zhao, Chin Daniel P, Jianjun Liu
Chinese Center for Disease Control and Prevention, Beijing, China.
China office, The Bill & Melinda Gates Foundation, Beijing, China.
Lancet Reg Health West Pac. 2020 Oct;3:100032. doi: 10.1016/j.lanwpc.2020.100032. Epub 2020 Sep 24.
In response to the COVID-19 epidemic, China implemented a series of interventions that impacted tuberculosis (TB) control in the country.
Based on routine surveillance data and questionnaires, the study analyzed TB notification, follow-up examinations, and treatment outcomes. The data were split into three phases in relation to outbreak, lockdown and reopen when the nationwide COVID-19 response started in 2020: control (11 weeks prior), intensive (11 weeks during and immediately after), and regular (4 additional weeks). Data from 2017-2019 were used as baseline.
The notified number of TB patients decreased sharply in the 1 week of the intensive period but took significantly longer to rebound in 2020 compared with baseline. The percentages of TB patients undergoing sputum examination within one week after 2 months treatment and full treatment course in the intensive period were most affected and decreased by 8% in comparison with control period. 75•2% (221/294) of counties reallocated CDC and primary health care workers to fight the COVID-19 epidemic, 26•9% (725/2694) of TB patients had postponed or missed their follow-up examinations due to travel restrictions and fear of contracting COVID-19.
In the short term, the COVID-19 epidemic mostly affected TB notification and follow-up examinations in China, which may lead to a surge of demand for TB services in the near future. To cope with this future challenge, an emergency response mechanism for TB should be established.
National Health Commission of China-Bill & Melinda Gates Foundation TB Collaboration project (OPP1137180).
为应对新冠疫情，中国实施了一系列影响国内结核病防控的干预措施。
该研究基于常规监测数据和问卷调查，分析了结核病报告、随访检查及治疗结果。数据根据2020年全国新冠疫情应对开始时的爆发、封锁和重新开放分为三个阶段：管控期（前11周）、强化期（期间及之后立即的11周）和常规期（额外4周）。2017 - 2019年的数据用作基线。
强化期第1周结核病报告患者数量急剧下降，但与基线相比，2020年反弹所需时间显著更长。强化期治疗2个月后1周内及全程治疗后1周内进行痰检的结核病患者百分比受影响最大，与管控期相比下降了8%。75.2%（221/294）的县重新调配了疾控中心和基层医护人员抗击新冠疫情，26.9%（725/2694）的结核病患者因出行限制和担心感染新冠而推迟或错过随访检查。
短期内，新冠疫情主要影响了中国的结核病报告和随访检查，这可能在不久的将来导致结核病服务需求激增。为应对这一未来挑战，应建立结核病应急响应机制。
中国国家卫生健康委员会 - 比尔及梅琳达·盖茨基金会结核病合作项目（OPP1137180）
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