TB in China 20160719课件.ppt

Controlling TB in China;Infectious diseases ;Incidence of infectious diseases (A B) from 1978 to 2008 in China; 1950-1970;In 1951: Smallpox, 60,000 cases In 1952: Malaria, 293 million cases In 1959,1967 and 1977: Epidemic cerebrospinal meningitis;2000-;Measles(1950-2008);Malaria (1984－2006);What are the major infectious diseases in China now?;Leading infectious diseases in China*;How much do you know about TB?;肺结核病主要通过哪种途径传播？;现代预防结核病最主要的方法是？;连续咳嗽、咳痰 以上（或痰中带血）就应该怀疑可能得了肺结核;我国推广的结核病病人治疗原则是？;肺结核病人开始经过正规药物治疗多长时间后就可以参加正常的社会活动 ;肺结核病人服药治疗通常需要几个月时间？;TB: an old disease;Understanding TB;1896, Wilhelm R?ntgen discovered the X-ray.;Understanding TB;Understanding TB;Treatment ;School in sanatorium;Strict bed rest;Sunbathing;Rib and pulmonary resection;Drug development;Estimated numbers of TB cases and deaths 1990–2014;Estimated TB incidence: top-ten countries, 2014.;;王建明 流行病学系 jmwang@njmu.edu.cn;结核分枝杆菌复合群;结核分枝杆菌－－形态染色;结核分枝杆菌－－所致疾病与免疫性;感染与发病;肺结核病的诊断;结核分枝杆菌－－涂片检查;结核分枝杆菌－－涂片检查;抗酸染色－－报告方式;肺结核病诊断标准;肺结核病诊断标准;*;*;结核病临床治疗;结核病临床治疗;结核病临床治疗;结核病临床治疗;结核病临床治疗;耐多药结核（MDR－TB）;广泛耐药结核 XDR－TB;自发突变 治疗管理 病人自身因素 ;TB流行过程及其影响因素;结核病流行过程; 传播途径 主要经空气传播 -飞沫、飞沫核 结核杆菌一般不能通过尘埃传播进入肺组织。;结核病流行过程;影响流行过程的因素;WHY TB EPIDEMIC IS NOT YET UNDER CONTROL;Difficulties we are facing;Prevention of TB;BCG is routinely used in China as a part of EPI. However, its impact preventing TB infection and active disease is unsatisfactory. New-generation vaccines are needed.;Case finding;Passive case-finding;Access to health service;Diagnosis of TB;Progress in the roll-out of GeneXpert MTB/RIF;Treatment of TB;Drug development;An investigation in 6 TB hospitals in China showed that: only 18% of patients with a new case of TB and 9% of patients with a retreatment case of TB were prescribed standard TB treatment regimens.;Treatment adherence;However, DOT(directly observed therapy) by doctors was not well accepted and performed in China. ;Case Management ;Drug resistance;;Percentage of new TB cases with MDR-TB;