Performance of prevention and treatment of drug-resistant tuberculosis in Jiangsu, Zhejiang and Shanghai, 2016−2022

  Objective  To evaluate the performance of drug-resistant tuberculosis (TB) prevention and treatment and analyze its social benefits in Jiangsu, Zhejiang and Shanghai from 2016 to 2022.

  Methods  The information about screening, treatment of drug-resistant TB patients were collected from National Tuberculosis Information Management System. The information about investment of central and local government and relevant data, such as gross domestic product per capita, were collected. The screening rate, treatment inclusion rate and the cure rate of drug resistant TB was used to evaluate the performance of the prevention and control of drug-resistant TB. Cost-effectiveness, cost-utility, and cost-benefit were analyzed to evaluate the effectiveness of drug-resistant TB prevention and treatment efforts from 2016 to 2022.

  Results  The screening rate of drug-resistant TB in Jiangsu, Zhejiang and Shanghai from 2016 to 2022 was 86.00% in new etiologic positive patients, 87.90% in patients at high risk. The treatment inclusion rate of drug-resistant TB patients was 75.47%, and the cure rate of drug resistant TB patients was 62.32%. The above four indicators all showed increases during the 7-year period (trend χ²=129.5793, P<0.001, trend χ²=35.3692, P<0.001, trend χ²=27.7113, P<0.001, trend χ²=10.5556, P<0.001). From 2016 to 2022, Jiangsu, Zhejiang and Shanghai invested a total of 0.26 billion yuan for drug-resistant TB prevention and treatment, and 3570 drug-resistant TB patients were successfully treated, reducing 37624.23 disability adjusted life years (DALYs) and 4.197 billion yuan of social and economic losses. An investment of 7459.72 (4973.15−12432.87) yuan can reduce 1 infection, an investment of 7078.20 yuan can reduce 1 DALY and an investment of 1 yuan can produce economic benefit of 15.76 yuan (14.94−16.79).

  Conclusion  During 2016−2022, the screening rate, treatment inclusion rate and cure rate of drug-resistant TB patients in Jiangsu, Zhejiang and Shanghai were higher than the average levels in China. The financial investment in drug-resistant tuberculosis prevention and treatment in Jiangsu, Zhejiang and Shanghai has gained high economic benefits, and it is recommended to continue increasing the investment for drug-resistant TB prevention and treatment.