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1.?China?has?a?large?number?of?tuberculosis?cases,?and?the?government?has?a?heavy?task?in?prevention?and?treatment

China?is?a?country?with?high?burden?of?pulmonary?tuberculosis.?According?to?the?WHO?report,?the?new?cases?in?30?countries?with?high?burden?of?tuberculosis?account?for?86%?of?all?cases?in?the?world.?Among?them,?the?cases?of?pulmonary?tuberculosis?in?8?countries?account?for?two-thirds?of?the?global?total,?of?which?India?accounts?for?27%,?China?for?9%?and?Indonesia?for?8%.

According?to?the?report?in?the?2021?China?Health?Statistics?Yearbook,?there?are?16?regions?in?China?with?more?than?20000?TB?cases,?mainly?in?East?China,?Southwest?China?and?South?China,?with?149200?in?East?China,?137800?in?Southwest?China?and?107000?in?South?China.

The?five?provinces?with?the?highest?number?of?cases?were?Guangdong,?Hunan,?Sichuan,?Henan?and?Guizhou.

The?areas?with?a?large?number?of?drug-resistant?tuberculosis?are?mainly?Guizhou,?Henan,?Guangdong,?Anhui,?Guangxi?and?other?places,?because?of?the?high?number?of?patients?and?the?high?total?drug?resistance?rate.

The?distribution?of?special?funds?for?tuberculosis?in?various?provinces?in?China?is?generally?preferred?to?provinces?and?cities?with?high?incidence?and?incidence?rate,?which?are?implemented?by?the?provincial?centers?for?Disease?Control?and?prevention?and?key?municipal?centers?for?Disease?Control?and?prevention,?mainly?used?for?the?prevention?and?management?of?drug-resistant?tuberculosis?and?the?follow-up?management?of?patients.?The?tuberculosis?prevention?and?control?costs?in?various?provinces?and?cities?are?as?follows:

2.?There?are?many?kinds?of?drugs?for?the?treatment?of?pulmonary?tuberculosis,?the?development?of?new?drugs?is?slow,?and?the?drug?resistance?of?patients?is?serious

At?present,?the?conventional?drugs?used?in?the?clinical?treatment?of?pulmonary?tuberculosis?have?been?used?for?more?than?half?a?century.?The?commonly?used?anti?tuberculosis?drugs?mainly?include?isoniazid,?rifampicin,?pyrazinamide,?ethambutol?and?streptomycin.?The?first?four?drugs?belong?to?oral?drugs,?and?streptomycin?belongs?to?injection.?The?first-line?drugs?of?anti?tuberculosis?drugs?are?as?follows:

With?the?abuse?of?various?drugs?and?the?long-term?non-standard?medication?of?patients,?the?phenomenon?of?drug-resistant?tuberculosis?becomes?more?and?more?serious.

According?to?the?report?of?China?Health?Statistics?Yearbook?2021,?the?incidence?rate?of?tuberculosis?in?China?in?2020?is?47.76/100000,?including:

(1)?There?are?13?regions?in?China?where?the?incidence?rate?of?tuberculosis?is?higher?than?the?average?level,?mainly?in?the?western?and?southern?regions.?Among?them,?the?five?regions?with?the?highest?incidence?rate?are?Tibet,?Xinjiang,?Guizhou,?Qinghai?and?Hainan;

(2)?According?to?the?results?of?sampling?surveys?in?various?regions,?the?total?drug?resistance?rate?in?Tibet,?Inner?Mongolia,?Anhui,?Guizhou?and?Northeast?China?is?generally?high,?mainly?due?to?drug?induction.?The?main?factors?are?irregular?medication,?irregular?treatment?and?lack?of?good?rest?and?nutrition.

In?terms?of?drug?research?and?development,?the?focus?is?on?the?research?and?development?of?drugs?that?are?resistant?to?multidrug?resistance?and?extensive?drug?resistance.?A?number?of?new?drugs?have?been?listed?one?after?another.?There?are?also?some?breakthrough?new?drugs?in?the?research?and?development?stage.?However,?traditional?drugs?have?not?been?invested?in?new?drugs?due?to?long?time?and?low?profit.?For?drug-resistant?tuberculosis?and?multidrug-resistant?tuberculosis?(MDR-TB),?who?divides?the?drugs?for?treating?drug-resistant?tuberculosis?into?four?groups?a,?B,?C?and?d?according?to?the?effectiveness?and?safety?of?drugs,?of?which?group?A,?B?and?C?are?core?second-line?drugs,?as?shown?in?the?following?figure:

3.?The?application?of?tuberculosis?detection?methods?and?detection?institutions

Tuberculosis?is?an?infectious?disease,?which?is?strictly?controlled?by?the?state,?and?the?amount?of?detection?by?third-party?testing?institutions?is?small.?In?China,?tuberculosis?is?mainly?detected?by?designated?TB?medical?institutions,?and?the?amount?of?detection?by?non?designated?medical?institutions?and?third-party?testing?laboratories?is?small;?Molecular?testing?is?widely?used?in?specialized?hospitals,?secondary?and?tertiary?designated?general?hospitals?and?centers?for?Disease?Control?and?prevention.

From?the?fixed-point?and?non?fixed-point?dimensions,?the?detection?of?combined?diseases?is?basically?as?follows:

(1)?Non?designated?institutions:?it?only?involves?the?screening?and?diagnosis?of?tuberculosis,?and?the?detection?methods?are?different?depending?on?the?size?of?the?hospital?and?the?region;

a.?The?detection?methods?of?small?hospitals?are?mainly?imaging?and?PPD;

b.?In?addition?to?conventional?imaging,?the?detection?methods?of?large?hospitals?include?sputum?smear,?PCR?and?culture,?and?a?small?amount?of?T-SPOT?and?ngs.

(2)?Designated?institutions:?screening?diagnosis,?strain?identification?and?drug?sensitivity?test?are?all?involved,?and?the?above?methods?are?adopted?in?each?link.

4.?Future?development?of?tuberculosis?testing?market

The?national?"13th?five?year?plan"?for?tuberculosis?prevention?and?control?and?the?"action?plan?for?curbing?tuberculosis?(2019-2022)"?give?instructions?on?the?active?screening?of?people?with?suspected?symptoms?of?tuberculosis?and?key?groups,?and?strengthen?the?active?screening?of?people?with?close?contacts?of?tuberculosis,?patients?with?AIDS?and?diabetes,?elderly?people?over?65?years?old?and?enrolled?students.

At?present,?some?regions?in?China?have?carried?out?the?pilot?work?of?active?tuberculosis?screening.?For?example,?Henan,?Hebei,?Hunan,?Yuxi,?Shaanxi,?Xi'an,?Quzhou,?Zhejiang,?Jining,?Shandong?and?other?regions?have?all?carried?out?the?pilot?work?of?active?tuberculosis?screening?for?key?populations,?but?on?the?whole,?it?is?still?relatively?elementary:?the?detection?strategy?of?domestic?tuberculosis?is?still?mainly?passive?detection,?and?the?main?detection?strategy?is?applied?to?AIDS?patients?Smear?positive?pulmonary?tuberculosis?patients?and?close?contacts.

Tuberculosis?prevention?and?control?departments?such?as?the?center?for?Disease?Control?and?prevention?and?the?Institute?for?tuberculosis?control?have?great?demand?for?active?screening?of?tuberculosis.?Only?by?doing?a?good?job?of?tuberculosis?screening?as?soon?as?possible?can?we?find?and?treat?tuberculosis?as?soon?as?possible,?reduce?the?number?of?tuberculosis?patients?from?the?source,?reduce?the?infectious?risk?of?tuberculosis?and?the?difficulty?of?curing?drug-resistant?tuberculosis.?The?current?situation?of?tuberculosis?prevention?and?control?in?China?shows?that?the?competent?authorities?have?a?great?demand?for?screening?equipment?for?combined?diseases,?and?the?market?prospect?of?active?screening?for?tuberculosis?is?huge.