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Open Access Research article

Changes in pulmonary tuberculosis prevalence: evidence from the 2010 population survey in a populous province of China

Xiaolin Wei12, Xiulei Zhang3*, Jia Yin12, John Walley4, Rachel Beanland4, Guanyang Zou4, Hongmei Zhang3, Fang Li3, Zhimin Liu3, Benny CY Zee1 and Sian M Griffiths1

Author Affiliations

1 Chinese University of Hong Kong, Hong Kong, China

2 Shenzhen Municipal Key Laboratory for Health Risk Analysis, Shenzhen Research Institute of The Chinese University of Hong Kong, Shenzhen, Guangdong Province, China

3 Center for Tuberculosis Control, Shandong Provincial Chest Hospital, 12 Lieshishan Dong Lu, Jinan 250101, China

4 Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK

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BMC Infectious Diseases 2014, 14:21  doi:10.1186/1471-2334-14-21

Published: 11 January 2014

Abstract

Background

This paper reports findings from the prevalence survey conducted in Shandong China in 2010, a province with a population of 94 million. This study aimed to estimate TB prevalence of the province in 2010 in comparison with the 2000 survey; and to compare yields of TB cases from different case finding approaches.

Methods

A population based, cross-sectional survey was conducted using multi-stage random cluster sampling. 54,279 adults participated in the survey with a response rate of 96%. Doctors interviewed and classified participants as suspected TB cases if they presented with persistent cough, abnormal chest X-ray (CXRAY), or both. Three sputum specimens of all suspected cases were collected and sent for smear microscopy and culture.

Results

Adjusted prevalence rate of bacteriologically confirmed cases was 34 per 100,000 for adults in Shandong in 2010. Compared to the 2000 survey, TB prevalence has declined by 80%. 53% of bacteriologically confirmed cases did not present persistent cough. The yield of bacteriologically confirmed cases was 47% by symptom screening and 95% by CXRAY. Over 50% of TB cases were among over 65’s.

Conclusions

The prevalence rate of bacteriologically confirmed cases was significantly reduced compared with 2000. The survey raised challenges to identify TB cases without clear symptoms.

Keywords:
Tuberculosis; Population based prevalence survey; Case finding; China