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| Shifting the focus upstream, innovation drive: toward ending the tuberculosis epidemic |
| CHEN Bin
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| Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang 310051, China |
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Abstract The World Health Organization (WHO) has proposed the goal of ending the tuberculosis (TB) epidemic by 2035, aiming to eliminate the harm of tuberculosis to human health as soon as possible. Based on current context of TB prevention and control in China, this paper proposes strategies of shifting the focus upstream and innovation drive to end the TB epidemic. Shifting the focus upstream mainly relies on proactive screening to control infectious sources, epidemiological investigations to trace and block transmission, and preventive interventions to protect vulnerable populations. Innovation drive primarily depends on technological innovations in TB screening, diagnosis, treatment, and intelligent prevention and control to enhance prevention and control efficacy and accelerate the decline of the epidemic. Challenges remain in the implementation of shifting the focus upstream and innovation drive. It is recommended to enhance government commitment and investment, and adopt measures such as comprehensive interventions in TB-free communities to drive China towards achieving the goal of ending the TB epidemic.
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Received: 02 December 2025
Revised: 02 March 2026
Published: 23 March 2026
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[1] World Health Organization.Global tuberculosis report 2025[R].Geneva:WHO,2025.
[2] 张立杰,刘宇红.联合国大会第二届结核病防治高级别会议政治宣言解读[J].中国防痨杂志,2023,45(12):1117-1119.
[3] HOUBEN R M G J,MENZIES N A,SUMNER T,et al.Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa,China,and India:a combined analysis of 11 mathematical models[J].Lancet Glob Health,2016,4(11):806-815.
[4] JIANG H L,LI R,ZHANG T H,et al.Cost-effectiveness of preventive treatment regimens for latent tuberculosis infection among key community-level populations[J/OL].BMC Med,2025,23(1)[2026-03-02].https://doi.org/10.1186/s12916-025-04413-3.
[5] 钱秉中,郑志杰.中国可以终止结核病[J].中国防痨杂志,2024,46(10):1185-1187.
[6] XIONG J L,KONG L M,SHEN Y L,et al.Model-informed evaluation of interventions to eliminate tuberculosis transmission in China[J].Public Health,2025,241:33-38.
[7] 马琼锦,严慧琴,吴蕴华,等.闵行区肺结核就诊延误、诊断延误和发现延误的影响因素分析[J].预防医学,2025,37(1):59-64.
[8] 葛锐,田敏,侯志刚,等.2013—2022年嘉兴市儿童青少年肺结核发现延迟分析[J].预防医学,2023,35(12):1089-1092.
[9] TODD H,HUDSON M,GROLMUSOVA N,et al.Social protection interventions for TB-affected households:a scoping review[J].Am J Trop Med Hyg,2023,108(4):650-659.
[10] RICHARDS A S,SOSSEN B,EMERY J C,et al.Quantifying progression and regression across the spectrum of pulmonary tuberculosis:a data synthesis study[J].Lancet Glob Health,2023,11(5):684-692.
[11] EMERY J C,DODD P J,BANU S,et al.Estimating the contribution of subclinical tuberculosis disease to transmission:an individual patient data analysis from prevalence surveys[J/OL].Elife,2023,12[2026-03-02].https://doi.org/10.7554/eLife.82469.
[12] HU Z F,LIU K,ZHOU M,et al.Mass tuberculosis screening among the elderly:a population-based study in a well-confined,rural county in Eastern China[J].Clin Infect Dis,2023,77(10):1468-1475.
[13] XU Y W,CANCINO-MUÑOZ I,TORRES-PUENTE M,et al.High-resolution mapping of tuberculosis transmission:whole genome sequencing and phylogenetic modelling of a cohort from Valencia Region,Spain[J/OL].PLoS Med,2019,16(10)[2026-03-02].https://doi.org/10.1371/journal.pmed.1002961.
[14] World Health Organization.WHO consolidated guidelines on tuberculosis. Module 2:screening - systematic screening for tuberculosis disease[R].Geneva:WHO,2021.
[15] 成君,赵雁林.无结核社区建设中的主动筛查策略[J].中国防痨杂志,2024,46(6):605-612.
[16] 王森路,刘年强,王新旗,等.结核病防治“新疆模式”的发展及成效[J].中国防痨杂志,2024,46(2):141-144.
[17] 郑平明,金玫华,丁忠明,等.浙江省湖州市“无结核城市”建设实践与思考[J].中国防痨杂志,2024,46(10):1193-1197.
[18] 中华人民共和国国家卫生健康委员会基层卫生健康司.关于做好2025年基本公共卫生服务工作的通知[EB/OL].[2026-03-02].https://www.nhc.gov.cn/jws/c100073/202506/14a23782324542f59137bbf24a1c988f.shtml.
[19] DEB S,BASU J,CHOUDHARY M.An overview of next generation sequencing strategies and genomics tools used for tuberculosis research[J/OL].J Appl Microbiol,2024,135(7)[2026-03-02].https://doi.org/10.1093/jambio/lxae174.
[20] FAN Y F,LIU D X,CHEN Y W,et al.Inferring mycobacterium tuberculosis drug resistance and transmission using whole-genome sequencing in a high TB-burden setting in China[J].Biomed Environ Sci,2024,37(2):157-169.
[21] LIU Z W,LI X C,XIONG H Y,et al.Genomic and spatial analysis reveal the transmission dynamics of tuberculosis in areas with high incidence of Zhejiang,China:a prospective cohort study[J/OL].Infect Genet Evol,2024,121[2026-03-02].https://doi.org/10.1016/j.meegid.2024.105603.
[22] YANG T,GAN M,LIU Q,et al.SAM-TB:a whole genome sequencing data analysis website for detection of Mycobacterium tuberculosis drug resistance and transmission[J/OL].Brief Bioinform,2022,23(2)[2026-03-02].https://doi.org/10.1093/bib/bbac030.
[23] PAN J H,LI X C,ZHANG M W,et al.TransFlow:a Snakemake workflow for transmission analysis of Mycobacterium tuberculosis whole-genome sequencing data[J/OL].Bioinformatics,2023,39(1)[2026-03-02].https://doi.org/10.1093/bioinformatics/btac785.
[24] ZHU P,CHEN X Y,PAN J,et al.Prognostic value of an abnormal chest X-ray result in predicting the development of tuberculosis[J/OL].Nat Commun,2025,16(1)[2026-03-02].https://doi.org/10.1038/s41467-025-64834-9.
[25] 高磊,张慧,胡茂桂,等.基于多中心调查数据和空间统计模型的全国结核分枝杆菌潜伏感染率估算[J].中国防痨杂志,2022,44(1):54-59.
[26] ZHU P,HAO X G,WANG W,et al.Incidence and risk factors of active tuberculosis among older individuals with latent tuberculosis infection:a cohort study in two high-epidemic sites in Eastern China[J/OL].Front Cell Infect Microbiol,2024,14[2026-03-02].https://doi.org/10.3389/fcimb.2024.1332211.
[27] World Health Organization.WHO consolidated guidelines on tuberculosis:tuberculosis preventive treatment:annex 1:methods and expert panels[M].Geneva:WHO,2020.
[28] ALSDURF H,HILL P C,MATTEELLI A,et al.The cascade of care in diagnosis and treatment of latent tuberculosis infection:a systematic review and meta-analysis[J].Lancet Infect Dis,2016,16(11):1269-1278.
[29] 王大宽,张彬,刘自森,等.基层结核病预防性治疗门诊建设的探索与展望[J].中国防痨杂志,2023,45(5):442-445.
[30] 于慧敏,郑徽,刘二勇,等.结核病疫苗免疫策略研究进展[J].中国防痨杂志,2025,47(7):930-939.
[31] XIN H N,WANG W,WANG X M,et al.The performance of computer-aided detection for chest radiography in tuberculosis screening:a population-based retrospective cohort study[J/OL].Emerg Microbes Infect,2025,14(1)[2026-03-02].https://doi.org/10.1080/22221751.2025.2470998.
[32] ABDULGADER S M,OKUNOLA A O,NDLANGALAVU G,et al.Diagnosing tuberculosis:what do new technologies allow us to(not)do?[J].Respiration,2022,101(9):797-813.
[33] LIU Z W,CHEN R Q,LI B,et al.Community-based “X-ray+Xpert® MTB/RIF ultra pooling test” case-finding strategy among high-risk groups in rural areas:a prospective application study[J/OL].Emerg Microbes Infect,2026,15(1)[2026-03-02].https://doi.org/10.1080/22221751.2025.2610857.
[34] CHEN B,LI Y,PENG Y,et al.Care-seeking and treatment pathways of multidrug-resistant tuberculosis patients:an analysis of real-world data from regional health information system in Ningbo City in Eastern China[J/OL].Ann Med,2025,57(1)[2026-03-02].https://doi.org/10.1080/07853890.2025.2496405.
[35] SAUKKONEN J J,DUARTE R,MUNSIFF S S,et al.Updates on the treatment of drug-susceptible and drug-resistant tuberculosis:an official ATS/CDC/ERS/IDSA clinical practice guideline[J].Am J Respir Crit Care Med,2025,211(1):15-33.
[36] MENON S,KOURA K G.Artificial intelligence for tuberculosis control:a scoping review of applications in public health[J/OL].J Glob Health,2025,15[2026-03-02].https://doi.org/10.7189/jogh.15.04192. |
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