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Migrating TB in China 中國結核的城鄉遷移

(added on 2012/03/20)

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As one of the 22 high burden countries for tuberculosis (TB), China reported an estimated one million TB cases each year, accounting for more than one eighth of global cases. In 2010, the number of reported cases was 70 per 100,000 population.

The map shows the distribution of TB cases in China. As depicted by graduated colours, the number of reported cases per 100,000 population in 2010 was generally higher in rural central-western China than that in urban eastern China. The circle symbols, indicating retreatment patients, suggested that this could be high not just in high TB burden provinces but also municipalities with low incidence, as a result of rural-to-urban migration.

Tuberculosis in retreatment patients requires extensive chemotherapy and poses a threat to public health as drug resistance might have developed. Therefore, better case management and appropriate treatment regimens are important to control tuberculosis in China.

Data for the map were obtained from Chinese Center for Disease Control and Prevention.

中國是全球22個結核病高負擔國家之一，每年新增約一百萬個病例，佔全球超過八份之一的病例數目。2010年，中國每十萬人口中便有70個新增病例。

地圖顯示中國結核病的分佈情況。依圖中顏色所示，2010年中國中西部的農村地區每十萬人計的結核病病例數目較東部的城鎮地區為高。圖中圓圈符號則顯示，高比例的復發患者除了出現於結核病高負擔的省份外，亦因城鄉遷移而出現於發病率低的直轄市。

相比一般結核病，復發患者需要較長時間的療程。由於可能已產生抗藥性，高復發現象對公共衛生構成更嚴重的威脅。要有效控制中國結核病疫情，妥善個案管理及適當的治療處方均為重要。

地圖資料源自中國疾病預防控制中心。

Directly observed treatment, short course 短程全監督治療

DOTS (directly observed treatment, short course) remains an important tuberculosis (TB) control strategy. DOTS comprises five components including (a) government commitment to sustained TB control, (b) quality-ensured diagnosis, (c) regular and uninterrupted supply of high-quality TB drugs, (d) standardized short-course treatment under direct observation of healthcare staff, and (e) systematic recording and evaluation for treatment performance.

Through DOTS, essential support is provided for TB patients to complete the full course of treatment. Hence, treatment failure, emergence of drug resistance and spread of the disease can be avoided.

短程全監督治療至今仍是結核病控制的主要策略，當中包括五大原素：政府對結核病持續性防治的承諾、品質良好的診斷、定期及無間斷的高品質結核藥物供應、在醫護人員直接觀察下服用標準化的抗結核藥物、以及有系統的紀錄和評估治療成效。

透過短程全監督治療，結核病病人可得到所需的支援以完成整個療程，從而防止治療失效，避免耐藥性結核桿菌的產生及遏制結核病的散播。

Tuberculosis 結核病

What is Tuberculosis? 什麼是結核病？

Tuberculosis, or TB, is a bacterial disease caused by Mycobacterium tuberculosis, which most commonly affects the lungs.
In healthy people, infection with Mycobacterium tuberculosis often causes no symptom, since the person’s immune system acts to “wall off” the bacteria. The symptoms of active TB of the lungs are cough, sometimes with sputum or blood, chest pain, general weakness, weight loss, fever and night sweats. Tuberculosis is normally treated with a six to nine-month course of antibiotics.
結核病是由一種名為結核桿菌的細菌所引起的傳染病，通常影響肺部。
受結核桿菌感染的病人，部份因本身的免疫系統發揮作用而不會有任何病癥。而活躍肺結核病的病癥則包括咳嗽，痰涎中帶血、胸口痛、疲倦、體重下降、發燒、夜間冒汗等。結核病者一般需要接受為期六至九個月的抗生素療程治療。

How does it spread? 如何傳播？

TB is transmitted from person to person via droplets from the throat and lungs of people with the active respiratory infection.
結核病是經患者呼吸系統產生的飛沫於空氣中人傳人感染的。

Vaccine? 疫苗?

BCG, or bacillus Calmette-Guérin, is a vaccine for tuberculosis disease. In Hong Kong, all the new born babies receive BCG vaccine as a part of the childhood immunisation programme. Vaccination does not guarantee protection.
卡介苗是用以預防結核病的一種疫苗。每一個香港新生嬰兒需要接受一系列免疫接種，當中包括卡介苗注射。接種卡介苗並不保證不受結核桿菌感染。