终结结核病的中国路径：主动筛查、医防融合与预防性治疗

Core Viewpoint - Tuberculosis (TB) remains a significant public health challenge in China, with over 600,000 new cases reported annually despite a declining incidence rate. The country is exploring effective prevention and control strategies to achieve the global goal of ending TB epidemics [3][4]. Group 1: Transition from Passive to Active Prevention - Historically, TB control in China has relied on passive diagnosis, with over 90% of new cases identified only after symptoms appear. This approach has led to significant underdiagnosis, particularly among asymptomatic patients [5]. - The National TB Prevention and Control Plan (2024-2030) emphasizes proactive screening of high-risk populations, integration of medical and preventive measures, and preventive treatment for latent infections to block transmission at the source [5][6]. Group 2: Technological and Community-Based Innovations - Dr. Chen Zhongdan highlighted the need for more sensitive, effective, and accessible screening and treatment tools, noting that even imperfect tools can yield good results if utilized effectively [6]. - Shenzhen has developed a modern TB prevention system that integrates community health services with technology, establishing a closed-loop system for screening, diagnosis, management, and treatment [7][9]. Group 3: Successful Models in Shenzhen and Yuxi - In Shenzhen, proactive screening has led to the identification of 574 active TB cases from 37,964 screenings, with a focus on integrating TB screening into routine health checks for high-risk groups [9][10]. - Yuxi has embedded TB screening into basic public health services, achieving a significant reduction in TB incidence from 58.9 per 100,000 in 2004 to 24.14 per 100,000 in 2023, demonstrating a 59% decrease [10][12]. Group 4: Preventive Treatment as a Key Strategy - Preventive treatment for latent TB infection (LTBI) is now a core strategy in China's TB control efforts, with a focus on high-risk groups such as close contacts of infectious patients and immunocompromised individuals [14][15]. - The introduction of a six-week short-course preventive treatment regimen has shown a 69% protective effect, making it suitable for grassroots implementation [18]. Group 5: Challenges and Future Directions - Despite progress, challenges remain, including slow technology adoption, side effects of preventive treatment drugs, and resource limitations at the grassroots level [18][19]. - The need for large-scale, symptom-independent community screening is emphasized as essential for increasing coverage and blocking transmission, with historical precedents from other countries supporting this approach [20]. Group 6: Overall Progress and Goals - China's TB treatment success rate remains stable at over 90%, with increasing coverage of screening among high-risk populations and expanding preventive treatment initiatives. The country aims to achieve the goal of ending TB epidemics through a three-pronged approach of proactive screening, medical-preventive integration, and prioritizing prevention [20].