◆The smear positive prevalence for all provinces, municipalities and autonomous regions should be 50% of that of in 1990;
◆The national smear positive prevalence should decline to 70/100,000;
◆The detection rate of new smear positive cases should be 60%-70%; and
◆The sputum negative conversion rate of new smear positive cases should be 90%.
2.2 STRENGTHENING OF THE NATIONAL TUBERCULOSIS CONTROL NETWORK
The National Tuberculosis Control Center (in Beijing) and Subcenter (in Shanghai) were established since 1981. The main responsibilities of the national center and subcenter were: designing, planning and implementation of the national tuberculosis control programme; supervision of the provincial tuberculosis control programme; central registration and reporting system; national tuberculosis surveillance system; health education and training; national tuberculosis research programme and quality control of the national tuberculosis laboratory surveillance system.
At present, all thirty-one provinces, municipalities and autonomous regions had established their own tuberculosis dispensary of institute. They are responsible for the provincial tuberculosis control programme. A total of 1,354 professional staffs worked at provincial specialized tuberculosis control agencies in the Country.
319 out of 333 (95.8%) prefectural administrative areas had established prefectural tuberculosis dispensaries and 2,252 out of 2,850 (79.0%) counties had established county tuberculosis dispensaries.
Nowadays, a total of 25,787 staffs is invloved in the national tuberculosis control network.
2.3 CASE-FINDING
In accordance with the data reported by Yuan Fu Qian, 3,633 cases out of 4,597 new pulmonary tuberculosis patients (79%) had suspectable symptoms of tuberculosis. Among bacteriological positive patients, 85,9% of them had symptoms and it was 90.1% among cavitary cases. The percentage of various symptoms were: cough (23.3%), expectoration (18.3%), fatigue (10.9%), chest stuffiness (10/9%), chest pain (8.3%), fever (8.1%), loss of appetite (7.8%), bloody sputum or hemoptysis (5.4%), loss of body weight (5.0%) and others (2.9%).
A report used cough and expectoration more than three weeks and bloody sputum and/or hemoptysis as the main criteria of tuberculosis symptomatic to screen out tuberculosis symptomatic on a case-finding study. Among 864 symptomatic, 199 were smear positive and the detection rate was 23.0%. 166 out of these 199 smear positive patients (83.4%) had cough and expectoration more than three weeks and only 33 patients (16.6%) had bloody sputum and/or hemoptysis. Among patients who had cough and expectoration more than three weeks, the detection rate of smear positive cases was 33.7% and it was 29.4% among patients who had bloody sputum and/or hemoptysis. The detection rate among the patients who had cough and expectoration for 14-20 days was 3.7%.
2.4 NOTIFICATION AND REGISTRATION
The central notification and registration system were established since 1982. The county dispensaries were the basic units for notification and registration and the data was compiled level by level and finally submit to the National Center. Quarterly report was adopted. The overall newly registered tuberculosis cases in the Country were 4,377,272 accumulated from 1982 to 1996. Among them, 1,303,156 (29.8%) were bacteriological positive cases. Thanks to the improvement of case-finding activity as well as the strengthening of recording and reporting system, the new case rate of active tuberculosis in 1996 was 34.8/100,000 and it was significantly higher than that of 1982 (13.3/100,000).
Owing to the emphasizing of the importance of sputum examination in case-finding and confirmation of diagnosis, the new case rate of bacteriological positive tuberculosis increased from 2.7/100,000 in 1982 to 16.5/100,000 in 1996. The percentage of bacteriological positive cases among overall tuberculosis patients also increased from 20.1% in 1982 to 47.3% in 1996.
2.5 TREATMENT
The information of the outcome of treatment was included in the ordinary report since 1986. The cure rate of new bacteriological positive cases was 59.9% in that year. It rose to 80.9% in 1991 and rose further to 92.7% in 1995. Such an improvement was mainly attributed to the extensively utilization of DOTS in the Country. The average duration of case-holding for treatment for all kind of bacteriological positive patient decreased from 2.2 years in 1982 to 0.8 year in 1996.
The fatality of initially treated bacteriological positive patient at the end of one year's treatment was 3.2% in 1986 and it decreased to 1.71% in 1995. The case lost rates for above-mentioned years were 4.0% and 1.41% respectively.
2.5.1 CHEMOTHERAPY REGIMEN
A Tuberculosis Control Project in China supported by the World Bank loan was initiated in 13 provinces since 1992. The whole course intermittent short course chemotherpy regimens were introduced. The regimen 2H,R,Z,S(E),/4H,R, was used for new smear positive pulmonary tuberculosis cases and the regimen 2H,R,Z,S,E,/6H,R,E, was used for re-treated smear positive cases. Up to the end of 1996, 316, 806 new smear positive patients has
