treated cases (28.1%) were resistant to at least one drug. 14.2% were resistant to one drug; 5.9%- two drugs; 3.1%- three drugs and 4.9% resistant to four drugs. The frequency and sequence of drug resistance among six anti-tuberculosis drugs were: SM- 11.8%, INH- 9.6%, PAS- 4.5% RFP- 2.7%, EMB- 4.4%, Thioacetylzone (TB,)- 6.0%. Among 816 already treated pulmonary tuberculosis patients, 335 cases showed drug resistance and the secondary resistant rate was 41.1%.
2.6 BCG VACCINATION
BCG vaccination of newborns has already been involved in the National Expanded Programme of Immunization (EPI) for years. The BCG coverage of newborns was above 90%. The BCG scar rate was above 90% and post-vaccination positive conversion rate of PPD test after 12 weeks was above 85%. There were some side effects of primary vaccination i.e. continuous ulcer more than 6 months, keloid formation, local lymphadenitis, allergic purpura, etc. The occurrence of above-mentioned side-effects was 0.13% within a five years' investigation period.
3 SOCIOLOGICAL INFLUENCE
3.1 COMMON KNOWLEDGE AND AWARENESS ON TUBERCULOSIS
A sociological study on tuberculosis was carried out coincided with the third nationwide survey in 1990. 7,110 tuberculosis patients were involved in this survey. Only 2,615 cases (35.3%) had received certain kind of health education concerning tuberculosis before suffering tuberculosis. Regarding the type of health education received, the most common type (30.0%) was general forms of propaganda, e.g. wall solgan on the street; propaganda given by relative and friend second (26.6%). Other types were as follows: broadcasting (11.2%), poster (8.9%), news paper and magazine (7.8%) and other types (all less than 5%).
3.2 PSYCHOLOGICAL REACTION
More than half (59.1%) of the patients had only very light psychological reaction after being diagnosed as tuberculosis patients, that are, not mind (47.2%) and small illness (11.9%). 39.6% of the patients had moderate psycological effect including unhappy (21.4%), and frightened (18.2%). Serious reaction was encountered only in 1.3% of patients; great shock (1.0%), and attempt suicide (0.3%).
3.3 CLINICAL CONSULTATION
Among 3,633 symptomatic, only 1,240 cases (34,1%) had made clinical consultation after their occurrence of symptom. The average delay of clinical consultation was 25 days. There were 52.6% of patients whose delays were more than 2 weeks. Among those patients who has made clinical consultation, 34.7% of patients firstly visited their village health clinic and 35.2% first visited township health clinic.
The main cause of delay of clinical consultation was patients did not mind and it accounted for 56.2% of consultation delay. Financial problem ranked the second cause and amounted to 25.9% of consultation delay. There were only 8.6% of delayed patients whose cause of delay was due to insufficient health services, e.g. there is no village health unit, health unit too far and/or poor services etc.
4. FINACIAL PROBLEM
Financial problem occupied the first cause of the treatment delay. 45.3% of treatment delayed cases were due to this and 44.2% of intermittent and/or early interruption of treatment was also due to financial problem. Financial problem was much serious in some remote provinces and areas. For instance, as high as 80.7% of treatment delay were due to financial problem in Sichuan Province.
The "Tuberculosis Control Project in China" supported by the World Bank loan was initiated since 1992. 13 provinces were involved in this project. The amount of loan within seven years' duration was US$ 58,200,000 and US$ 54,800,000 of counterpart fund were added. The total amount of fund was thus $113,000,000. All sputum positive tuberculosis cases received free diagnostic and treatment services. The coverage of population was about 561,230,268 at present. Up to the end of June 1997, about 3,917,435 symptomatic had been examined and about 613,339 smear positive infecious sources had been detected. The cure rate of new smear positive patients was 93.3%.
A "promoting and Strengthening Tuberculosis Control Project, MOH" was initiated since 1993 and covered another 15 municipality and provinces. The Ministry of Health provided a special budget about RMB\ 3,000,000 every year for this project and each involved province provided counterpart fund according to the proportion 1:2. Nowadays, the Project has involved 312 counties and has covered 158,590,000 population. About 47,244 smear positive cases had been detected at present. The payment of treatment can be reduced or even free in charge for patients who were difficult to pay for treatment. The cure rate for new smear positive patients was 93.4%.
5 CONCLUSION
5.1 Since tuberculosis control is a community public health task, the government's commitment is thus the first important and even decided factor for a successful and effective national tuberculosis control programme. All kind of efforts taken by Chinese governments at various levels in the past years has
