China’s TB Portfolio for Advancing the 2030 End TB Goals

Shaojun Pei^1,2,&, Caihong Xu^3,4,&, Dongmei Hu³, Yanlin Zhao^3,#

1. Department of Global Health, School of Public Health, Peking University, Beijing, China;

2. Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, MA, USA;

3. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for Tuberculosis Control and Prevention, Chinese Centre for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China;

4. Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China.

^& Joint first authors.

^# Corresponding author: Zhao Yanlin, zhaoyl@chinacdc.cn.

The global trajectory for tuberculosis (TB) elimination remains precarious, characterized by a recent but fragile and insufficient decline in its incidence by 2024, the first since the COVID-19 pandemic. Progress is severely hampered by the failure to meet the ambitious 2025 End TB targets and is further threatened by anticipated funding cuts, necessitating a translation of widely accepted concepts of “high-level multi-sectoral cooperation” and “strict accountability” to concrete solutions. In contrast, China has achieved remarkable progress, meeting its goal of a 20% reduction in TB incidence from 2015 to 2024, suggesting a transition toward a lower-incidence setting. This success reflects a deliberate, science-driven, and strategic transformation. In this Personal View, we describe China’s clearly defined national and provincial TB incidence-reduction targets for 2025 and 2030, as well as its comprehensive TB control program spanning the full continuum of care. China’s integrated strategy, combining political commitment, rigorous strategy, sustainable financing, empowering research and innovation, the zoonotic and anthroponotic TB approach, and strong accountability mechanisms, offers a replicable blueprint for low- and middle-income countries. It outlines a specific implementation pathway to revitalize global efforts to combat tuberculosis and restore confidence in the feasibility of ending TB.

中国面向2030年终结结核病目标的结核病防控体系及启示

裴少君^1,2,&, 徐彩红^3,4,&, 胡冬梅³, 赵雁林^3,#

1. 全球卫生学系，公共卫生学院，北京大学，北京，中国；

2. 普通内科和初级保健系, 布莱根妇女医院, 波士顿，马萨诸塞州，美国；

3. 传染病溯源预警与智能决策全国重点实验室, 结核病预防控制中心, 中国疾病预防控制中心（中国预防医学科学院）, 北京, 中国；

4. 流行病学系, 公共卫生学院, 南京医科大学, 南京市，江苏省，中国。

^& 共同第一作者。

^# 通信作者: 赵雁林, zhaoyl@chinacdc.cn。

全球实现终结结核病目标的进程依然充满挑战。尽管2024年结核病发病率在新冠疫情后首次出现下降，但这一趋势仍然脆弱且幅度有限，尚不足以扭转全球结核病防控的整体困境。与此同时，全球结核病防控经费的削减进一步加剧了挑战，也使得将“多部门问责框架”转化为具体解决方案变得尤为迫切。在全球防控进展承压的背景下，中国取得了显著进展，实现了2015年至2024年结核病发病率下降20%的目标，并正向低发病率国家迈进。这一成就反映了中国结核病防控体系在科学引领下开展的系统性、战略性转型。在这篇观点文章中，我们介绍了中国在2025年和2030年国家及省级层面明确设定的结核病发病率下降目标，以及为实现目标所制定的覆盖结核病防治各个环节的综合控制体系。中国的综合防控策略将政治承诺、系统规划、可持续融资、科研与创新赋能、人畜共患与人际传播结核病协同防控，以及有力的问责机制有机结合，为中低收入国家提供了一个可借鉴的蓝图。它勾勒出一条具体的实施路径，为推动全球结核病防控工作走出当前困境、重建终结结核病的信心提供了现实参考。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.059

Epidemiological Characteristics of Asymptomatic Tuberculosis — China, 2021–2024

Caihong Xu^1,2, Yaxin Wen², Yanlin Zhao^2,#, Biao Kan^1,3,#

1. Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

2. Center for Tuberculosis Prevention and Control, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China;

3. National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.

^# Corresponding author: Yanlin Zhao, zhaoyl@chinacdc.cn; Biao Kan, kanbiao@icdc.cn.

Tuberculosis remains a major global public health challenge, with China ranking fourth among the world's 30 high-burden countries, making its prevention and control a core task of the Healthy China 2030 Strategy. Asymptomatic pulmonary tuberculosis (aPTB) patients act as silent transmitters, leading to hidden community transmission and hindering the achievement of End-TB goals, while systematic research on aPTB in China is still insufficient. This study analyzed 973,299 pulmonary tuberculosis cases with complete symptom records from the China Information System for Disease Control and Prevention during 2021–2024, and found that asymptomatic cases accounted for 16.66% of the total.The bacteriologically confirmed rate among asymptomatic cases was 48.60%, markedly lower than the 68.45% observed in symptomatic pulmonary tuberculosis cases during the same period. The study further revealed that the elderly 、male and farmers/herders are high-prevalence groups.Specifically, the highest incidence rates were observed in those aged over 75 years (20.47/100,000) and 65—74 years (20.37/100,000). Males predominated, with a male-to-female ratio of 1.96:1. Occupationally, farmers and herders accounted for 50.87%. Geographically, the highest notification rates of asymptomatic pulmonary tuberculosis were concentrated in western and southwestern China, with Tibet (9.50/100,000), Guizhou (7.56/100,000), and Yunnan (5.30/100,000) ranking as the top three. Notably, most high-incidence areas for asymptomatic cases overlapped with those for symptomatic pulmonary tuberculosis.The study confirms a significant hidden disease burden of aPTB in China, and symptom-based screening is far from meeting the prevention and control needs. This research provides scientific evidence for optimizing China's tuberculosis prevention and control strategies, suggesting that aPTB control should be integrated into the national tuberculosis prevention and control plan, active case finding should be strengthened in high-risk populations, medical resource allocation should be optimized to reduce hidden transmission, and thus facilitate the achievement of the global goal of ending the tuberculosis epidemic.

无症状肺结核流行病学特征 — 中国，2021–2024年

徐彩红^1,2，文雅欣²，赵雁林^2,#，阚飙^1,3,#

1. 流行病学系，公共卫生学院，南京医科大学，南京，江苏，中国；

2. 结核病预防控制中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国；

3. 传染病预防控制所，中国疾病预防控制中心，北京，中国。

^# 通信作者：赵雁林，zhaoyl@chinacdc.cn；阚飙，kanbiao@icdc.cn。

结核病是全球重大公共卫生问题，中国位列全球 30 个结核病高负担国家第四位，结核病防控是 “健康中国 2030” 战略的核心任务。无症状肺结核患者作为 “隐性传播者”，易造成社区隐匿传播，阻碍终止结核病目标的实现，而我国针对无症状肺结核的系统研究尚为缺乏。本研究利用 2021—2024 年中国疾病预防控制信息系统的监测数据，对 97.33 万份有完整症状记录的肺结核病例展开分析，发现无症状肺结核病例占比达 16.66%，其中无症状病例的细菌学确诊率为 48.60%，显著低于同期有症状肺结核病例的 68.45%。研究还揭示，老年人、男性和农/牧民是高发群体。75岁以上人群（20.47/100,000）和65至74岁人群（20.37/100,000）的发病率最高。男女比例为 1.96:1。农/牧民占病例总数的50.87%。从地域上看，无症状肺结核的通报率最高的地区集中在中国西部和西南部，其中西藏（9.50/100,000）、贵州（7.56/100,000）和云南（5.30/100,000）位列前三。值得注意的是，大多数无症状病例高发地区与有症状肺结核的高发地区重合。研究证实了我国无症状肺结核存在显著的隐匿疾病负担，现有以症状为基础的筛查手段已难以满足防控需求，亟需针对高危人群强化主动病例发现，优化医疗资源配置，并将无症状肺结核防控纳入国家结核病防控总体规划，以此减少隐匿传播，推进国家终止结核病目标的实现。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.060

Scaling Up Tuberculosis Preventive Treatment: Progress and Factors Influencing Optimization — China, 2022–2025

Caihong Xu^1,2, Jinhao Li², Wen Yaxin², Dongmei Hu², Rongbin Yu^1,#, Yanlin Zhao^2,#

1. Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing City, Jiangsu Province, China;

2. Center for Tuberculosis Prevention and Control, Chinese Center for Disease Control and Prevention & Chinese Academy of Preventive Medicine, Beijing, China.

^# Corresponding authors: Rongbin Yu, rongbinyu@njmu.edu.cn; Yanlin Zhao, zhaoyl@chinacdc.cn.

Tuberculosis preventive treatment (TPT) is pivotal in preventing the progression of latent tuberculosis infection (LTBI) to active tuberculosis (ATB). However, systematic, national data on TPT implementation in China are scarce. We characterized the scale-up of the TPT between 2022 and 2025, and identified the factors associated with its acceptance and completion. This preplanned cross-sectional study utilized two levels of national TPT surveillance (31 PLADs, 2022–2025) and 2,676 individuals with LTBI (five PLADs, 2023–2024). The analyses included descriptive statistics and Firth-penalized logistic regression (R 4.3.1). The number of TPT recipients increased 2.5-fold (37,514–92,331) with approximately 79% short-course regimen use. The acceptance and completion rates were 45.14% and 85.18%, respectively. Higher acceptance was observed in individuals aged 15–44 years (OR=0.648, 95% CI=0.469, 0.896,), ethnic minorities (OR=5.045, 95% CI=1.910, 16.914,), healthcare workers (OR=82.029, 95% CI: 16.422, 822.390), and designated hospitals (OR=3.620, 95% CI=2.507, 5.281). It was lower in immunocompromised individuals (OR=0.409, 95% CI=0.219, 0.749) and those with moderate purified protein derivative (PPD) positivity (OR=0.384, 95% CI=0.275, 0.533). China has progressed in scaling up the TPT; however, low acceptance and subgroup disparities persist. Integrating TPT into routine clinical practice, prioritizing short-course regimens, and targeting high-risk groups are critical for TB elimination.

结核病预防性治疗扩展实施进展与优化策略 — 中国，2022–2025年

徐彩红^1,2, 李锦浩², 文雅欣², 胡冬梅², 喻荣彬^1,#, 赵雁林^2,#

1. 流行病学系，公共卫生学院，南京医科大学，南京，江苏，中国;

2. 结核病预防控制中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者：喻荣彬, rongbinyu@njmu.edu.cn; 赵雁林, zhaoyl@chinacdc.cn。

结核病预防性治疗对于阻断潜伏性结核感染发展为活动性结核病至关重要。然而，中国尚缺乏关于结核病预防性治疗实施的系统性全国数据。本研究旨在描述2022年至2025年间结核病预防性治疗规模的扩大情况，并确定影响其接受率和完成率的相关因素。本研究中的横断面研究利用了两个层面的数据：全国结核病预防性治疗监测数据（覆盖31个省，2022–2025年）和2,676名潜伏性结核感染个体的数据（覆盖5个省，2023–2024年）。分析采用描述性统计和Firth惩罚logistic回归（R 4.3.1）。接受结核病预防性治疗的人数增加了2.5倍（从37,514人增至92,331人），其中约79%采用了短程治疗方案。结核病预防性治疗的接受率为45.14%，完成率为85.18%。接受率在以下人群中较高：15–44岁年龄组（OR=0.648, 95% CI=0.469, 0.896）、少数民族（OR=5.045, 95% CI=1.910, 16.914）、医疗卫生工作者（OR=82.029, 95% CI: 16.422, 822.390）以及在定点医院就诊者（OR=3.620, 95% CI=2.507, 5.281）。接受率在免疫功能低下者（OR=0.409, 95% CI=0.219, 0.749）和纯化蛋白衍生物试验（PPD）中度阳性者（OR=0.384, 95% CI=0.275, 0.533）中较低。中国在扩大结核病预防性治疗规模方面取得了进展，但接受率仍然偏低，且存在亚组差异。将结核病预防性治疗纳入常规临床实践、优先采用短程治疗方案以及针对高危人群是消除结核病的关键。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.061

Drug Resistance and Risk Factors of Bacteriologically Confirmed Tuberculosis Cases in 10 Sites — Hunan Province, China, 2018–2025

Jingwei Guo¹; Jun Liang¹; Yunhong Tan¹; Zuhui Xu¹; Baozhen Peng²; Xichao Ou²; Peilei Hu¹; Zhenhua Chen¹; Hua Bai¹; Binbin Liu¹; Wenjie Zhao¹; Liqin Liu¹; Yanhong Li¹; Xiaojie Wan¹; Jue Wang¹; Jie Duan¹; Yi Liu¹; Dehua Gong^1,#

1. Hunan Institute for Tuberculosis Control (Hunan Chest Hospital), Changsha City, Hunan Province, China;

2. National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Center for Tuberculosis Control and Prevention, Chinese Centre for Disease Control and Prevention & Chinese Academy of Preventive Medicine,Beijing, China.

^# Corresponding authors: Dehua Gong, gloriagexiaobao@hnstb.com.

Drug-resistant tuberculosis (TB) poses a significant threat to public health. This study aimed to analyze the drug resistance patterns of Mycobacterium tuberculosis (MTB) and its risk factors in 10 districts of Hunan Province from 2018‒2025. The study provides a reference for formulating strategies to prevent and control drug-resistant TB. Isolates were collected from patients with pulmonary TB between January 2018 and December 2025 at 10 surveillance sites in Hunan Province. Drug resistance profiles were determined for two anti-TB drugs, rifampicin (RIF) and isoniazid (INH). Statistical analyses of epidemiological characteristics and risk factors for drug resistance were performed. Among the 25,978 MTB isolates tested, 1320 (5.08%) strains were resistant to one or more anti-TB drugs. The prevalence of rifampicin-resistant (RR) and multidrug-resistant (MDR) TB was 553 (2.13%) and 310 (1.19%), respectively. Univariate analysis revealed that sex, age, occupation, patient source, prior treatment history, comorbidities, residential district, and time of diagnosis were significantly associated with overall TB drug resistance (all P<0.05). RR-TB was significantly associated with all variables except occupation (all P<0.05). Multivariate logistic regression revealed the following independent predictors of drug resistance: male sex, retreatment status, age 25–44 years, diabetes mellitus, and residence in Lengshuitan. The results demonstrated the factors that indicated a significant risk of MDR-TB. Therefore, intensifying MDR-TB surveillance to develop treatment and monitoring guidelines is urgently needed.

10监测点病原学阳性肺结核患者耐药特征及危险因素分析 — 湖南省，中国，2018–2025年

郭婧玮¹；梁军¹；谭云洪¹；徐祖辉¹；彭宝珍²；欧喜超²；胡培磊¹；陈振华¹；白桦¹；刘彬彬¹；赵文杰¹；刘礼亲¹；李艳红¹；万小洁¹；王珏¹；段洁¹；刘怡¹；龚德华^1,#

1. 湖南省结核病防治所（湖南省胸科医院），长沙市，湖南省，中国；

2. 传染病溯源预警与智能决策全国重点实验室，结核病预防控制中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者：龚德华，gloriagexiaobao@hnstb.com。

耐药结核病对公共卫生安全形成了严峻威胁。本研究聚焦于2018 - 2025年期间湖南省10个地区结核分枝杆菌的耐药模式及其风险因素展开分析，以期为耐药结核病防控策略的制定提供科学参考。在2018年1月至2025年12月期间，于湖南省10个监测点收集肺结核患者的分离株。针对利福平和异烟肼这两种抗结核药物开展耐药性检测，并对流行病学特征以及耐药风险因素实施统计学分析。在25,978例结核分枝杆菌分离株中，有1,320株（5.08%）对一种或多种抗结核药物呈现耐药性。利福平耐药结核病和多药耐药结核病的患病率分别为553例（2.13%）和310例（1.19%）。单因素分析表明：性别、年龄、职业、患者来源、既往治疗史、合并症、居住区域以及确诊时间与结核病总体耐药性均存在显著相关性（P<0.05）；除职业因素外，利福平耐药结核病与其余变量均显著相关（P<0.05）。多因素Logistic回归分析确定了以下耐药性独立预测因素：男性、复治状态、25–44岁年龄组、糖尿病合并症以及冷水滩区居住史。研究结果揭示了多药耐药结核病的关键风险因素。建议强化多药耐药结核病监测工作，从而制定具有针对性的治疗与监测方案。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.062

An Imported Case of Dengue/Zika Coinfection — Sichuan Province, China, 2026

Liwen Hu^1,&; Lyubo Tian^2,&；Ke Yan¹; Shuang Zhang¹; Wenjun Xie¹; Jing Feng¹; Xunbo Du¹; Liang Wang¹; Weixuan Liu¹; Junrong Luo¹; Fengzhu Tang¹; Ning Yang¹; Yao Wang¹; Yun Peng¹; Zhenhua Chen¹; Qing Zhang^2,#; Jiantong Meng¹; Rong Lu^1,#

1. Chengdu Center for Disease Control and Prevention (Chengdu Institute of Health Supervision), Chengdu City, Sichuan Province, China;

2. Sichuan International Travel Health Care Center, Port Epidemic Disease Monitoring Key Laboratory of Sichuan Province, Chengdu City, Sichuan Province, China.

^& Joint first authors.

^# Corresponding authors: Qing Zhang, zhangqingcd@cd.intra.customs.gov.cn; Rong Lu, lurong@cdcdc.org.

On January 19, 2026, customs screening identified a foreign national arriving in Sichuan, China from Kuala Lumpur, Malaysia with an elevated body temperature. Subsequent testing yielded positive results for dengue virus (DENV) and Zika virus (ZIKV). Upon notification, local CDCs immediately launched a comprehensive epidemiological investigation, performed laboratory testing, and implemented preventive control measures. Blood samples collected from the patient underwent quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) for viral nucleic acid detection. Next-generation sequencing (NGS) was performed on serum samples to obtain complete viral genome sequences. Phylogenetic analysis was then conducted to determine the origin and genotype of the viruses in this imported case. The qRT-PCR analysis confirmed the simultaneous presence of DENV and ZIKV in the patient's serum. NGS successfully yielded the complete DENV and ZIKV genome sequences. Phylogenetic analysis revealed that the ZIKV belongs to the Asian lineage, sharing 99.48% nucleotide homology with a Thailand ZIKV strain (OR264645.1); the DENV was classified as clade 3I_A.1, sharing 99.10% nucleotide homology with a Singapore DENV strain (OP410996.1).

一起登革病毒寨卡病毒共感染病例输入事件 — 四川省，中国， 2026年

胡力文^1,&；田绿波^2,&；严可¹；张双¹；谢汶君¹；冯静¹；杜训波¹；王亮¹；刘蔚玄¹；罗俊容¹；唐凤祝¹；杨宁¹；王瑶¹；彭云¹；陈振华¹；张青^2,#；孟建彤¹；鹿茸^1,#

1. 成都市疾病预防控制中心（成都市卫生监督所）, 成都市, 四川省, 中国；

2. 四川国际旅行卫生保健中心（成都海关口岸门诊部），口岸疫病疫情监测四川省重点实验室，成都市, 四川省, 中国。

^& 共同第一作者

^# 通信作者：张青，zhangqingcd@cd.intra.customs.gov.cn; 鹿茸，lurong@cdcdc.org。

报告一例来自马来西亚的登革病毒寨卡病毒共感染病例的流行病学调查和事件处置经过，为完善口岸传染病防控体系和建立输入性疫情预警机制提供建议。采集患者的血液样本进行分析。应用实时荧光定量逆转录聚合酶链反应检测病毒核酸，并对血清样本进行二代基因组测序；最后通过系统发育分析，探讨该输入病例的来源和基因型。核酸检测分析确认患者血清样本中同时存在登革病毒和寨卡病毒。二代基因组测序成功获得了完整的登革病毒和寨卡病毒基因组序列。系统发育分析显示，该寨卡病毒为Asian型，与泰国寨卡病毒株具有99.48%的核苷酸同源性；该登革病毒为3I_A.1型，与新加坡登革病毒株遗传关系密切，序列相似性达99.10%。基于流行病学史、临床表现和实验室检测结果，该患者被确认为一例输入性登革病毒寨卡病毒共感染病例。基因溯源结果表明与新加坡和泰国的毒株亲缘关系最近。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2026.063