title: [A study on the cooperation between centers for disease control and special tuberculosis hospitals for treatment and management of multi-drug resistant tuberculosis].
abstract: OBJECTIVE
  To improve the effectiveness of case detection and treatment of multi-drug resistant tuberculosis (MDR-TB) by implementing a mechanism of cooperation between hospitals and centers for disease control (CDC).
  
  
  METHODS
  Since 1 March 2010, a new mechanism of cooperation between hospitals and CDCs had been established in 5 cities including Daqing, Quzhou, Puyang, Tianjin and Wanzhou in China. Data of MDR-TB case-detection, treatment and economic burdens before the intervention (January 1, 2006-June 30, 2009) and after the intervention (March 1, 2010-February 29, 2012) were collected. Then all data were analyzed by statistical method.
  
  
  RESULTS
  After the intervention, samples from 68.4% (5 287/7 733) of smear-positive TB patients in the study regions underwent TB drug-resistant testing, and the number of the detected MDR-TB cases were 9.8 times that prior to the intervention. 93.1% (108/116) of the patients incorporated into the treatment of MDR-TB received the standardized initial chemotherapy program, and the number was 7 times that before the intervention. The referral rates after hospital discharge raised from 0% before the intervention to 92.8% after (90/97) the intervention; and 85.7% (83/97) of the patients received treatment and management by CDC. When the 6-month injection ended, MDR-TB patients still under treatment after the intervention were 84.5% (82/97), and those whose sputum culture became negative were 56.7% (55/97). The proportion of patients with self-paid and with catastrophic expenditures after the intervention were reduced to 18.0% (1 678/9 324) and 44.7% (17/38) respectively, as compared to 75.4% (7 659/10 158) and 76.7% (23/30) respectively before the intervention.
  
  
  CONCLUSIONS
  To establish a well-performed Hospital-CDC cooperation mechanism could promote the performance of MDR-TB case detection and treatment.
authors.affiliation: Department of Drug-resistant Tuberculosis, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
authors.forename: Renzhong
authors.initials: R
authors.lastname: Li
authors.forename: Yunzhou
authors.initials: Y
authors.lastname: Ruan
authors.forename: Yunting
authors.initials: Y
authors.lastname: Fu
authors.forename: Jin
authors.initials: J
authors.lastname: Zhao
authors.forename: Wei
authors.initials: W
authors.lastname: Su
authors.forename: Jun
authors.initials: J
authors.lastname: Cheng
authors.forename: Canyou
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of General Affair, National Center for Tuberculosis Control and Prevention. Email: wanglx@chinatb.org.
authors.forename: Lixia
authors.initials: L
authors.lastname: Wang
mesh_terms: D002681:China; D005102:Health Expenditures; D006763:Hospitals, Chronic Disease; D006801:Humans; D010351:Patient Discharge; D012017:Referral and Consultation; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics