New research published in the journal BMC Infectious Diseases has shown that levels of drug-resistant tuberculosis (TB) in China have skyrocketed to almost twice the global average. Nearly 10% of TB cases in China are resistant to first-line drugs.

“The prevalence of drug resistance varied greatly between the provinces, but on average was worryingly high, with a weighted mean for MDR-TB of 9.3% among all cases; 5.4% among new cases, and 25.6% among previously treated cases,” say the authors, “The global MDR-TB estimates at 4.8% for all cases, 3.1% for new cases, and 19.3% for previously treated cases.”

The authors of the study estimate many possible explanations for the unusually high rates of drug-resistant TB, including inadequate use of anti-TB drugs in public hospitals and the absence of infection control measures in hospitals.

“Also, availability of anti-TB drugs without a prescription in some areas of China in the past may have contributed to the development of drug resistance,” say the authors.