[A-cohort study on the standard short-course chemotherapy program for drug resistant tuberculosis in the rural counties in Eastern China].

Objective: To investigate the therapeutic efficacy of short course chemotherapy (SCC) on drug resistant tuberculosis (DR-TB) cases and related influencing socioeconomic factors. TB patients registered in local county TB dispensaries of two rural counties were followed up in Deqing and Guanyun of Eastern China, during 2004/2005.

Methods: Culture-positive patients (Deqing: 182, Guanyun: 217) were selected as subjects of this study. A cohort of TB patients was established at the beginning of their treatment and each patient was followed-up three times by questionnaires. Proportional method of drug susceptibility test was used to define the resistance to the 1st-line anti-TB drugs. chi2 test Kaplan-Meier method and Cox analysis were applied in multivariate analysis to investigate the negative conversion of smear positive sputum, treatment result of SCC and its socioeconomic influencing factors.

Results: The cure rates of multi-drug resistant TB (MDR-TB), other drug resistant TB (ODR-TB) and pan-drug susceptible TB, were 58.3%, 91.0%, 98.7% and 51.3%, 89.5%, 93.5% respectively in Deqing and Guanyun. The liver dysfunction (RR = 0.18, 95% CI: 0.04-0.69) and previous treatment history (RR = 0.26, 95% CI: 0.07-0.93) were associated with treatment result among MDR-TB. Result on treatment in ODR-TB was influenced by previous treatment history (RR = 0.66, 95% CI: 0.44-0.98) and Patient delay (> 2 weeks) (RR = 0.67, 95% CI: 0.46- 0.97).

Conclusion: The priority in treating MDR-TB would include: managing side effect, developing the fast sensitive drug susceptibility test and modifying the treatment regimen corresponding to drug resistance.