AI Article Synopsis
- Primary drug-resistant tuberculosis (DR-TB) has become a significant health issue in China, with a study analyzing its epidemiological characteristics between 2004 and 2018.
- The study reviewed data from over 11,000 newly diagnosed and retreated TB cases, revealing a more than 12% reduction in primary DR-TB and mono-resistant TB (MR-TB) rates during this period, although certain resistance patterns, particularly MDR-TB and RFP-resistant cases, increased significantly.
- The findings indicate a shift in DR-TB patterns toward male patients and those with cavity infections, highlighting the need for targeted interventions for specific populations to effectively manage and control DR-TB in China.
Article Abstract
Background: Primary drug-resistant tuberculosis (DR-TB) has contributed to a significant health and economic burden on a global scale, especially in China. we sought to estimate epidemiological characteristics of primary DR-TB in China from 2004 to 2018.
Methods: Eleven thousand four hundred sixty-seven newly diagnosed and 1981 retreated TB cases with drug susceptibility data were included. Chi-Square test for trends, linear regression, a joinpoint regression model and temporal trend in proportions of the different resistance patterns were carried out.
Results: The proportion of primary DR-TB and mono-resistant TB (MR-TB) in China had reduced by more than 12% since 2004, and were 21.38%, 13.35% in 2018 respectively. Among primary DR-TB cases (2173,18.95%), the percentage of multiresistant TB (MDR-TB, from 5.41 to 17.46%), male (from 77.03 to 84.13%), cavity (from 13.51 to 43.92%), rifampicin(RFP)-resistant TB (from 8.11 to 26.98%), streptomycin(SM)-resistant TB (from 50.00 to 71.43%) increased significantly (P < 0.05). On the contrary, the proportion of female, non-cavity, isoniazide(INH)-resistant TB (from 55.41 to 48.15%) and MR-TB (from 82.43 to 62.43%) decreased significant (P < 0.05). The primary drug resistance rate among female, cavity, smoking, drinking, 15 to 44 year-old TB subgroups increased by 0.16, 6.24, 20.95, 158.85, 31.49%, respectively. The percentage of primary DR-TB, RFP-resistant TB dropped significantly during 2004-2007 in Joinpoint regression model.
Conclusion: The total rate of drug resistance among new TB cases showed a downward trend in Shandong, China, from 2004 to 2018. Primary drug resistance patterns were shifting from female, non-cavity, INH-resistant TB, and MR-TB groups to male, cavity, RFP/SM-resistant TB, and MDR-TB groups. Considering the rising drug resistance rate among some special population, future control of primary DR-TB in China may require an increased focus on female, cavity, smoking, drinking, or 15 to 44 year-old TB subgroups.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798379 | PMC |
| http://dx.doi.org/10.1186/s12931-019-1199-3 | DOI Listing |
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