Drug Susceptibility of Mycobacterium tuberculosis from 10 Provinces in China, 2004 - 2006 Público

Abstract

Abstract
Background: The prevalence of drug-resistant tuberculosis (DRTB) threatens TB control. Little is know about this in China. We conducted a drug-resistance survey in 10 provinces of China among TB patients from 2004 - 2006 to understand the distribution of DRTB and make policy recommendations.

Methods: The proportions of DRTB were determined from provincial surveys that included all clinical Myobacterium tuberculosis strains (Mtb) tested for susceptibility to isoniazid, rifampin, ethambutol, and streptomycin by means of the absolute concentration and the proportional drug susceptibility testing methods.

Results: Among DRTB the greatest percentage were single drug-resistant (SDR) TB (29.1%). Sichuan had the largest percentage of multiple drug-resistance (MDR) TB (38.7%). For SDR TB, being female (OR=1.18; 95%CI=0.88-1.57), having been previously treated (OR=1.48; 95%CI=1.08-2.04), and being < 15 years old were risk factors. For MDR TB, being male (OR 1.12; 95%CI=0.86-1.46), having been previously treated (OR 5.46; 95% CI=4.12-7.24), and being < 15 years old were risk factors.

Conclusions: China has a serious epidemic of DRTB, especially MDR TB, and the status varied between provinces. Patients with previous treatment history were at higher risk for DRTB. China was much higher compared to the global estimated average of 4.8%.

Table of Contents

INTRODUCTION...1
REVIEW OF LITERATURE...3
METHODS...10 Data resources and sampling methods...10
M. tuberculosis selection and Drug Susceptibility Testing (DST)...10
Statistical analysis...11 RESULTS...13 General...13
Single drug-resistant TB...13
MDR...13
Multiple drug-resistant TB...14
Analysis of risk factors for Drug-resistant TB...14 DISCUSSION...16
CONCLUSION...21
RECOMMENDATIONS...22
REFERENCES...23
TABLES AND FIGURES...30 Table 1. Patient Characteristics for the 10 Provinces in China, 2004 - 2006...31
Table 2.Drug Susceptibility to First-line TB Drugs, 10 Provinces in China, 2004 - 2006...32
Table 3.Drug Resistant TB, 10 Provinces in China, 2004 - 2006...33
Table 4.Risk Factors for Drug-resistant TB, 10 Provinces in China, 2004 - 2006...34
Figure 1.Geographic Location of 10 Provinces in China, 2004 - 2006...35
Figure 2.Single Drug-resistant TB, 10 Provinces in China, 2004 - 2006...36

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Palavra-chave	Drug-resistant Drug Susceptibility MTB-TB
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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