Authors: Shen, X.¹; DeRiemer, K.²; Yuan, Z-A.n.³; Shen, M.³; Xia, Z.³; Gui, X.³; Wang, L.³; Gao, Q.⁴; Mei, J.³

Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 2, February 2009 , pp. 253-259(7)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: During 2000-2006, a regional anti-tuberculosis drug resistance surveillance study was conducted in Shanghai, China.

OBJECTIVE: To determine the prevalence, trends and risk factors for drug-resistant tuberculosis (TB) in Shanghai, China.

DESIGN: A retrospective study of all pulmonary TB patients reported in Shanghai during 2000-2006 was conducted.

RESULTS: Of 8419 pulmonary TB patients, 16.6% had resistance to any first-line anti-tuberculosis drug and 4.0% had multidrug resistance (MDR). The percentage of TB patients with resistance to any first-line anti-tuberculosis drug and MDR significantly increased during 2000-2003 (P = 0.01 and P < 0.01, respectively). After improvements in the TB control programme in 2004, the increasing trend in drug resistance was contained. Age 30-59 years, being an urban migrant and residence in an urban area of Shanghai were independently associated with resistance to any first-line drug and MDR in new cases, while age 30-59 years and being an urban migrant were independently associated with resistance to any first-line drug and MDR in previously treated cases.

CONCLUSIONS: Drug-resistant TB and MDR-TB pose a challenge for TB control in Shanghai. Improved case management, including DOTS and appropriate treatment regimens, should be sustained to prevent further transmission and development of drug-resistant TB in this setting.

Keywords: tuberculosis; drug resistance; MDR-TB; epidemiology

Document Type: Regular paper

Affiliations: 1: Department of Tuberculosis Control, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, People's Republic of China; Key Laboratory of Medical Molecular Virology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China 2: School of Medicine, University of California, Davis, California, USA 3: Department of Tuberculosis Control, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, People's Republic of China 4: Key Laboratory of Medical Molecular Virology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China

Publication date: 2009-02-01

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