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Free Content Drug-resistant tuberculosis in Shanghai, China, 2000–2006: prevalence, trends and risk factors

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

Document Type: Regular Paper

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

Publication date: February 1, 2009

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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