Epidemiology of drug-resistant tuberculosis in Chongqing, China: A retrospective observational study from 2010 to 2017

Autoři: Bo Wu aff001;  Ya Yu aff002;  Changting Du aff001;  Ying Liu aff003;  Daiyu Hu aff002
Působiště autorů: Outpatient Department, The Institute of Tuberculosis Prevention and Control, Chongqing, People’s Republic of China aff001;  Department of Prevention and Control, The Institute of Tuberculosis Prevention and Control, Chongqing, People’s Republic of China aff002;  Medical Administration Department, The Institute of Tuberculosis Prevention and Control, Chongqing, People’s Republic of China aff003
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0216018


China is one of the top 30 countries with high multidrug-resistant tuberculosis (MDR-TB) and rifampin-resistant tuberculosis (RR-TB) burden. Chongqing is a southwest city of China with a large rural population. A retrospective observational study has been performed based on routine tuberculosis (TB) surveillance data in Chongqing from 2010 to 2017. The MDR/RR-TB notification rate increased from 0.03 cases per 100,000 population in 2010 to 2.1 cases per 100,000 population in 2017. The extensively drug-resistant TB (XDR-TB) notification rate has increased to 0.09 cases per 100,000 population in 2017. There was a decreasing detection gap between the number of notified MDR/RR-TB cases and the estimate number of MDR/RR-TB cases in new TB cases. The treatment success rate of MDR/RR-TB was 59% (95% confidence interval [CI], 53%-65%) in this period. Despite the progress achieved, the prevalence of MDR/RR-TB was still high facing challenges including detection gaps in new TB cases, the regional disparity, and the high risk for MDR/RR-TB in elderly people and farmers. Sustained government financing and policy support should be guaranteed in the future.

Klíčová slova:

Age groups – Drug therapy – Extensively drug-resistant tuberculosis – China – Medical risk factors – Multi-drug-resistant tuberculosis – Sputum – Tuberculosis


1. World Health Oragnization. WHO treatment guidelines for drug-resistant tuberculosis, 2016 update. World Health Organization, Geneva, Switherland. 2016; 04. Available from: http://www.tbonline.info/media/uploads/documents/mdrtbguidelines2016.pdf

2. World Health Oragnization. Global tuberculosis report 2017. World Health Organization, Geneva, Switherland. 2017; 23. Available from: https://www.who.int/tb/publications/global_report/MainText_13Nov2017.pdf?ua=1

3. Wang L, Li R, Xu C, Zhang H, Ruan Y, Chen M, Wang D, et al. The Global Fund in China: Multidrug-resistant tuberculosis nationwide programmatic scale-up and challenges to transition to full country ownership. PLoS One. 2017; 12(6): e0177536. doi: 10.1371/journal.pone.0177536 28628669

4. Long Q, Qu Y, Lucas H. Drug-resistant tuberculosis control in China: progress and challenges. Infect Dis Poverty. 2016; 5: 9. doi: 10.1186/s40249-016-0103-3 26822738

5. World Health Organization. Definitions and reporting framework for tuberculosis 2013 revision. World Health Organization, Geneva, Switherland. 2013; 2. Available from: https://apps.who.int/iris/bitstream/handle/10665/79199/9789241505345_eng.pdf;sequence=1

6. World Health Oragnization. Guidelines fo Surveillance of Drug Resistance in Tuberculosis. World Health Organization, Geneva, Switherland. 2015;13. Available from: https://www.who.int/tb/publications/2015/drs_guidelines/en/

7. Ministry of Public Health of the People's Republic of China. Diagnostic criteria of tuberculosis (WS288-2008). Beijing: Ministry of Public Health of the People's Republic of China; 2008.

8. Farazi A, Sofian M, Zarrinfar N, Katebi F, Hoseini SD, Keshavarz R. Drug resistance pattern and associated risk factors of tuberculosis patients in the central province of Iran. Caspian J Intern Med. 2013; 4(4): 785–9. 24294475

9. Nair SA, Raizada N, Sachdeva KS, Denkinger C, Schumacher S, Dewan P, et al. Factors Associated with Tuberculosis and Rifampicin-Resistant Tuberculosis amongst Symptomatic Patients in India: A Retrospective Analysis. PLoS One. 2016; 11(2): e0150054. doi: 10.1371/journal.pone.0150054 26918818

10. Li WB, Zhang YQ, Xing J, Ma ZY, Qu YH, Li XX. Factors associated with primary transmission of multidrug-resistant tuberculosis compared with healthy controls in Henan Province, China. Infect Dis Poverty. 2015; 4, 14. doi: 10.1186/s40249-015-0045-1 25806104

11. Lv XT, Lu XW, Shi XY, Zhou L. Prevalence and risk factors of multi-drug resistant tuberculosis in Dalian, China. J Int Med Res. 2017; 45 (6): 1779–1786. doi: 10.1177/0300060516687429 28345426

12. Yin QQ, Jiao WW, Li QJ, Xu F, Li JQ, Sun L. Prevalence and molecular characteristics of drug-resistant Mycobacterium tuberculosis in Beijing, China: 2006 versus 2012. BMC Microbiol. 2016; 16: 85. doi: 10.1186/s12866-016-0699-2 27176471

13. Chen S, Huai P, Wang X, Zhong J, Wang X, Wang K, et al. Risk factors for multidrug resistance among previously treated patients with tuberculosis in eastern China: a case-control study. Int J Infect Dis. 2013; 17(12): e1116–20. doi: 10.1016/j.ijid.2013.06.006 23916547

14. Wang SF, Zhou Y, Pang Y, Zheng HW, Zhao YL. Prevalence and Risk Factors of Primary Drug-Resistant Tuberculosis in China. Biomed Environ Sci. 2016; 29(2): 91–8. doi: 10.3967/bes2016.010 27003166

15. Liu Q, Zhu L, Shao Y, Song H, Li G, Zhou Y, et al. Rates and risk factors for drug resistance tuberculosis in Northeastern China. BMC Public Health. 2013; 13: 1171. doi: 10.1186/1471-2458-13-1171 24330553

16. Rumende C. M. Risk Factors for Multidrug-resistant Tuberculosis. Acta Med Indones. 2018; 50(1): 1–2. 29686169

17. Dean AS, Cox H, Zignol M. Epidemiology of Drug-Resistant Tuberculosis. Adv Exp Med Biol. 2017; 1019: 209–220. doi: 10.1007/978-3-319-64371-7_11 29116637

18. Van der Werf MJ, Langendam MW, Huitric E, Manissero D. Multidrug resistance after inappropriate tuberculosis treatment: a meta-analysis. Eur Respir J. 2012; 39(6):1511–9. doi: 10.1183/09031936.00125711 22005918

19. Liu Q, Li W, Xue M, Chen Y, Du X, Wang C, et al. Diabetes mellitus and the risk of multidrug resistant tuberculosis: a meta-analysis. Sci Rep. 2017; 7(1): 1090. doi: 10.1038/s41598-017-01213-5 28439071

20. Saktiawati AMI, Subronto YW. Influence of Diabetes Mellitus on the Development of Multi Drug Resistant-Tuberculosis in Yogyakarta. Acta Med Indones. 2018; 50(1): 11–17. 29686171

21. He GX, Wang HY, Borgdorff MW, van Soolingen D, Van der Werf MJ, Liu ZM, et al. Multidrug-resistant tuberculosis, People's Republic of China, 2007–2009. Emerg Infect Dis. 2011; 17(10): 1831–8. doi: 10.3201/eid1710.110546 22000352

22. Keshavjee S, Gelmanova IY, Pasechnikov AD, Mishustin SP, Andreev YG, Yedilbayev A, et al. Treating multidrug-resistant tuberculosis in Tomsk, Russia: developing programs that address the linkage between poverty and disease. Ann N Y Acad Sci. 2008; 1136:1–11. doi: 10.1196/annals.1425.009 17954675

23. Marahatta SB. Multidrug-resistant tuberculosis burden and risk factors: an update. Kathmandu Univ Med J (KUMJ). 2010; 8(29): 116–25.

24. Kirenga BJ, Ssengooba W, Muwonge C, Nakiyingi L, Kyaligonza S, Kasozi S, et al. Tuberculosis risk factors among tuberculosis patients in Kampala, Uganda: implications for tuberculosis control. BMC Public Health. 2015; 15:13. doi: 10.1186/s12889-015-1376-3 25604986

25. Cai X, Zhang D, Yan Y, Tan D, Xu Y. Meta-analysis on risk factors of multidrug resistant tuberculosis in China. Zhonghua Liu Xing Bing Xue Za Zhi. 2015; 36(12): 1424–9. 26850405

26. Xu Z, Xiao T, Li Y, Yang K, Tang Y, Bai L, et al. Reasons for Non-Enrollment in Treatment among Multi-Drug Resistant Tuberculosis Patients in Hunan Province, China. PLoS One. 2017; 12(1): e0170718. doi: 10.1371/journal.pone.0170718 28114320

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2019 Číslo 12
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