Trends and impact factors of drug-resistant tuberculosis in Ningbo from 2007 to 2010 / 中华传染病杂志

ABSTRACT

Objective To determine the prevalence,trends and risk factors of drug-resistant tuberculosis (TB) in Ningbo during 2007-2010,and to explore the efficient control strategy of drugresistant TB.Methods A cross-sectional study of regional anti-TB drug resistance was conducted in Ningbo.The registered and culture-positive TB patients were enrolled and drug sensitivity test was performed.The demographic and clinical information were collected from the national TB report system.Logistic regression model was used to determine the risk factors of drug resistance.Results Of 1613 enrolled TB patients,39.3％-48.3％ were resistant to any first-line anti-TB drug and 14.0％-19.9％ were multidrug resistant (MDR)-TB.The proportion of new cases resistant to any first-line anti-TB drug was 35.4 ％-42.1％ and MDR TB was 9.8％- 12.2 ％,which were both significantly lower than those of retreated patients (69.5％-72.7％ and 33.9％ - 54.5％,respectively).The multivariate Logistic regression model showed that anti-TB treatment history and migration were significantly associated with any drug resistance (OR=3.298,95 ％ CI 2.391 4.550and OR=0.771,95 ％CI 0.608 - 0.978,respectively) ; while age,treatment history and migration were also significantly associated with MDR-TB.Conclusions Drug-resistant TB prevalence showed a decrease trend in Ningbo,while the resistant rates in both new cases and retreated cases still remain at high levels. Improved case management,including directly observed treatment short-course and appropriate treatment regimens specifically for drug-resistant TB,should be developed to prevent further transmission and development of drug-resistant TB in this setting.