Longitudinal Analysis of Prevalence and Risk Factors of Rifampicin-Resistant Tuberculosis in Zhejiang, China. (12th February 2020)

• Record Type: Journal Article
• Authors: Liu, Zhengwei; Zhang, Mingwu; Wang, Jianmei; Chen, Songhua; Wu, Beibei; Zhou, Lin; Pan, Aizhen; Wang, Weibing; Wang, Xiaomeng
• Other Names: Portugal Isabel Academic Editor.
• Is Part Of: BioMed research international. Volume 2020(2020)
• Publication Date: 2020-02-12
• Subjects: Medicine -- Periodicals; Biology -- Periodicals; Biotechnology -- Periodicals; Life sciences -- Periodicals; 610.5
• DOI: 10.1155/2020/3159482
• Languages: English
• ISSNs: 2314-6133

Abstract

Abstract : Objectives . To investigate the factors associated with rifampicin-resistant tuberculosis among drug resistant tuberculosis patients and to determine the correlation of rifampicin-resistant TB with MDR-TB in a high MDR-TB burden province of china. Methods . A retrospective longitudinal analysis on four surveys of anti-TB drug resistance done in 1998, 2003, 2008, and 2013 in Zhejiang province, China. 4289 sputum-smear microscopy positive suspected tuberculosis patients were eligible at 30 investigation points, chosen by stratified random sampling at survey sites from all over the province. Culturing samples in L-J medium and the drug-susceptibility testing for the 4 first-line anti-TB drugs were performed to all patients. Multivariate logistic regression was carried out to determine the factors associated with the rifampicin-resistance in the study population. Results . Overall, there were 3832 patients with positive mycobacterial cultures, and 2813 of the isolates (73.4%) were susceptible to all 4 first-line drugs. Analysis of rifampin monoresistant (RMR) TB indicated the prevalence was 1.1% in new cases and 3.4% in previously treated cases. Among the 359 rifampicin resistant TB (RR-TB) cases, 279 (77.7%) were also resistant to isoniazid, indicating MDR-TB. From 1998 to 2013, the proportion of MDR-TB among rifampicin-resistant TB cases varied between 80.0% and 87.5% (P for trend: 0.768) among previously treated cases and varied from 68.6% to 79.5% (P for trend: 0.403) among new cases. Among previously treated patients, those who received treatment for less than 6 months were less likely to have drug resistant TB (OR: 0.40, 95% CI: 0.16–0.97) or MDR-TB (OR: 0.24, 95% CI: 0.07–0.81). Patients who received anti-TB treatment in a general hospital were less likely to develop MDR-TB than those treated in a TB clinic (OR: 0.08, 95% CI: 0.01–0.72). Conclusion . This study highlights a high proportion of RMR-TB among new RR-TB cases in Zhejiang, China. The management of treatment with rapid and accurate diagnosis of MDR-TB other than only relying on RIF susceptibility testing is crucial for improving adherence and outcomes in patients with drug-resistant TB.