Zhengwei Liu1, Huali Dong2, BeiBei Wu1, Mingwu Zhang1, Yelei Zhu1, Yu Pang3, Xiaomeng Wang4. 1. The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399, Binsheng road, Binjiang District, Hangzhou 310005, China. 2. Department of Clinical Laboratory, Zhejiang Xiao Shan Hospital, Hangzhou, China. 3. National Clinical Laboratory on Tuberculosis, Beijing Key laboratory on Drug-resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, No. 9, Beiguan Street, Tongzhou District, Beijing 101149, China. Electronic address: pangyupound@163.com. 4. The Institute of TB Control, Zhejiang Provincial Center for Disease Control and Prevention, No. 3399, Binsheng road, Binjiang District, Hangzhou 310005, China. Electronic address: xmwang@cdc.zj.cn.
Abstract
OBJECTIVES: Systematic review of multidrug-resistant tuberculosis (MDR-TB) prevalence among rifampicin (RIF)-resistant tuberculosis (RR-TB) patients in 34 provinces of China was conducted to correlate RIF resistance with concurrent isoniazid (INH) resistance. METHODS: Database searches (PubMed, Embase, China National Knowledge Infrastructure, Chinese Scientific Journal, Wanfang), identified drug resistance surveillance studies conducted between January 1, 2000 and June 30, 2018. Of 1554 records, random-effects meta-analysis of 34 studies of adequate methodological quality yielded 108,366 TB cases for MDR-TB prevalence analysis of RR-TB cases. RESULTS: MDR-TB prevalence among RR-TB cases varied from 57% (Xinjiang; 95% CI 47%, 67%) to 95% (Taiwan; 95% CI 92%, 98%), for a pooled national rate of 77% (95% CI 75%, 80%). Subgroup and meta-regression analyses revealed greater MDR-TB prevalence in previously treated versus new RR-TB cases (P < 0.001), with no significant differences of regional initial drug resistance rates or sampling methods. Regional MDR-TB prevalence among RR-TB cases was lowest (69%) in the Northeast Region (95% CI 65%, 73%) and highest (90%) in Hong Kong, Macao and Taiwan (95% CI 81%, 98%). CONCLUSIONS: In China, ∼77% of RR-TB cases are MDR-TB. Thus, RIF resistance cannot effectively predict MDR-TB. Highly variable RR-TB prevalence across China warrants improved TB management.
OBJECTIVES: Systematic review of multidrug-resistant tuberculosis (MDR-TB) prevalence among rifampicin (RIF)-resistant tuberculosis (RR-TB) patients in 34 provinces of China was conducted to correlate RIF resistance with concurrent isoniazid (INH) resistance. METHODS: Database searches (PubMed, Embase, China National Knowledge Infrastructure, Chinese Scientific Journal, Wanfang), identified drug resistance surveillance studies conducted between January 1, 2000 and June 30, 2018. Of 1554 records, random-effects meta-analysis of 34 studies of adequate methodological quality yielded 108,366 TB cases for MDR-TB prevalence analysis of RR-TB cases. RESULTS: MDR-TB prevalence among RR-TB cases varied from 57% (Xinjiang; 95% CI 47%, 67%) to 95% (Taiwan; 95% CI 92%, 98%), for a pooled national rate of 77% (95% CI 75%, 80%). Subgroup and meta-regression analyses revealed greater MDR-TB prevalence in previously treated versus new RR-TB cases (P < 0.001), with no significant differences of regional initial drug resistance rates or sampling methods. Regional MDR-TB prevalence among RR-TB cases was lowest (69%) in the Northeast Region (95% CI 65%, 73%) and highest (90%) in Hong Kong, Macao and Taiwan (95% CI 81%, 98%). CONCLUSIONS: In China, ∼77% of RR-TB cases are MDR-TB. Thus, RIF resistance cannot effectively predict MDR-TB. Highly variable RR-TB prevalence across China warrants improved TB management.
Authors: Samantha Pillay; Karen R Steingart; Geraint R Davies; Marty Chaplin; Margaretha De Vos; Samuel G Schumacher; Rob Warren; Grant Theron Journal: Cochrane Database Syst Rev Date: 2022-05-18
Authors: Ji Lecai; Peierdun Mijiti; Hong Chuangyue; Li Mingzhen; Gao Qian; Tan Weiguo; Chen Jihong Journal: Infect Drug Resist Date: 2021-10-27 Impact factor: 4.003