Prevalence of Drug-Resistant Tuberculosis in Mainland China: Systematic Review and Meta-Analysis
Open Access
- 3 June 2011
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 6 (6), e20343
- https://doi.org/10.1371/journal.pone.0020343
Abstract
The spread of drug-resistant tuberculosis (TB) is one of the major public health problems in the world. Surveillance of anti-TB drug resistance is important for monitoring TB control strategies. However, the status of drug-resistant TB in China has been reported inconsistently. We systematically reviewed published studies on drug-resistant TB in China until March 31, 2011, and quantitatively summarized prevalence and patterns of anti-TB drug resistance among new cases and previously treated cases, respectively. Ninety-five eligible articles, published during 1993–2011, were included in this review. The meta-analyses showed that the prevalence of drug-resistant TB in new cases was 27.9% (95% CI, 25.6%–30.2%) (n/N = 27360/104356) and in previously treated cases was 60.3% (95% CI, 56.2%–64.2%) (n/N = 30350/45858). Furthermore, in these two study populations, the prevalence of multiple drug resistance was found to be 5.3% (95% CI, 4.4%–6.4%) (n/N = 8810/101718) and 27.4% (95% CI, 24.1%–30.9%) (n/N = 10486/44530) respectively. However, the results were found to be frequently heterogeneous (p for Q tests <0.001). The most common resistance was observed for isoniazid among both study populations. Different patterns of drug resistance were observed in the subgroup analysis with respect to geographic areas, drug susceptibility testing methods and subject enrollment time. Results of meta-analyses indicated a severe status of drug-resistant TB in China, which attaches an importance to strength TB prevention and control.This publication has 18 references indexed in Scilit:
- Prevalence of Multidrug and Extensively Drug-Resistant Tuberculosis in Beijing, China: a Hospital-Based Retrospective StudyJapanese Journal of Infectious Diseases, 2010
- High prevalence of drug-resistant tuberculosis and other mycobacteria among HIV-infected patients in Brazil: a systematic review.Memórias do Instituto Oswaldo Cruz, 2010
- Drug Resistant TuberculosisDeutsches Ärzteblatt international, 2010
- Vitamin D receptor genetic polymorphisms and tuberculosis: updated systematic review and meta-analysis.2010
- Standardized Treatment of Active Tuberculosis in Patients with Previous Treatment and/or with Mono-resistance to Isoniazid: A Systematic Review and Meta-analysisPLoS Medicine, 2009
- Epidemiology of antituberculosis drug resistance 2002–07: an updated analysis of the Global Project on Anti-Tuberculosis Drug Resistance SurveillanceThe Lancet, 2009
- Direct observation and adherence to tuberculosis treatment in Chongqing, China: a descriptive studyHealth Policy and Planning, 2007
- Measuring inconsistency in meta-analysesBMJ, 2003
- [Report on fourth national epidemiological sampling survey of tuberculosis].2002
- The DOTS strategy in China: results and lessons after 10 years.2002