International Journal of Tuberculosis and Lung Disease
Volume 21, Issue 7, 2017, Pages 759-765

Trends in drug-resistant tuberculosis after the implementation of the DOTS strategy in Shenzhen, China, 2000-2013 (Article)

Zhu L. , Yang Y.-Z.* , Guan H.-Y. , Cheng S.-M. , Jin Y.-Y. , Tan W.-G. , Wu Q.-F. , Liu X.-L. , Zhao M.-G. , Lu Z.-H. , Jia Z.-W.
  • a Department of Epidemiology and Biostatistics, Peking University Health Science Center, School of Public Health, Beijing, China, National Institute of Drug Dependence, Peking University, Beijing, China
  • b Shenzhen Chronic Disease Control Centre, Shenzhen, China
  • c Shenzhen Chronic Disease Control Centre, Shenzhen, China
  • d National Centre for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
  • e Department of Epidemiology and Biostatistics, Peking University Health Science Center, School of Public Health, Beijing, China
  • f Shenzhen Chronic Disease Control Centre, Shenzhen, China
  • g Shenzhen Chronic Disease Control Centre, Shenzhen, China
  • h Shenzhen Chronic Disease Control Centre, Shenzhen, China
  • i Shenzhen Chronic Disease Control Centre, Shenzhen, China
  • j Department of Biomedical Engineering, Peking University, Beijing, China
  • k National Institute of Drug Dependence, Peking University, Beijing, China

Abstract

SETTING: The DOTS strategy has been regarded as the most cost-effective way to stop the spread of tuberculosis (TB) since its launch by the World Health Organization. OBJECTIVE : To estimate the effects of DOTS by tracking long-Term trends in multidrug-resistant TB (MDR-TB). DESIGN: A retrospective cohort study was conducted from 2000 to 2013 to analyse trends in resistance to antituberculosis drugs and the effect of DOTS-based treatment in Shenzhen, China, using the v2 test. RESULT S : An overall MDR-TB rate of 4.2% was observed between 2000 and 2013, with an annual reduction of 0.16%. From 2000 to 2013, trends in resistance to isoniazid (INH), rifampicin (RMP) and MDR-TB declined significantly in new TB patients (P , 0.01), but not in retreatment cases. Sputum smear conversion rates after 2 months of treatment decreased significantly, in particular after 2007, in new and retreatment cases. CONCLUS ION: INH and RMP resistance and MDR-TB rates declined significantly, suggesting that DOTS-based programmes were successful in reducing drug resistance in new cases but not in retreatment cases. The decreasing sputum smear conversion rates may have been due to an increase in the number of migrants. These two findings suggest that TB is unlikely to be completely eliminated by 2050 in Shenzhen. ©2017 The Union.

Author Keywords

Migrants MDR-TB tuberculosis DOTS Trends

Index Keywords

treatment response China retreatment sputum smear public health service drug effects human trend study middle aged Cohort Studies controlled study multidrug resistant tuberculosis time factor priority journal Mycobacterium tuberculosis Time Factors Tuberculosis, Multidrug-Resistant procedures Young Adult health program school child Sputum Humans Adolescent Antitubercular Agents Rifampin tuberculostatic agent male preschool child female Infant Child, Preschool short course therapy Article Retrospective Studies major clinical study adult isoniazid microbiology cohort analysis Directly Observed Therapy retrospective study rifampicin Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85021061610&doi=10.5588%2fijtld.16.0759&partnerID=40&md5=68e160b1cab5a5e3432f4e952cedc312
DOI: 10.5588/ijtld.16.0759
ISSN: 10273719
Cited by: 1
Original Language: English