Zhang Jingya, Gou Haimei, Hu Xuejiao, Hu Xin, Shang Mengqiao, Zhou Juan, Zhou Yi, Ye Yuanxin, Song Xingbo, Lu Xiaojun, Chen Xuerong, Ying Binwu, Wang Lanlan
Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Am J Infect Control. 2016 Jun 1;44(6):671-6. doi: 10.1016/j.ajic.2015.12.042. Epub 2016 Mar 2.
We conducted a systematic review and meta-analysis on drug-resistant tuberculosis in China to provide useful data for tuberculosis (TB) surveillance and treatment.
Several databases, including PubMed, Embase, and the Chinese Biological Medical Database, were systematically searched between January 1, 1999, and August 31, 2015, using strict inclusion and exclusion criteria.
The corresponding drug-resistant TB prevalence between the new and previously treated cases was significantly different in almost all of the economic regions. The Eastern coastal region is the most developed economic region with the lowest total drug-resistant TB prevalence (any drug resistance: 28%; 95% confidence interval [CI], 25%-32%; multidrug resistance: 9%; 95% CI, 8%-12%) and the lowest number of new cases (any drug resistance: 21%; 95% CI, 19%-23%; multidrug resistance: 4%; 95% CI, 3%-5%). The Northwest is the least developed area with the lowest drug-resistant TB prevalence for previously treated cases (any drug resistance: 45%; 95% CI, 36%-55%; multidrug resistance: 17%; 95% CI, 11%-26%). The prevalence (multidrug and first-line drug resistance) exhibited a downward trend from 1996-2014. The extensively drug-resistant prevalence in China was 3% (95% CI, 2%-5%) in this review.
Overall, the status of drug-resistant tuberculosis in China is notably grim and exhibits regional epidemiologic characteristics. We are in urgent need of several comprehensive and effective control efforts to reverse this situation.
我们对中国耐药结核病进行了系统评价和荟萃分析，以提供用于结核病监测和治疗的有用数据。
利用严格的纳入和排除标准，于1999年1月1日至2015年8月31日期间对多个数据库进行系统检索，包括PubMed、Embase和中国生物医学数据库。
几乎在所有经济区域，新发病例和既往治疗病例的相应耐药结核病患病率存在显著差异。东部沿海地区是最发达的经济区域，其总体耐药结核病患病率最低（任何耐药：28%；95%置信区间[CI]，25%-32%；多重耐药：9%；95%CI，8%-12%），新发病例数也最少（任何耐药：21%；95%CI，19%-23%；多重耐药：4%；95%CI，3%-5%）。西北地区是最不发达的地区，既往治疗病例的耐药结核病患病率最低（任何耐药：45%；95%CI，36%-55%；多重耐药：17%；95%CI，11%-26%）。1996 - 2014年期间，患病率（多重耐药和一线药物耐药）呈下降趋势。在本综述中，中国广泛耐药患病率为3%（95%CI，2%-5%）。
总体而言，中国耐药结核病状况严峻，呈现出区域流行病学特征。我们迫切需要采取多项全面有效的防控措施来扭转这一局面。
