Objective To determine the prevalence and risk factors of drug-resistant tuberculosis(DRTB) among migratory population in Shanghai, so as to provide the basis for developing and implementing measures for DRTB prevention and control, suppressing the epidemic and improving the management level.
Methods All DRTB sputum culture positive patients, confirmed at any district (county) tuberculosis dispensary in Shanghai from Jan to Dec of 2006 were enrolled. Basic information, epidemiological and management data of each case were collected. Bacterial-type and susceptibility to rifampin, isoniazid, streptomycin and ethambutol were also identified. Univariate and multivariate analysis were performed to determine the relevance between risk factors and drug-resistance.
Results A total of 585 patients were enrolled in this study. Most of these cases were first diagnosed and treated, mainly young adults. Their medical insurance was obviously insufficient, thus, led to the postponement of treatment. Some patients were lost follow-up. The full course directly observed treatment, the short course (DOTS)management rate, the sputum conversion rate and the cure rate were relatively poor. The total drug resistance rate was 20.00%, the multiple drug resistance rate was 4.10%, the initial drug resistance rate was 17.14% and the initial rate of multiple drug resistance was 3.43%. The acquired drug resistance rate was 45.00% and the acquired rate of multiple drug resistance was 10.00%. The resistance rates of streptomycin and isoniazid were leading drug resistances observed (14.87% and 10.94% respectively). The total drug resistance rate in the 30-49 year group was the highest (8.72%) and the initial drug resistance rate of the 15-29 year group was the highest (8.57%). Overall, the drug resistance was associated with retreated cases among migratory population in Shanghai.
Conclusion The prevalence and risk factors of drug-resistant tuberculosis among migratory population are relatively high in Shanghai. It in dicates the necessity to enforce the tuberculosis control program for migratory population.
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