Contribution of rural-to-urban migration in the prevalence of drug resistant tuberculosis in China
Contribution of rural-to-urban migration in the prevalence of drug resistant tuberculosis in China
复制标题
农村人口向城市迁移对中国耐药结核病流行的贡献
DOI：
10.1007/s10096-010-1125-6
复制
发表时间：
2011-04-01
影响因子：
4.5
通讯作者：
Xu, B.
中科院分区：
文献类型：
--
作者：
Wang, W.;Wang, J.;Xu, B.
我国结核病对一线抗结核药物的耐药率和多药耐药率均呈上升趋势。本研究的目的是确定中国城市耐药结核病（TB）的患病率和危险因素，更具体地说，确定人口流动对城市病例负担和耐药率的贡献。对2008年4月1日至2009年3月31日期间上海市和宁波市四个区报告的所有活动性肺结核患者进行了以设施为基础的流行病学研究。居民的耐药率明显高于流动人口（任何耐药率分别为29.8%和23.5%，P= 0.038; MDR率分别为10.9%和6.1%，P = 0.048）。既往接受过治疗的移民患者比新移民病例更容易携带耐药结核病和耐多药结核病，调整后的比值比分别为3.85和6.52。既往治疗病例中INH、SM、RMP和EMB的耐药率分别为46.2%、38.5%、33.3%和30.8%;新发病例中INH、SM、RMP和EMB的耐药率分别为13.1%、17.5%、7.0%和6.8%。为了防止耐药结核病在移民和居民中传播，应持续改进病例管理和适当的治疗方案，以防止获得性耐药性。
Increased drug resistance rates to the first-line anti-tuberculosis drugs and multidrug resistance (MDR) were observed in China. The objectives of this study were to determine the prevalence and risk factors for drug-resistant tuberculosis (TB) in urban China and, more specifically, to determine the contribution of migration to case burden and drug resistance rates of urban cities. A facility-based epidemiological study of all active TB patients reported in the four districts of Shanghai and Ningbo between April 1, 2008 and March 31, 2009 was conducted. Residents had significantly higher drug-resistance rates than migrants (any drug resistance: 29.8% vs. 23.5%, respectively,P= 0.038; MDR: 10.9% vs. 6.1%,P= 0.048). Previously treated migrant patients were more likely to harbor drug-resistant TB and MDR-TB than new migrant cases, with adjusted odds ratios of 3.85 and 6.52, respectively. In total, 46.2% of the previously treated cases were resistant to INH, 38.5% to SM, 33.3% to RMP and 30.8% to EMB, while 13.1%, 17.5%, 7.0% and 6.8% of new cases were resistant to the four agents, respectively. To prevent the transmission of drug-resistant TB among migrants and residents, improved case management and appropriate treatment regimens should be sustained to prevent acquired drug resistance.