Transmission of Drug-Resistant Tuberculosis in Rural China
Author Information
Author(s): Hu Yi, Mathema Barun, Jiang Weili, Kreiswirth Barry, Wang Weibing, Xu Biao, Mokrousov Igor
Primary Institution: Key Laboratory of Public Health Safety, Ministry of Education, and Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
Hypothesis
The study aimed to investigate the impact of DOTS on the transmission of drug-resistant TB in eastern rural China.
Conclusion
Transmission of drug-resistant TB in eastern rural China is characterized by small clusters and limited geographic spread.
Supporting Evidence
- 73 drug-resistant isolates were identified with clustered IS6110 RFLP patterns.
- The clustering proportion among total drug-resistant TB was higher in Guanyun than Deqing.
- Patients with cavitary disease had an increased risk of clustering.
- 71.2% of patients with clustered drug-resistant isolates lived in the same or neighboring villages.
- Epidemiological links were confirmed in 12.3% of the clustered isolates.
Takeaway
This study found that drug-resistant tuberculosis spreads in small groups in rural China, and we need better strategies to find and treat these cases.
Methodology
A cross-sectional study of all patients diagnosed with drug-resistant TB over a one-year period in two rural Chinese counties with varying lengths of DOTS implementation.
Potential Biases
Potential misclassification of clustering using IS6110 RFLP alone.
Limitations
The study may have missed intermediate cases in the transmission chain due to its one-year duration and passive case detection strategies.
Participant Demographics
Patients diagnosed with drug-resistant TB from two rural counties in China, Deqing and Guanyun.
Statistical Information
P-Value
0.04
Confidence Interval
95% CI: 1.332–28.64
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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