10% Of TB Cases In China Are Drug-Resistant Strains

Date: Jun-07-2012Drug resistant tuberculosis (TB) in China makes up about 1 in every 10 new cases, according to a report based on data from China's Centers for Disease Control and Prevention and published in NEJM (New England Journal of Medicine). Experts say that more rapid testing of the estimated 9 million infected individuals each year globally is crucial. In China alone, there are at least 1 million new infections annually.

The authors explained that they obtained their data from local and regional surveys in China. A national survey of drug-resistant TB in China was carried out by the researchers in 2007.

Yanlin Zhao, Ph.D., Shaofa Xu, M.D., Lixia Wang, M.S., and team estimated what proportion of Chinese TB cases were drug resistant by cluster-randomized sampling of cases in the national public health system, and resistance testing for the first-line use of the following antibiotics, streptomycin, ethambutol, rifampin, and isoniazid, as well as the second-line medications kanamycin and ofloxacin.

They also used patient-interview data in compiling their estimate.

Below are some highlighted data from their study:

Out of 3,037 new TB cases, 5.7% had MDR (multidrug-resistant) TB

Out of 892 previously treated cases, 25.6% had MDR TB.

MDR means the TB is resistant to at least rifampin and ironiazid

Out of all patients with TB, new and old cases, 1 in every 4 was resistant to rifampin, isoniazid, or both

Out of all patients with TB, 1 in every 10 had the multi-drug resistant type

About 8% of all MDR TB patients had "extensively drug-resistant TB".

Extensively drug-resistant TB refers to infection that is resistant to at least isoniazid, kanamycin, rifampin, and ofloxacin

There were 110,000 MDR TB incidence cases in 2007

There were 8,200 extensively drug-resistance TB cases in 2007

In the majority of cases, extensively drug-resistance TB and MDR TB resulted from primary transmission

Those with the highest risk of MDR TB were patients who had received their last treatment in a TB hospital

43.8% of the 226 patients with MDR B had not completed their last treatment. The majority of them had received treatment in hospital. Even among those who completed their treatment, TB recurred after being treated in the public health system.

In an Abstract in the same journal, the authors wrote:

"China has a serious epidemic of drug-resistant tuberculosis. MDR tuberculosis is linked to inadequate treatment in both the public health system and the hospital system, especially tuberculosis hospitals; however, primary transmission accounts for most cases."

Written by Christian Nordqvist

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