Is rifampin resistance a reliable predictive marker of multidrug-resistant tuberculosis in China: A meta-analysis of findings - 19/09/19
, Xiaomeng Wang a, ⁎ Highlights |
• | Only 77% of RR-TB cases were MDR-TB; thus RR-TB cannot predict INH resistance in China. |
• | Greater MDR-TB prevalence was seen in previously treated versus new RR-TB cases. |
• | The prevalence of RR-TB exhibited great diversity across regions in China. |
Summary |
Objectives |
Systematic review of multidrug-resistant tuberculosis (MDR-TB) prevalence among rifampicin (RIF)-resistant tuberculosis (RR-TB) patients in 34 provinces of China was conducted to correlate RIF resistance with concurrent isoniazid (INH) resistance.
Methods |
Database searches (PubMed, Embase, China National Knowledge Infrastructure, Chinese Scientific Journal, Wanfang), identified drug resistance surveillance studies conducted between January 1, 2000 and June 30, 2018. Of 1554 records, random-effects meta-analysis of 34 studies of adequate methodological quality yielded 108,366 TB cases for MDR-TB prevalence analysis of RR-TB cases.
Results |
MDR-TB prevalence among RR-TB cases varied from 57% (Xinjiang; 95% CI 47%, 67%) to 95% (Taiwan; 95% CI 92%, 98%), for a pooled national rate of 77% (95% CI 75%, 80%). Subgroup and meta-regression analyses revealed greater MDR-TB prevalence in previously treated versus new RR-TB cases (P < 0.001), with no significant differences of regional initial drug resistance rates or sampling methods. Regional MDR-TB prevalence among RR-TB cases was lowest (69%) in the Northeast Region (95% CI 65%, 73%) and highest (90%) in Hong Kong, Macao and Taiwan (95% CI 81%, 98%).
Conclusions |
In China, ∼77% of RR-TB cases are MDR-TB. Thus, RIF resistance cannot effectively predict MDR-TB. Highly variable RR-TB prevalence across China warrants improved TB management.
Le texte complet de cet article est disponible en PDF.Keywords : Tuberculosis, Rifampin, Multidrug-resistance, Predict marker
Plan
Vol 79 - N° 4
P. 349-356 - octobre 2019 Retour au numéro
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