Analysis on trend of drug resistance tuberculosis, Liuzhou, Guangxi

  Objective  To understand the spread trend of drug resistant tuberculosis (DR TB) over time in Liuzhou City, Guangxi Zhuang Autonomous Region, and provide evidences to contain the spread and transmission of DR-TB.

  Methods  Data from the DR TB surveillance network in Liuzhou were analyzed. The percentage of DR-TB cases among the newly registered TB cases and the average annual percentage change (APC) were calculated. The regression model was constructed with linear and binomial regression. The hypothesis testing of the average APC was conducted by using line/curve fitting approach.

  Results  A total of 571 DR-TB cases were detected through the DR surveillance network in Liuzhou from 2014 to 2019, accounting for 2.14% (571/26691) of new registered TB cases. The number of DR-TB cases increased from 50 in 2014 to 189 in 2019, an increase of 2.60 times. Of those with drug resistant TB, 30.30% (173/571) were isoniazid resistant, 19.26% (110/571) were rifampin resistant, 29.25% (167/571) were multi-drug resistant (MDR), and 7.01% (40/571) were extensive drug resistant (XDR). In MDR TB cases, XDR TB cases accounted for 23.95%. From 2014 to 2019, the proportion of XDR-TB cases among newly registered TB cases increased from 0.15% to 0.17%. After 2016, the result of APC testing indicated that the total number of DR TB, isoniazid resistant TB cases and rifampin resistant TB were significant increased among new tuberculosis cases (P=0.031, P=0.018, P=0.043). Although the increasing trends of MDR TB and XDR TB cases were observed among new tuberculosis cases, the differences were not significant (P_{MDR TB}=0.098, P_{XDR TB}=0.484).

  Conclusion  The average APCs of DR TB, isoniazid resistant TB and rifampin resistant TB cases significantly increased in Liuzhou overtime, but the difference in case increase over time between MDR TB and XDR TB had no significance. It is necessary to conduct consecutive surveillance to facilitate the development of evidence based prevention and control measures for DR TB and improve the prevention and control of TB and the spread of DR TB.