Detection of rifampicin-resistant tuberculosis in Guizhou during the 13^th Five-Year Plan period

  Objective  To analyze the detection of the rifampicin-resistant tuberculosis (TB) in Guizhou province during the 13^th Five-Year Plan period (2016−2020), identify the main factors affecting the detection of rifampicin-resistant TB in Guizhou, and provide reference and evidence for the development of more precise national drug resistant TB prevention and control policy.

  Methods  The data related to rifampicin resistance screening in Guizhou were collected from 2016 to 2020 from the National Tuberculosis Information Management System (TBIMS), and descriptive research method was used to analyze the estimated and actual incidence of rifampicin-resistant TB, drug resistance testing time and methods and etiological diagnosis results in each year. Kruskal-Wallis test was used to compare the differences in median days needed for the detection of rifampicin-resistant TB in each year.

  Results  A total of 3 588 rifampicin-resistant TB cases were detected in Guizhou during 2016−2020. The number and detection rate of rifampicin-resistant TB cases increased from 280 cases and 7.65% in 2016 to 1038 cases and 32.05% in 2020, which was closely related to the increase of etiological positive rate and drug resistance screening rate from 30.19% and 12.01% in 2016 to 56.82% and 67.59% in 2020, but there were significant differences in etiological positive rate and drug resistance screening rate among 9 area in Guizhou. In addition, in 2020, fuoroquinolone (FQ) susceptibility testing was performed for only 8.07% of rifampicin-resistant TB cases, and this proportion has been declining year by year since 2016. As the use of molecular rapid drug sensitivity test increased, the time interval for drug resistance diagnosis was significantly shortened from 103 days in 2016 to 33 days in 2020.

  Conclusion  With the government's commitment and the introduction of TB prevention and control plan, as well as the implementation of comprehensive drug-resistant TB prevention and control measures in Guizhou, the detection level of rifampicin-resistant TB has been significantly improved, but there are still problems, such as low detection rate of rifampicin-resistant TB, long interval of drug-resistant TB diagnosis, and low proportion of FQ susceptibility testing rate in rifampicin-resistant TB patients. Therefore, it is necessary to strengthen laboratory capacity, staff capability and rational allocation of health resources in TB prevention and control institutions at all levels to stop the spread of drug-resistant TB.