Epidemic trend of initial drug-resistant tuberculosis in Zhejiang province

ObjectiveTo investigate the current status and trend of initial drug-resistant tuberculosis epidemic in Zhejiang province, and evaluate the effect of current TB control strategies. MethodsThe drug-resistant tuberculosis surveillance was performed for newly registered smear-positive tuberculosis cases in Zhejaing province according to the Guidelines for Surveillance of Drug-resistance in Tuberculosis by World Health Organization (WHO/IUATLD), and the results were compared with the first resistance surveillance in 1998/1999. ResultsA total of 936 TB cases were recruited from 30 surveillance spots. The resistance of 834 strains of Mycobacterium tuberculosis to four anti-TB drugs, streptomycin (S), isoniazid (H), rifampicin and ethambutol (E) was tested. The initial drug resistance rate was 26.6%, and the initial multi-drug resistance rate was 3.7%. In initial drug-resistant cases, 65.8% were resistance to only one drug. The resistance rates to 4 anti-TB drugs ranked as follows: 19.2% for S, 12.4% for H, 5.0% for R and 4.0% for E. The initial resistance rates to 1 drug and to 2 drugs were 17.5% and 9.0%, respectively. Compared with the records in 1998/1999, the initial drug resistance rates increased significantly in the province (I/Isup2/sup = 34.606, IP/I=0.000), while multidrug resistance rate showed a decreasing trend. Mycobacterium tuberculosis tended to show single drug resistance. ConclusionDespite some alleviation, initial drug-resistant tuberculosis epidemic was still serious in Zhejiang, so it is necessary to improve the quality of DOTS.