Prevalence of Drug-Resistant Tuberculosis in Mainland China: Systematic Review and Meta-Analysis

BackgroundTuberculosis and HIV co-epidemics are problems in many parts of the world. Xinjiang is a high tuberculosis and HIV prevalence area in China. We aimed to investigate the prevalence and cure rate of tuberculosis among HIV positive patients in Xinjiang.MethodsIn a retrospective study between 2006 and 2011, clinical and laboratory data on 333 patients with HIV and tuberculosis were compared to 2668 patients with HIV only. There were 31 HIV positive patients with no data on tuberculosis.ResultsThe prevalence of tuberculosis co-infection among the HIV positive patients was 11% (95% CI 10–12%), significantly higher than the national figure in China of 2%. In most cases HIV was diagnosed late, with advanced immunodeficiency. The use of isoniazid preventive therapy was only 57.9% in patients without tuberculosis who fulfilled the criteria for receiving this prevention. The cure rate one year after diagnosis was 69.2%, which was lower than the officially reported 91.4% in all tuberculosis cases in Xinjiang in 2011. The hazard of not surviving over the five years was significantly higher in patients with HIV + tuberculosis compared to HIV only after adjusting for sex and Intravenous drug use with HR = 1.84 (95% CI 1.43-2.35; p < 0.0001).ConclusionsThe prevalence of tuberculosis among HIV positive patients in Xinjiang was higher than in China taken as a whole, and HIV was diagnosed late, with underuse of isoniazid preventive therapy. The low cure rate and reduced survival can be due to late diagnosis of HIV and no testing for antibiotic resistance, together with insufficient control of adherence to the treatment regimens for tuberculosis and HIV.

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“…The incidence of drug resistance is higher in the north, west, and central areas of China, and lower in south and east China [30–32]. …”

Section: Discussionmentioning

confidence: 99%

“…Although TB control and prevention in the Centre of Disease Control and prevention (CDC) system have professional follow-up systems, the patients from the hospitals are sometimes missed at transfer from hospitals to local TB dispensaries, and will thus not complete their follow-up treatment and get a high risk of drug resistance [30]. …”

Section: Discussionmentioning

confidence: 99%

High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China

et al. 2017

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“…A report of National Baseline Survey of drug-resistant TB (2007-2008) in China showed that resistance to at least one anti-TB drug among new cases with smear positive pulmonary TB was 35.2% [27]. Borann in Cambodia also reported high resistance to at least one anti-TB drug of 52% [28].…”

Section: Discussionmentioning

confidence: 99%

Drug Resistance among Pulmonary Tuberculosis Patients in Calabar, Nigeria

et al. 2013

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Background. This study aimed to determine the pattern of drug susceptibility to first-line drugs among pulmonary TB patients in two hospitals in Calabar, Nigeria. Methods. This was a descriptive cross-sectional study carried out between February 2011 and April 2012. Sputum samples from consecutive TB patients in Calabar were subjected to culture on Lowenstein-Jensen (LJ) slopes followed by drug susceptibility testing (DST). The DST was performed on LJ medium by the proportion method. Results. Forty-two of the 100 Mycobacterium tuberculosis strains were found to be resistant to at least one drug. Resistance to only one drug (monoresistance) was found in 17 patients. No strains with monoresistance to rifampicin were found. Resistance to two drugs was found in 22 patients, while one patient was resistant to both three and four drugs. MDR TB was seen in 4% (4/100). The independent variables of HIV serology and sex were not significantly associated with resistance (P > 0.05). Conclusion. There was a high prevalence of anti-TB drug resistance in Calabar.

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“…Combinations of the key words “sport” and “ACE” or “angiotensin-converting enzyme” were used to screen for potentially relevant studies focused on ACE . Additional studies were also identified by cross-referencing [37].…”

Section: Methodsmentioning

confidence: 99%

The Association of Sport Performance with ACE and ACTN3 Genetic Polymorphisms: A Systematic Review and Meta-Analysis

et al. 2013

PLoS ONE

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BackgroundGenetic polymorphism is suggested to be associated with human physical performance. The angiotensin I-converting enzyme insertion/deletion (ACE I/D) polymorphism and the α-actinin-3 gene (ACTN3) R577X polymorphism have been most widely studied for such association analysis. However, the findings are frequently heterogeneous. We aim to summarize the associations of ACE I/D and ACTN3 R577X with sport performance by means of meta-analysis.MethodsWe systematically reviewed and quantitatively summarized published studies, until October 31, 2012, on relationship between ACE/ACTN3 genetic polymorphisms and sports performance, respectively.ResultsA total of 366 articles on ACE and 88 articles on ACTN3 were achieved by literature search. A significant association was found for ACE II genotype compared to D allele carriage (DD+ID) with increased possibility of physical performance (OR, 1.23; 95% CI, 1.05–1.45). With respect to sport discipline, the II genotype was found to be associated with performance in endurance athletes (OR, 1.35; 95% CI, 1.17–1.55). On the other hand, no significant association was observed for ACTN3 RR genotype as compared to X allele carriage (XX+RX) (OR, 1.03; 95% CI, 0.92–1.15). However, when restricted the analyses to power events, a significant association was observed (OR, 1.21; 95% CI, 1.03–1.42).ConclusionOur results provide more solid evidence for the associations between ACE II genotype and endurance events and between ACTN3 R allele and power events. The findings suggest that the genetic profiles might influence human physical performance.

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Prevalence of Drug-Resistant Tuberculosis in Mainland China: Systematic Review and Meta-Analysis

Cited by 35 publications

References 12 publications

High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China

High prevalence and low cure rate of tuberculosis among patients with HIV in Xinjiang, China

Drug Resistance among Pulmonary Tuberculosis Patients in Calabar, Nigeria

The Association of Sport Performance with ACE and ACTN3 Genetic Polymorphisms: A Systematic Review and Meta-Analysis

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