Social Behaviour Risk Factors for Drug Resistant Tuberculosis in Mainland China: A Meta-Analysis

Abstract

OBJECTIVE: To determine risk factors associated with drug resistant tuberculosis (TB) in mainland China. METHODS: PubMed and Chinese BioMedical databases were searched. Cohort, case—control and cross-sectional studies providing effect estimates of risk factors for any-drug resistant or multidrug resistant (MDR) TB were included. RESULTS: The meta-analysis included 16 studies. Any-drug resistant TB was significantly associated with poor quality directly observed treatment, short-course (DOTS) (odds ratio [OR] 2.65, 95% confidence interval [CI] 1.22, 5.79), long term illness > 1 year (OR 2.71, 95% CI 1.34, 5.48), poor treatment adherence (OR 2.00, 95% CI 1.17, 3.40), previous treatment (OR 4.54, 95% CI 2.71, 7.61) and age 40 – 60 years (OR 1.62, 95% CI 1.10, 2.38). MDR-TB was significantly associated with poor quality DOTS (OR 1.84, 95% CI 1.36, 2.49), poor treatment adherence (OR 4.39, 95% CI 2.97, 6.50), previous treatment (OR 3.83, 95% CI 2.12, 6.89) and poverty (OR 1.87, 95% CI 1.38, 2.52). CONCLUSIONS: Previous treatment, poor quality DOTS, poor treatment adherence, long term illness, age 40 – 60 years and poverty are associated with a greater risk of drug resistant TB in mainland China.