title: Drug-resistant tuberculosis in Shanghai, China, 2000-2006: prevalence, trends and risk factors.
abstract: METHODS
  During 2000-2006, a regional anti-tuberculosis drug resistance surveillance study was conducted in Shanghai, China.
  
  
  OBJECTIVE
  To determine the prevalence, trends and risk factors for drug-resistant tuberculosis (TB) in Shanghai, China.
  
  
  METHODS
  A retrospective study of all pulmonary TB patients reported in Shanghai during 2000-2006 was conducted.
  
  
  RESULTS
  Of 8419 pulmonary TB patients, 16.6% had resistance to any first-line anti-tuberculosis drug and 4.0% had multidrug resistance (MDR). The percentage of TB patients with resistance to any first-line anti-tuberculosis drug and MDR significantly increased during 2000-2003 (P=0.01 and P<0.01, respectively). After improvements in the TB control programme in 2004, the increasing trend in drug resistance was contained. Age 30-59 years, being an urban migrant and residence in an urban area of Shanghai were independently associated with resistance to any first-line drug and MDR in new cases, while age 30-59 years and being an urban migrant were independently associated with resistance to any first-line drug and MDR in previously treated cases.
  
  
  CONCLUSIONS
  Drug-resistant TB and MDR-TB pose a challenge for TB control in Shanghai. Improved case management, including DOTS and appropriate treatment regimens, should be sustained to prevent further transmission and development of drug-resistant TB in this setting.
authors.affiliation: Department of Tuberculosis Control, Shanghai Municipal Centre for Disease Control and Prevention, Key Laboratory of Medical Molecular Virology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
authors.forename: X
authors.initials: X
authors.lastname: Shen
authors.forename: K
authors.initials: K
authors.lastname: DeRiemer
authors.forename: Z-An
authors.initials: ZA
authors.lastname: Yuan
authors.forename: M
authors.initials: M
authors.lastname: Shen
authors.forename: Z
authors.initials: Z
authors.lastname: Xia
authors.forename: X
authors.initials: X
authors.lastname: Gui
authors.forename: L
authors.initials: L
authors.lastname: Wang
authors.forename: Q
authors.initials: Q
authors.lastname: Gao
authors.forename: J
authors.initials: J
authors.lastname: Mei
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014171:Transients and Migrants / Q000706:statistics & numerical data; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000453:epidemiology*; D014504:Urban Health / Q000706:statistics & numerical data* / Q000639:trends*; D055815:Young Adult