title: Prevalence of drug-resistant tuberculosis in mainland China: systematic review and meta-analysis.
abstract: BACKGROUND
  The spread of drug-resistant tuberculosis (TB) is one of the major public health problems in the world. Surveillance of anti-TB drug resistance is important for monitoring TB control strategies. However, the status of drug-resistant TB in China has been reported inconsistently.
  
  
  METHODS
  We systematically reviewed published studies on drug-resistant TB in China until March 31, 2011, and quantitatively summarized prevalence and patterns of anti-TB drug resistance among new cases and previously treated cases, respectively.
  
  
  RESULTS
  Ninety-five eligible articles, published during 1993-2011, were included in this review. The meta-analyses showed that the prevalence of drug-resistant TB in new cases was 27.9% (95% CI, 25.6%-30.2%) (n/N = 27,360/104,356) and in previously treated cases was 60.3% (95% CI, 56.2%-64.2%) (n/N = 30,350/45,858). Furthermore, in these two study populations, the prevalence of multiple drug resistance was found to be 5.3% (95% CI, 4.4%-6.4%) (n/N = 8810/101,718) and 27.4% (95% CI, 24.1%-30.9%) (n/N = 10,486/44,530) respectively. However, the results were found to be frequently heterogeneous (p for Q tests <0.001). The most common resistance was observed for isoniazid among both study populations. Different patterns of drug resistance were observed in the subgroup analysis with respect to geographic areas, drug susceptibility testing methods and subject enrollment time.
  
  
  CONCLUSIONS
  Results of meta-analyses indicated a severe status of drug-resistant TB in China, which attaches an importance to strength TB prevention and control.
authors.affiliation: State Key Laboratory for Molecular Virology and Genetic Engineering, Institute of Pathogen Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Yang
authors.forename: Xiangwei
authors.initials: X
authors.lastname: Li
authors.forename: Feng
authors.initials: F
authors.lastname: Zhou
authors.forename: Qi
authors.initials: Q
authors.lastname: Jin
authors.forename: Lei
authors.initials: L
authors.lastname: Gao
mesh_terms: D002681:China; D024881:Drug Resistance, Bacterial; D006801:Humans; D014376:Tuberculosis / Q000188:drug therapy / Q000503:physiopathology*