title: 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, shortcourse (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.
authors.affiliation: Chaoyang Centre for Disease Control and Prevention, Beijing, China.
authors.forename: P
authors.initials: P
authors.lastname: Zhao
authors.forename: X J
authors.initials: XJ
authors.lastname: Li
authors.forename: S F
authors.initials: SF
authors.lastname: Zhang
authors.forename: X S
authors.initials: XS
authors.lastname: Wang
authors.forename: C Y
authors.initials: CY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011203:Poverty; D012307:Risk Factors; D012919:Social Behavior; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents