title: The burden of MDR/XDR tuberculosis in coastal plains population of China.
abstract: BACKGROUND
  We conducted a first baseline survey in Jilin Province of China to determine the proportion of drug-resistant tuberculosis (TB), and to analyze risk factors associated with the emergence of drug-resistance.
  
  
  RESULTS
  Thirty counties in Jilin Province were randomly selected as survey sites using a stratified cluster sampling method. People enrolled in the survey were new and re-treated, smear-positive pulmonary TB patients newly enrolled in local TB control and prevention institutions during the survey period. Sputum samples were collected, and the susceptibility of bacterial strains to anti-TB drugs was analyzed by proportion method. Based on the survey results, we estimated the number of drug-resistant TB patients and analyzed the risk factors associated with the emergence of drug resistance. Of 1,174 new TB patients and 597 re-treated TB patients, 8.6% and 23.2% were multi-drug resistant (MDR)-TB patients, respectively. Approximately 12% of MDR-TB patients were extensively drug-resistant. We estimate that approximately 1,290 new MDR-TB cases develop in Jilin Province every year. Of these, 810 cases would be new patients, and 480 cases would involve re-treated patients. Risk factors associated with MDR-TB include employment status, educational background, and income level.
  
  
  CONCLUSIONS
  Jilin Province remains one of the highest-burden areas in China for drug-resistant TB. The higher number of MDR-TB among new cases suggested that the transmission of drug-resistant strains in Jilin is an urgent problem in the MDR-TB control and prevention system of Jilin Province. Improving the treatment compliance of TB patients and the quality of medical care in public health institutions is urgently needed.
authors.affiliation: Jilin Province Center for Disease Control and Prevention, Changchun, China.
authors.forename: Xiujun
authors.initials: X
authors.lastname: Yang
authors.affiliation: Jilin Province Center for Disease Control and Prevention, Changchun, China.
authors.forename: Yanli
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Pang
authors.affiliation: Jilin Province Center for Disease Control and Prevention, Changchun, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.affiliation: Jilin Province Center for Disease Control and Prevention, Changchun, China.
authors.forename: Yunlong
authors.initials: Y
authors.lastname: Bai
authors.affiliation: Jilin Province Center for Disease Control and Prevention, Changchun, China.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Jilin Province Center for Disease Control and Prevention, Changchun, China.
authors.forename: Baozhu
authors.initials: B
authors.lastname: Yu
authors.affiliation: PATH Office, Beijing, China.
authors.forename: Zhiying
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Jilin Province Center for Disease Control and Prevention, Changchun, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Fan
authors.affiliation: Chinese Center for Disease Control and Prevention, Beijing, China.
authors.forename: Yanlin
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D024901:Drug Resistance, Multiple, Bacterial; D054908:Extensively Drug-Resistant Tuberculosis / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents