title: Status of drug-resistant tuberculosis in China: A systematic review and meta-analysis.
abstract: We conducted a systematic review and meta-analysis on drug-resistant tuberculosis in China to provide useful data for tuberculosis (TB) surveillance and treatment.
  
  
  
  Several databases, including PubMed, Embase, and the Chinese Biological Medical Database, were systematically searched between January 1, 1999, and August 31, 2015, using strict inclusion and exclusion criteria.
  
  
  
  The corresponding drug-resistant TB prevalence between the new and previously treated cases was significantly different in almost all of the economic regions. The Eastern coastal region is the most developed economic region with the lowest total drug-resistant TB prevalence (any drug resistance: 28%; 95% confidence interval [CI], 25%-32%; multidrug resistance: 9%; 95% CI, 8%-12%) and the lowest number of new cases (any drug resistance: 21%; 95% CI, 19%-23%; multidrug resistance: 4%; 95% CI, 3%-5%). The Northwest is the least developed area with the lowest drug-resistant TB prevalence for previously treated cases (any drug resistance: 45%; 95% CI, 36%-55%; multidrug resistance: 17%; 95% CI, 11%-26%). The prevalence (multidrug and first-line drug resistance) exhibited a downward trend from 1996-2014. The extensively drug-resistant prevalence in China was 3% (95% CI, 2%-5%) in this review.
  
  
  
  Overall, the status of drug-resistant tuberculosis in China is notably grim and exhibits regional epidemiologic characteristics. We are in urgent need of several comprehensive and effective control efforts to reverse this situation.
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Jingya
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Haimei
authors.initials: H
authors.lastname: Gou
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Hu
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Mengqiao
authors.initials: M
authors.lastname: Shang
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yuanxin
authors.initials: Y
authors.lastname: Ye
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xingbo
authors.initials: X
authors.lastname: Song
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Lu
authors.affiliation: Division of Pulmonary Disease, Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Xuerong
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China. Electronic address: docbwy@126.com.
authors.forename: Binwu
authors.initials: B
authors.lastname: Ying
authors.affiliation: Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Lanlan
authors.initials: L
authors.lastname: Wang
mesh_terms: D002681:China / Q000453:epidemiology; D006801:Humans; D015995:Prevalence; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*
keywords: China; Drug resistance; Mycobacterium tuberculosis; microbial susceptibility tests; prevalence