Abstract
BackgroundMultidrug-resistant tuberculosis (MDR-TB) resulting from various factors has raised serious public health concerns worldwide. Identifying the ecological risk factors associated with MDR-TB is critical to its prevention and control. This study aimed to explore the association between the development of MDR-TB and the risk factors at the group-level (ecological risk factors) in China.MethodsData on MDR-TB in 120 counties were obtained from the National Tuberculosis Information Management System, and data on risk-factor variables were extracted from the Health Statistical Yearbook, provincial databases, and the meteorological bureau of each province (municipality). Partial Least Square Path Modeling was used to detect the associations.ResultsThe median proportion of MDR-TB in new TB cases was 3.96% (range, 0–39.39%). Six latent factors were extracted from the ecological risk factors, which explained 27.60% of the total variance overall in the prevalence of MDR-TB. Based on the results of PLS-PM, TB prevention, health resources, health services, TB treatment, TB detection, geography and climate factors were all associated with the risk of MDR-TB, but socioeconomic factors were not significant.ConclusionsThe development of MDR-TB was influenced by TB prevention, health resources, health services, TB treatment, TB detection, geography and climate factors. Such information may help us to establish appropriate public health intervention strategies to prevent and control MDR-TB and yield benefits to the entire public health system in China.
Highlights
Tuberculosis (TB) is still the world's leading infectious cause of adult deaths and a major public health burden in developing countries [1,2]
Based on the results of PLS-PM, TB prevention, health resources, health services, TB treatment, TB detection, geography and climate factors were all associated with the risk of multidrug-resistant TB (MDR-TB), but socioeconomic factors were not significant
The development of MDR-TB was influenced by TB prevention, health resources, health services, TB treatment, TB detection, geography and climate factors
Summary
Tuberculosis (TB) is still the world's leading infectious cause of adult deaths and a major public health burden in developing countries [1,2]. According to the 2014 World Health Organization (WHO) global TB report, China ranks as second among the world’s 22 high-burden countries with a TB incidence of approximately 0.9–1.1 million, accounting for 11% of the total number of cases in 2013 [2]. The increasing prevalence of drug-resistant TB (DR-TB), especially multidrug-resistant TB (MDR-TB), is a serious threat to global TB control and has become a major public health concern in several countries [1,3]. Multidrug-resistant tuberculosis (MDR-TB) resulting from various factors has raised serious public health concerns worldwide. This study aimed to explore the association between the development of MDR-TB and the risk factors at the group-level (ecological risk factors) in China
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