Rural Areas Of Eastern China Research Articles

Longitudinal links among paternal and maternal harsh parenting, adolescent emotional dysregulation and short-form video addiction

BackgroundDue to its diversifying and appealing content, short-form videos have developed very rapidly since its emergence, with more and more users enjoying the transient pleasures from such videos, which have triggered widespread concern over the detrimental influence of short-form video addiction on adolescent health. ObjectiveThe present study intended to examine the longitudinal relations among paternal/maternal harsh parenting, adolescents' emotional dysregulation and their short-form video addiction using a cross-lagged longitudinal design. Participants and settingWe recruited a sample of 1064 adolescent students from two middle schools located in rural areas of eastern China. MethodsAdolescents reported on paternal and maternal harsh parenting, their own emotional dysregulation and short-form video addiction at three time points across two years. Autoregressive and cross-lagged models were analyzed using three-wave variables to test the associations among parental (maternal) harsh parenting, adolescent emotional dysregulation, and short-form video addiction. A multi-group analysis was used to test for potential gender differences in the model. ResultsWe found that harsh fathering but not harsh mothering contributed to adolescent emotional dysregulation, which in turn predicted adolescent short-form video addiction. However, the reverse longitudinal relationships did not exist. Multiple group analyses revealed that the predictive effect of harsh fathering on adolescent emotional dysregulation was stronger in boys. ConclusionsOur findings help clarify the complex relationships among harsh parenting, adolescent emotional dysregulation and short-form addiction, providing more effective guidance for prevention against adolescent short-form video addiction.

Adenoma Detection Rate in Average-Risk Population: An Observational Consecutive Retrospective Study.

Although colonoscopy is considered the most effective tool for reducing colorectal cancer-related morbidity, the age at which average-risk individuals begin colonoscopic screening is undetermined. This study aimed to compare the adenoma and advanced adenoma detection rates according to age and sex in a large average-risk population in the rural areas of Eastern China. This observational, single-center, retrospective study included patients with average colorectal cancer risk and examined the adenoma and advanced adenoma detection rates using age intervals of 5years. We also compared the size and age of patients with and without advanced adenoma. We included 18928 patients with a median age of 54 years (range 15-90years), including 10143 men and 8785 women. The adenoma and advanced adenoma detection rates were 17.08% and 5.24%, respectively, and increased with age in the whole population. The adenoma detection rates increased from 8.97% (aged 40-44) to 14.98% (aged 45-49) and 6.24% (aged 45-49) to 11.00% (aged 50-54) in men and women (both P < .001), respectively. The advanced adenoma detection rates increased from 2.19% (aged 40-44) to 4.76% (aged 45-49) and 1.89% (aged 45-49) to 3.13% (aged 50-54) in men (P = .002) and women (P = .056), respectively. Patients with advanced adenomas were significantly older than those with non-advanced adenomas (P < .001). The tumors in the advanced adenoma group were significantly larger than those in the non-advanced adenoma group (P < .001). The adenoma and advanced adenoma detection rates increased significantly in average-risk population aged 45years and older, especially in men.

Psychological Resilience among Left-Behind Children in a Rural Area of Eastern China.

Childhood is an important period for individuals' psychological development. Due to long-term separation from the parents, left-behind children (LBC) more easily develop deviation in cognition and abnormal personality. In this study, we aimed to explore the status of psychological resilience among LBC in a rural area of eastern China. We carried out a cross-sectional survey including middle and high school students from Qingyuan County of Zhejiang Province. Psychological resilience was measured using a modified scale developed for Chinese children. Data from a total of 1086 participants were collected, and the mean ± standard deviation score of psychological resilience was 4.11 ± 0.42. Multivariable linear regression analyses revealed that being a class leader (p = 0.010) and having high self-evaluation of academic performance (p &lt; 0.001) were related with psychological resilience. Moreover, high contact frequency between parents and children (p = 0.019) was associated with better psychological resilience among LBC. In conclusion, we found that being a class leader and having high self-evaluation of academic performance were associated with better psychological resilience among the children in this rural area and contact between parent and child was an essential factor associated with psychological resilience among LBC.

Prevalence of sarcopenia was higher in women than in men: a cross-sectional study from a rural area in eastern China.

BackgroundThere were limited studies specifically evaluating whether the difference of the prevalence of sarcopenia exists in men and women in older adults from rural areas in China. The aim of this study was to compare the prevalence of sarcopenia between men and women in a rural area in eastern China and to explore the underlying causes.MethodsThis study included 1,105 participants aged 60-89 years. Muscle mass was measured by bio-electrical impedance analysis. Hand grip strength was measured by Jamar Hydraulic Hand Dynamometer. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia-2019 Consensus. Data were analyzed using log-binomial and linear regression.ResultsThe prevalence of sarcopenia was 21.7% in women and 12.9% in men among the study cohort. After adjusting for age, education level, number of diseases, income level, smoking, drinking, and eating habits, proportion of people with sarcopenia was 1.49-fold greater in women than in men (PR = 1.49, 95% CI [1.01–2.26], P = 0.055).ConclusionsThe prevalence of sarcopenia in elderly women in this rural area of eastern China is higher than in men, suggesting that women in rural areas in China seem to be more vulnerable for sarcopenia, thus early screening and prevention need to be provided for them to address such gender disparity in health.

Outdoor air pollution enhanced the association between indoor air pollution exposure and hypertension in rural areas of eastern China.

Recently, the high prevalence of hypertension (HTN) has caused serious disease burden. Previous studies mostly focused on the separate association between outdoor or indoor air pollution and HTN, and did not explore their possible interaction with HTN. To explore this issue, this study investigated the relationship between indoor and outdoor air pollution and HTN and their possible interactions among adult residents in 14 rural areas in eastern China. The generalized linear model (GLM) and interplot model were used to evaluate the separate effects and potential interaction of outdoor or indoor air pollutants on HTN. In separate analyses, we found a significant positive association between outdoor and indoor air pollution and HTN, and a significant negative association between range hood use and HTN. In the interaction analysis, outdoor air pollution could significantly enhance the positive effects of indoor air pollution on HTN. In addition, PM2.5 and O3 could significantly reduce the protective effect of range hoods use on HTN. Finally, we found that females were more susceptible to both indoor and outdoor air pollution.

The effects of air pollution on the lung cancer mortality in rural areas of eastern China: a multi-region study.

Recently, the burden of lung cancer (LC) has attracted global attention. Meanwhile, LC has become the leading cause of death in China. Many studies found a strong link between air pollutants and the risk of LC mortality in some large cities, but the results have been inconsistent, and most studies have only focused on the daily effects of six pollutants in large cities, ignoring their potential cumulative effects. This study was to investigate the weekly effects of six air pollutants (CO, NO2, O3, PM2.5, PM10, and SO2) on LC mortality in rural areas of eastern China and to further clarify which population groups were susceptible to air pollution and seasonal trends. First, a generalized additive model was combined with a distributed lag nonlinear model to evaluate the individual impact of air pollution on LC deaths in each area. The random-effect model was then used to pool the associations between air pollutants and LC mortality risk in ten counties or districts. The results showed that six air pollutants had a statistically significant effect on the risk of LC mortality at different lag weeks. The effects of NO2, PM10, and CO on weekly LC mortality were strongest at a cumulative lag of 1, 0, and 1 week, respectively, the maximum cumulative risk ratio (RR) of 1.37 (95%CI: 1.23 to 1.52), 1.30 (95%CI: 1.15 to 1.46), and 1.30 (95%CI: 1.17 to 1.43), with interquartile concentrations increasing. In summary, air pollution was an important factor in LC mortality, and the effect was stronger on males, the elderly, and during cold season. It was suggested that relevant departments should formulate air pollution management measures for the elderly, males, and in different seasons in rural areas and reduce the burden of lung cancer caused by air pollution.

A Geographic Hotspot and Emerging Transmission Cluster of the HIV-1 Epidemic Among Older Adults in a Rural Area of Eastern China.

Despite the implementation of health education and free condom distribution for decades, the HIV/AIDS epidemic among older adults in China shows no sign of declining. This study aims to identify HIV transmission patterns and pathways in a rural county area and provide insight for developing effective HIV prevention strategies among older adults. Epidemiological field surveys combined with phylogenetic analysis were used to identify potential HIV transmission linkage in one rural county with a rapidly increasing HIV epidemic among older adults. A total of 160 HIV-positive individuals and their HIV-positive sexual partners diagnosed between 2015 and 2018 were recruited. Among them, 69.4% (n = 111) were diagnosed at age 50 or older, 68.1% (n = 109) were men, and 55.0% (n = 88) were married. Ninety-six participants self-reported as having been infected with HIV through commercial heterosexual behavior and 24 were infected from their HIV-positive spouse. CRF08_BC (67.0%, n = 73) and CRF07_AE (19.3%, n = 21) were the prevalent HIV stains and formed 15 clusters at distance cutoff of 0.0025. Participants diagnosed with HIV at age ≥50, those who were divorced or bereft their spouse, or infected with HIV locally were more prevalent within the 15 molecular clusters. We identified specific venues as the primary hotspot and found that commercial heterosexual contact between older men and commercial sex workers contributed to the local HIV epidemic. In rural areas with an increasing HIV epidemic, detecting HIV transmission clusters through epidemiological and phylogenetic analysis as well as designing localized HIV prevention strategies should be prioritized.

Subjective well-being of left-behind children: a cross-sectional study in a rural area of eastern China

PurposePsychological well-beings of left-behind children (LBC) in rural areas of China remain under-studied. In this cross-sectional study, we aimed to explore the subjective well-being (SWB) in LBC and its associated factors in a rural area in eastern China.MethodsStratified random cluster sampling was used to select middle school and high school students in Qingyuan County of Zhejiang Province. Relevant information including sociodemographic characteristics was collected from each participant using an organized questionnaire. SWB was measured using the modified scale developed for Chinese adolescents. Univariable and multivariable regression analyses were performed using R version 3.3.0.ResultsA total of 1086 children were recruited and examined in the current analysis, with 365 (33.61%) being left-behind. Compared with non-left-behind children (NLBC), LBC had significantly lower scores in family satisfaction (P = 0.003) and environment satisfaction (P = 0.020). Multivariable regression analysis uncovered that frequent parent–child communication was associated with high positive affect (P = 0.003) and life satisfaction (P < 0.001), and the type of caregivers was associated with negative affect among LBC (P = 0.037).ConclusionsOur results suggest SWB was lower in LBC, and targeted interventions including strengthening parental-child communication should be developed and implemented to improve LBC’s SWB in rural areas of China.

Length of stay for acute myocardial infarction patients in eastern rural area in China from 2001 to 2011

Objective To describe the average hospital length of stay (LOS) and its trend and variation in rural areas of eastern China, and to analyze the hospital characteristics associated with LOS. Methods We collected the data of representative in-patients with acute myocardial infarction (AMI) in eastern rural areas in 2001, 2006 and 2011 by random sampling. The hospital length of stay and its changing trend were described. Hospitals were divided into tertiles-high, middle, low-based on the median LOS; the characteristics of patients, AMI treatment, as well as outcome were compared across the tertiles of hospitals. The association between the hospital characteristics and LOS was analyzed after adjusting for patient-level characteristics. Results We examined the medical records of 2 361 patients hospitalized with AMI from 32 hospitals in the eastern rural areas. The average LOS were (14.7±10)days in 2001, (12.4±10.1)days in 2006, and (11.9±6.5)days in 2011, decreasing annually (F=15.41, P<0.001). When looking at the cohort on the three time points (2001, 2006, and 2011) with ruling out the factors of complication during hospitalization and the LOS outliers, the average LOS still indicated an trend of decline (F=5.44, P=0.02). However, after adjusting for the differences in patient factors, few marked differences in LOS were found over the years (P=0.89). Across the three tertiles of hospitals, categorized as high, middle and low based on the average LOS, a statistical difference existed in the use rate of statin during hospitalization (P<0.05). After adjusting for patient-level characteristics, the hospital characteristics were not significantly associated with the average LOS. Conclusions This study showed a trend of an annual decrease of LOS in patients hospitalized with AMI from the eastern rural areas in China. There is nevertheless still significant room for further improvement. Therefore, it is crucial to effectively advance the standardization for AMI patients of diagnosis and treatment, improve healthcare quality, and reduce patient LOS, which is the very key to enhancing the AMI treatments in the rural region of Eastern China. Key words: Myocardial infarction; Length of stay; Quality of health care; Hospitals, rural

Framework for quantifying rural NPS pollution of a humid lowland catchment in Taihu Basin, Eastern China

Controlling of rural non-point sources (NPS) pollution has been a major priority of Chinese government in an initiative to improve the rural living environment. However, quantifying NPS pollution remains a considerable challenge in the humid lowland rural areas of Eastern China, which are characterized by complicated hydrological and nutrient processes and exhibits intensified artificial interference. In this study, a new and feasible framework was developed to estimate different NPSs specifically for this area by combing hydrological modelling, export coefficient, and sediment release experiment. Then the framework was applied to a typical lowland area (Zongjiaqiao River catchment) in Eastern China. The results showed that annual total nitrogen (TN), total phosphorus (TP), chemical oxygen demand (COD), and ammonia–nitrogen (NH3–N) in the area were 8.49 t, 0.63 t, 83.71 t, and 4.22 t, respectively. Rainfall-runoff contributed more NPS (except for TP) loads to the river than other sources and had a substantial spatiotemporal difference in contrast to other sources. Rural living was the largest source for TP, with a total TP load of 58%. The majority of this TP was derived from toilets and laundry areas. Sediment was another important source, particularly for TN and NH3–N pollution. Nevertheless, the livestock here contributed the least to water pollution. The proposed method has extensive application potential in critical source identification and policy drafting for rural NPS pollution control of lowland area.

The occurrence and transformation behaviors of disinfection byproducts in drinking water distribution systems in rural areas of eastern China

The occurrence and transformation behaviors of disinfection byproducts (DBPs) were investigated in the finished water and tap water of 14 water treatment plants in rural areas of eastern China. Mammalian cell toxicity data from previous studies were used to evaluate the cytotoxicity of trihalomethanes (THMs), haloacetic acids (HAAs), haloacetonitriles (HANs), trichloronitromethane (TCNM) and the genotoxicity of HAAs, HANs and TCNM. Correlation analysis was conducted to identify the factors that might influence the variability of DBPs. The measured median values were 29.76 μg/L for THMs, 20.47 μg/L for HAAs, 3.98 μg/L for HANs, 0.76 μg/L for haloketones (HKs) and 0.03 μg/L for TCNM. The spatial variability analysis showed that the total concentrations of HAAs and HANs decreased during long hydraulic residence time (HRT) in seven drinking water distribution systems, which could result in reduced mammalian cell cytotoxicity and genotoxicity at consumers’ taps. The concentrations of trihalogenated-DBPs were more stable than those of dihalogenated-DBPs and monohalogenated-DBPs during long HRT. Bromine acted as a more efficient substituting agent than chlorine for THMs and dihaloacetonitriles (DHANs) in actual drinking water. The dominant chlorinated-THMs and chlorinated-DHANs would transfer to brominated -THMs and brominated-DHANs when the concentration of bromide ion exceeds 450.67 and 610.25 μg/L, respectively. Correlation analysis indicated that particulate and soluble manganese (Mn) might play critical roles in promoting the production of DBPs in bulk water. Hydraulic disturbance could also result in secondary release of DBPs from loose deposits accumulated on distribution pipe walls.

Spatial variation of loose deposit characteristics in a 40 km long operational drinking water distribution system

Discoloration problems have occurred in drinking water distribution systems continuously for several years in a rural area of eastern China.

Impact of parental migration on psychosocial well-being of children left behind: a qualitative study in rural China

BackgroundTens of millions of rural “left-behind children (LBC)” in China grow up experiencing prolonged separation from their migrant worker parents. This study aimed to explore how children are affected by parental migration, from the perspectives of children, parents, and grandparents, focusing on the experiences of prolonged parent-child separation and relationship dynamics in the extended family.MethodsQualitative in-depth interviews were conducted in a migrant-sending rural area of eastern China. Participants included 25 children (aged 7 to 14), 17 parents, and 13 grandparents, from 30 families, as well as 24 key informants from the communities. Data analysis followed a grounded theory approach.ResultsThe results showed that despite the original purpose of benefiting children, parental migration resulted in challenges in child psychosocial well-being, due to the emotional impacts from prolonged parent-child separation. Parental absence also led to inadequate care and support for left-behind children. The negative effects of parental migration may be exacerbated by other vulnerabilities such as parents’ divorce, poverty and grandparent caregivers’ frailty. Concerns about child well-being made some migrants decide to return home permanently, because of the altered trade-offs of migration.ConclusionProlonged separation following migration often disrupts parent-child relationships and results in psychosocial difficulties in LBC, especially among those who live with multiple adversities in the family. Community-based interventions may help migrant parents and co-resident caregivers to better engage children and promote their resilience.

Determinants of the utilization of postpartum family visits: Evidence from rural areas of Eastern China.

BackgroundPostpartum Family Visits (PFVs) have been advocated as a way to improve health outcomes for puerperal women and their newborns. This study aimed to identify individual factors associated with the utilization of PFVs in rural Jiangsu Province, China.MethodsWe employed responses of the household survey in Jiangsu province, part of the National Health Service Survey (NHSS), a nationally representative survey in China. The data analysis framework was designed based on Andersen’s behavioral model. The outcome variables included nonuse and deficient use of PFVs, and the explanatory variables were organized into three hierarchical levels: predisposing, enabling and need factors. Univariate analysis and multivariate logistic regression analysis were conducted to examine the impact of the three hierarchical levels on PFVs utilization.ResultsA total of 884 rural women who had a childbearing history in the prior five years answered PFVs questions. About 23.4% of them had never received any PFVs, and 40.4% received <3 visits. In the results of multivariate logistic regression, educational level (OR = 0.43, 95% CI: 0.24–0.77), income (OR = 0.62, 95% CI: 0.43–0.88), the distance from the nearest hospital (OR = 1.49, 95% CI: 1.07–2.07) and parity (OR = 2.17, 95% CI: 1.54–3.05) had significant relationship with nonuse. Factors significantly associated with deficient use of PFVs included employment (OR = 0.62, 95% CI: 0.39–0.98), the distance from the nearest hospital (OR = 1.73, 95% CI: 1.26–2.36), level of delivery institution (OR = 1.57, 95% CI: 1.14–2.17), and parity (OR = 1.45, 95% CI: 1.03–2.05).ConclusionThe study found lower Social Economic Status (SES), long distance with primary health institutions, and the increased need for services stemming from multi-parity reduced the likelihood of nonuse or deficient use of PFVs in rural areas. Multiparous, low SES women and those living far away from primary health institutions should be paid more attention to assure the coverage of postpartum care.

Differences in the distribution of risk factors for stroke among the high-risk population in urban and rural areas of Eastern China.

IntroductionConsidering the program of screening for risk factors of stroke in Eastern China, the aim of this study was to compare the distribution differences in risk factors for stroke among the high‐risk population living in urban and rural areas.MethodsA total of 231,289 residents were screened and basic information collected. Risk factors for stroke among the high‐risk population were compared between the urban and rural groups.ResultsA total of 117,776 high‐risk residents from urban areas and 113,513 from rural areas were included in the analysis. The prevalence of hypertension was much higher in rural areas (73.3%) than that in urban areas (64.1%). Dyslipidemia (48.9% vs. 26.9%), sport lack (46.6% vs. 31.6%), diabetes mellitus (21.3% vs. 16.5%), and atrial fibrillation (18.7% vs. 9.8%) were more prevalent in the urban group, while smoking (26.5% vs. 28.8%), previous stroke (10.1% vs. 16.9%), and transient ischemic attack (20.9% vs. 24.6%) were less prevalent.ConclusionAmong the population at high risk of stroke, there were significant differences in the distribution of the following risk factors between the urban and rural groups: hypertension, atrial fibrillation, dyslipidemia, lack of physical exercise, and a previous stroke.

Risk factors for breast cancer in women residing in urban and rural areas of eastern China.

To investigate breast cancer risk factors in Chinese women residing in urban and rural areas of eastern China using a large-scale cross-sectional survey. In this multistage, stratified cluster sampling epidemiological survey, information on demographic characteristics, diet and lifestyle variables were gathered using a carefully designed questionnaire. Multivariate logistic regression analysis and subgroup analyses of the data were performed, including separate analyses of data from women residing in urban and rural areas. A total of 122,058 women were included in the survey. Age, body mass index, number of miscarriages, family history of breast cancer and menopausal status were found to be risk factors for breast cancer, while the consumption of soya bean products was a protective factor. Among women residing in urban areas, high or moderate intake of soya bean products and red meat were protective factors. Among women residing in rural areas, obesity and a high intake of milk were identified as risk factors for breast cancer, while a moderate intake of soya bean products was a protective factor. This type of data is crucial for understanding the risk factors for breast cancer and could facilitate the development and targeting of effective intervention strategies, with the ultimate aim of breast cancer prevention.

Analysis on the Relationship between Typical House Mode and Heating Energy Consumption in Cold Rural Areas of Eastern China

In cold rural areas of Eastern China, heating energy consumption was increased year by year, affected by some factors such as building materials, different courtyard layouts and residential constructions. Based on field measurements and multiple perspectives analysis of typical houses, the heat of cold air infiltration in one house could be reduced by 18.3 %, while the courtyard design was adapted to local climatic conditions. Heating energy consumption could be reduced by 15% for reasonable energy utilization, and which could be reduced by 50% for rational design of building layout and correct selection of materials for building envelope.

Improvement in visual function and quality of life following a blindness prevention surgery program in a rural area of Eastern China

The aim of this study was to assess the changes in visual function (VF) and quality of life (QOL) among patients following blindness prevention surgery in a rural area of Eastern China. The prospective study selected cataract patients via mobile eye screening camps. VF and QOL questionnaires originally developed by Fletcher et al were completed prior to and 6 months after surgery. Small-incision cataract surgery (SICS) with posterior chamber intraocular lens (IOL) implantation was performed on patients by a blindness prevention surgery group. The VF and QOL scores of 178 cataract patients preoperatively were 48.58±31.18 and 65.97±26.77, respectively. The scores decreased in proportion to decreasing vision status. The VF and QOL scale scores were significantly correlated with the vision grade of the patient (rVF=−17.2093, t=−10.87, P<0.001, rQOL=−13.1399, t=−8.87, P<0.001) and age (rVF=−0.6505, t=−3.87, P<0.001, rQOL=− 0.3309, t=−2.10, P=0.037). A total of 131 patients responded to the second survey, VF and QOL scores increased significantly over a six-month postoperative period (VF=83.21±16.40, P<0.001; QOL=86.53±16.33, P<0.001). The VF scale scores were correlated with the grade of vision and residence area, the QOL scale scores were correlated with the grade of vision and gender. The VF and QOL of patients were significantly improved by performing SICS with posterior chamber IOL implantation collectively in a short period in rural areas of Eastern China. It is important to follow-up cataract patients postoperatively as untreated complications of the surgery may affect the stability of VF and QOL postoperatively.

Characteristics and mechanism of agricultural transformation in typical rural areas of eastern China: A case study of Yucheng City, Shandong Province

Rural off-farm employment, rapid loss of agricultural land, and advanced technology popularization had led agricultural production in Chinese typical rural areas come at a critical transformation and upgrade stage. Based on sample survey data gathered from 401 households in Yucheng City, Shandong Province, this paper focuses on the characteristics and mechanism of agricultural transformation in typical rural areas of the eastern China. It was found that 74.3% of households surveyed kept at least one member engaging in off-farm employment, and 57.1% looked forward to expanding the operational scale of arable land, while just 13.7% had actually transferred their agricultural land. Since growing off-farm employment does not result in the collapse of traditional subsistence agriculture, therefore, agricultural production in Yucheng City is at an incomplete transformation phase from traditional small-holder farming to modern scale economy. It is caused by both macro environments and family characteristics, while urban-rural dual structure, imperfect rural development policy and agricultural technology popularization make peasant economy strengthen upon maintenance, and small-holder farming becomes peasant’s natural response owing to pluriactivity, local off-farm employment, reverse elimination, etc. In order to achieve smooth agricultural transformation of typical rural areas in the eastern China, it needs to promote professional differentiation among peasants, under clear policies adopted by central government. Providing comprehensive services for agricultural production and improving production skills and knowledge of farmers who are still living in the countryside will effectively stimulate the process of agricultural transformation.

Molecular-epidemiological study on the transmission of drug resistant tuberculosis and its influencing factors in rural areas of eastern China

To investigate the contribution of recent transmission in the epidemic of drug-resistant Mycobacterium tuberculosis (M.TB) and related factors from biomedical and social-demographic perspectives in the Eastern rural areas of China. Identified by proportion method of drug susceptibility test, 223 drug resistant M.TB isolates and their hosts were included in the present study. These drug resistant tuberculosis isolates were first genotyped by Mycobacterial Interspersed Repetitive Units (MIRU), and those isolates with identical MIRU genotype were further classified by IS6110 restricted fragment polymorphism (RFLP). 'Cluster' was defined as two patients' M. TB isolates harboring the identical MIRU genotype and IS6110-based RFLP pattern simultaneously. Unique strains denoted those with the unparalleled MIRU genotype in the study collection. Socio-demographic and biomedical characteristics of host patients were compared between the clusters and unique groups through univariate and multivariate logistic regression analysis. Based on the MIRU-IS6110 pattern, there were 52 isolates belonged to the "cluster" group and 171 as the "unique" group. Drug resistant M.TB strain isolated from patients at the age of 30 - 60 year had a higher probability of being clustered, comparing to those from patients below 30 years of age (30.9% vs. 11.9%; OR = 3.297; 95%CI: 1.169 - 9.297). Such finding were also seen in the isolates from patients with previous treatment history compared to newly diagnosed patients (32.9% vs. 18.4%; OR = 2.163, 95%CI: 1.144 - 4.090). The multi-drug resistant M.TB strain was found to have been more frequently clustered when comparing to the mono-drug resistant M.TB (47.2% vs. 15.5%; OR = 4.773; 95%CI: 2.316 - 9.837). The transmission pattern of drug resistant tuberculosis was presented mainly by the sporadic distribution in small group within rural villages. Transmission of drug-resistant tuberculosis was seen in the population living in the Eastern rural areas of China, and causal contact within villages was considered as the main route of recent transmission. Patients at middle age and having previous tuberculosis treatment history might have increased the risk of transmission by patients with drug resistant tuberculosis.