Unfavorable treatment outcome of multidrug-resistant tuberculosis in China: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Junping ¹ , SUN Yanbo ² , ZHANG Shulan ² , GUAN Li ³ , LIU Zhixin ¹ , SUN Minglei ¹ , ZHAO Juan ¹ , WANG Chen ¹ , ZOU Dandan ¹ ,  LIANG Libo ^1,4

1. School of Health Management, Harbin Medical University, Harbin 150081, P.R.China;
2. Heilongjiang Provincial Center for Disease Control and Prevention, Harbin 150030, P.R.China;
3. Infectious Disease Hospital of Heilongjiang Province, Harbin 150500, P.R.China;
4. National Health Social Risk Prevention and Collaboration Innovation Center, Shanghai 200032, P.R.China;

Corresponding?author：

LIANG Libo, Email: llbhit@163.com

Keywords：

Multidrug-resistant tuberculosis; Unfavorable treatment outcome; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202106123

Video：

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Objective To systematically review the unfavorable treatment outcome of multidrug-resistant tuberculosis in China. Methods CNKI, WanFang Data, CBM, PubMed, EMbase, and Web of Science databases were electronically searched to collect studies that reported unfavorable treatment outcomes of multidrug-resistant tuberculosis in China from inception to April 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed by using Stata 12.0 software. Results A total of 11 studies involving 4 465 patients were included. The results of meta-analysis showed that the overall rate of treatment success was 62% (95%CI 55% to 70%), the rate of treatment failure was 19% (95%CI 12% to 26%), the rate of default was 7% (95%CI 4% to 10%), the rate of mortality was 6% (95%CI 4% to 8%) and the rate of unfavorable treatment outcome was 25% (95%CI 19% to 32%). Conclusions Current evidence shows that the treatment failure rate of multidrug-resistant tuberculosis in China is slightly high. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.

Citation： LIU Junping, SUN Yanbo, ZHANG Shulan, GUAN Li, LIU Zhixin, SUN Minglei, ZHAO Juan, WANG Chen, ZOU Dandan, LIANG Libo. Unfavorable treatment outcome of multidrug-resistant tuberculosis in China: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2021, 21(10): 1174-1178. doi: 10.7507/1672-2531.202106123 Copy

1.	Daniel TM. The history of tuberculosis. Respir Med, 2006, 100(11): 1862-1870.
2.	Lange C, Aarnoutse RE, Alffenaar JWC, et al. Management of patients with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis, 2019, 23(6): 645-662.
3.	Khan I, Ahmad N, Khan S, et al. Evaluation of treatment outcomes and factors associated with unsuccessful outcomes in multidrug resistant tuberculosis patients in Baluchistan province of Pakistan. J Infect Public Health, 2019, 12(6): 809-815.
4.	Johnston JC, Shahidi NC, Sadatsafavi M, et al. Treatment outcomes of multidrug-resistant tuberculosis: a systematic review and meta-analysis. PLoS One, 2009, 4(9): e6914.
5.	Orenstein EW, Basu S, Shah NS, et al. Treatment outcomes among patients with multidrug-resistant tuberculosis: systematic review and meta-analysis. Lancet Infect Dis, 2009, 9(3): 153-161.
6.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
7.	曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
8.	王丹, 翟俊霞, 牟振云, 等. Meta 分析中的異質性及其處理方法. 中國循證醫學雜志, 2009, 9(10): 1115-1118.
9.	Tang S, Tan S, Yao L, et al. Risk factors for poor treatment outcomes in patients with MDR-TB and XDR-TB in China: retrospective multi-center investigation. PLoS One, 2013, 8(12): e82943.
10.	Li Q, Shi CX, Lu M, et al. Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015. Medicine (Baltimore), 2020, 99(30): e21296.
11.	Zhang Q, Wu Z, Zhang Z, et al. Efficacy and effect of free treatment on multidrug-resistant tuberculosis. Exp Ther Med, 2016, 11(3): 777-782.
12.	Alene KA, Yi H, Viney K, et al. Treatment outcomes of patients with multidrug-resistant and extensively drug resistant tuberculosis in Hunan Province, China. BMC Infect Dis, 2017, 17(1): 573.
13.	Zhang L, Meng Q, Chen S, et al. Treatment outcomes of multidrug-resistant tuberculosis patients in Zhejiang, China, 2009-2013. Clin Microbiol Infect, 2018, 24(4): 381-388.
14.	Yu MC, Chiang CY, Lee JJ, et al. Treatment outcomes of multidrug-resistant tuberculosis in taiwan: tackling loss to follow-up. Clin Infect Dis, 2018, 67(2): 202-210.
15.	王丹吉, 盧鵬, 劉巧, 等. 耐多藥肺結核患者治療轉歸的影響因素分析. 結核病與肺部健康雜志, 2017, 6(3): 254-259.
16.	張玲. 耐多藥肺結核治療及其影響因素分析. 臨床肺科雜志, 2016, 21(8): 1508-1511.
17.	呂德良, 譚衛國, 張樂平, 等. 影響深圳市耐多藥結核病患者治愈的相關因素的雙向性隊列研究. 臨床肺科雜志, 2017, 22(7): 1165-1168.
18.	丁曉艷, 劉巧, 孔雯, 等. 2009-2013 年江蘇省耐多藥患者治療轉歸及影響因素分析. 結核病與肺部健康雜志, 2016, (4): 271-276.
19.	周正華, 梁志勇, 鄧小懂. 清遠市耐多藥肺結核患者治療效果及其影響因素分析. 吉林醫學, 2020, 41(3): 648-650.
20.	Collaborative group for the meta-analysis of individual patient data in MDR-TB treatment-2017, Ahmad N, Ahuja SD, et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet, 2018, 392(10150): 821-834.
21.	沈勝偉. DOT 管理模式在肺結核疾病控制中的應用. 中醫藥管理雜志, 2014, 22(2): 244-245.
22.	Park SK, Lee WC, Lee DH, et al. Self-administered, standardized regimens for multidrug-resistant tuberculosis in South Korea. Int J Tuberc Lung Dis, 2004, 8(3): 361-368.
23.	屠德華. 肺結核化學治療中標準化方案與個體化方案的應用. 中華結核和呼吸雜志, 2004, 27(2): 75-76.
24.	杜建, 徐彩紅, 李琦, 等. 不同類型治療方案治療耐多藥結核病效果文獻分析. 中國防癆雜志, 2010, 32(8): 421-426.
25.	李春華, 趙攀, 呂圣秀, 等. 127 例耐多藥肺結核 CT 影像學改變與臨床. 重慶醫學, 2014, (23): 3078-3080.
26.	Keshavjee S, Gelmanova IY, Farmer PE, et al. Treatment of extensively drug-resistant tuberculosis in Tomsk, Russia: a retrospective cohort study. Lancet, 2008, 372(9647): 1403-1409.
27.	Dheda K, Shean K, Zumla A, et al. Early treatment outcomes and HIV status of patients with extensively drug-resistant tuberculosis in South Africa: a retrospective cohort study. Lancet, 2010, 375(9728): 1798-1807.
28.	吳蘭香. 耐多藥結核病人影響因素病例對照研究. 中國公共衛生, 2011, 27(4): 401-402.
29.	郭紅革, 陳偉, 趙文鈞. 珠海市 2015-2017 年結核病耐藥狀況分析. 華南預防醫學, 2018, 44(3): 258-260.

1. Daniel TM. The history of tuberculosis. Respir Med, 2006, 100(11): 1862-1870.
2. Lange C, Aarnoutse RE, Alffenaar JWC, et al. Management of patients with multidrug-resistant tuberculosis. Int J Tuberc Lung Dis, 2019, 23(6): 645-662.
3. Khan I, Ahmad N, Khan S, et al. Evaluation of treatment outcomes and factors associated with unsuccessful outcomes in multidrug resistant tuberculosis patients in Baluchistan province of Pakistan. J Infect Public Health, 2019, 12(6): 809-815.
4. Johnston JC, Shahidi NC, Sadatsafavi M, et al. Treatment outcomes of multidrug-resistant tuberculosis: a systematic review and meta-analysis. PLoS One, 2009, 4(9): e6914.
5. Orenstein EW, Basu S, Shah NS, et al. Treatment outcomes among patients with multidrug-resistant tuberculosis: systematic review and meta-analysis. Lancet Infect Dis, 2009, 9(3): 153-161.
6. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
7. 曾憲濤, 劉慧, 陳曦, 等. Meta 分析系列之四: 觀察性研究的質量評價工具. 中國循證心血管醫學雜志, 2012, 4(4): 297-299.
8. 王丹, 翟俊霞, 牟振云, 等. Meta 分析中的異質性及其處理方法. 中國循證醫學雜志, 2009, 9(10): 1115-1118.
9. Tang S, Tan S, Yao L, et al. Risk factors for poor treatment outcomes in patients with MDR-TB and XDR-TB in China: retrospective multi-center investigation. PLoS One, 2013, 8(12): e82943.
10. Li Q, Shi CX, Lu M, et al. Treatment outcomes of multidrug-resistant tuberculosis in Hangzhou, China, 2011 to 2015. Medicine (Baltimore), 2020, 99(30): e21296.
11. Zhang Q, Wu Z, Zhang Z, et al. Efficacy and effect of free treatment on multidrug-resistant tuberculosis. Exp Ther Med, 2016, 11(3): 777-782.
12. Alene KA, Yi H, Viney K, et al. Treatment outcomes of patients with multidrug-resistant and extensively drug resistant tuberculosis in Hunan Province, China. BMC Infect Dis, 2017, 17(1): 573.
13. Zhang L, Meng Q, Chen S, et al. Treatment outcomes of multidrug-resistant tuberculosis patients in Zhejiang, China, 2009-2013. Clin Microbiol Infect, 2018, 24(4): 381-388.
14. Yu MC, Chiang CY, Lee JJ, et al. Treatment outcomes of multidrug-resistant tuberculosis in taiwan: tackling loss to follow-up. Clin Infect Dis, 2018, 67(2): 202-210.
15. 王丹吉, 盧鵬, 劉巧, 等. 耐多藥肺結核患者治療轉歸的影響因素分析. 結核病與肺部健康雜志, 2017, 6(3): 254-259.
16. 張玲. 耐多藥肺結核治療及其影響因素分析. 臨床肺科雜志, 2016, 21(8): 1508-1511.
17. 呂德良, 譚衛國, 張樂平, 等. 影響深圳市耐多藥結核病患者治愈的相關因素的雙向性隊列研究. 臨床肺科雜志, 2017, 22(7): 1165-1168.
18. 丁曉艷, 劉巧, 孔雯, 等. 2009-2013 年江蘇省耐多藥患者治療轉歸及影響因素分析. 結核病與肺部健康雜志, 2016, (4): 271-276.
19. 周正華, 梁志勇, 鄧小懂. 清遠市耐多藥肺結核患者治療效果及其影響因素分析. 吉林醫學, 2020, 41(3): 648-650.
20. Collaborative group for the meta-analysis of individual patient data in MDR-TB treatment-2017, Ahmad N, Ahuja SD, et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet, 2018, 392(10150): 821-834.
21. 沈勝偉. DOT 管理模式在肺結核疾病控制中的應用. 中醫藥管理雜志, 2014, 22(2): 244-245.
22. Park SK, Lee WC, Lee DH, et al. Self-administered, standardized regimens for multidrug-resistant tuberculosis in South Korea. Int J Tuberc Lung Dis, 2004, 8(3): 361-368.
23. 屠德華. 肺結核化學治療中標準化方案與個體化方案的應用. 中華結核和呼吸雜志, 2004, 27(2): 75-76.
24. 杜建, 徐彩紅, 李琦, 等. 不同類型治療方案治療耐多藥結核病效果文獻分析. 中國防癆雜志, 2010, 32(8): 421-426.
25. 李春華, 趙攀, 呂圣秀, 等. 127 例耐多藥肺結核 CT 影像學改變與臨床. 重慶醫學, 2014, (23): 3078-3080.
26. Keshavjee S, Gelmanova IY, Farmer PE, et al. Treatment of extensively drug-resistant tuberculosis in Tomsk, Russia: a retrospective cohort study. Lancet, 2008, 372(9647): 1403-1409.
27. Dheda K, Shean K, Zumla A, et al. Early treatment outcomes and HIV status of patients with extensively drug-resistant tuberculosis in South Africa: a retrospective cohort study. Lancet, 2010, 375(9728): 1798-1807.
28. 吳蘭香. 耐多藥結核病人影響因素病例對照研究. 中國公共衛生, 2011, 27(4): 401-402.
29. 郭紅革, 陳偉, 趙文鈞. 珠海市 2015-2017 年結核病耐藥狀況分析. 華南預防醫學, 2018, 44(3): 258-260.

Chinese Journal of Evidence-Based Medicine

Unfavorable treatment outcome of multidrug-resistant tuberculosis in China: a meta-analysis

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