[Surveillance of drug resistant tuberculosis in Hubei, China]

To establish a surveillance system for antituberculous drug resistance according to WHO and IUATLD guidelines, to collect the data of initial and acquired drug resistance, and to evaluate the efficacy of ongoing tuberculosis control strategies.

Thirty counties (or cities or districts) were randomly selected as surveillance points by cluster sampling. Thirty new cases of smear positive pulmonary tuberculosis in each cluster were enrolled consecutively. Bacterial typing and susceptibility tests (proportion method for SM, INH, RFP and EMB) were done in all culture positive samples. Laboratory quality control was implemented by Korean Super-country Reference Laboratory. Data were analyzed by WHO SDRTB2 software.

1,136 patients with pulmonary tuberculosis were enrolled in 30 clusters, among them 1,097 were culture positive. Smear-positive culture-positive rate was 96.6% and the contamination rate was 0.4%. The total drug resistance rate was 23.3%, the initial drug resistance being 17.5% and the acquired drug resistance being 44.5%. The initial multi-drug resistance rate (H + R) was 2.1% and the acquired multi-drug resistance rate (H + R) was 21.8%.

Laboratory methods for surveillance of drug resistant tuberculosis and quality control were established, and reliable data on the status of antituberculous drug resistance in Hubei province were collected. The results showed that implementation of DOTS and regular surveillance were very important.