ArticleBMJ open2021
Policy changes and the screening, diagnosis and treatment of drug-resistant tuberculosis patients from 2015 to 2018 in Zhejiang Province, China: a retrospective cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Economic burden of MDR/RR-TB and implementation of a treatment subsidy policy in Lishui City, China: a retrospective study following strobe guidelines.BMC health services research · 2026Article
- Risk factors for poor outcomes in patients with drug-resistant tuberculosis: a 6-year multicenter prospective study in Zhejiang, China.BMC infectious diseases · 2025Article
- Prevalence and epidemic pattern of ecdemic multidrug-resistant tuberculosis during 2012-2022 in Hangzhou, China: implication for public health strategies.BMC public health · 2024Article
- Diagnosis and Treatment Pathway of MDR/RR-TB in Taizhou, Zhejiang Province, China.Tropical medicine and infectious disease · 2023Article
- Trends of Rifampicin Resistance in Patients with Pulmonary Tuberculosis: A Longitudinal Analysis Based on Drug Resistance Screening in Eastern China Between 2015 and 2019.Infection and drug resistance · 2022Article
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Authors and funding
8 authors at 6 institutions in 3 countries.
Funding
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Abstract
objectivesTo examine changes in the screening, diagnosis, treatment and management of drug-resistant tuberculosis (DRTB) patients, and investigate the impacts of DRTB-related policies on patients of different demographic and socioeconomic characteristics.
designA retrospective cohort study using registry data, plus a survey on DRTB-related policies.
settingAll prefecture-level Centres for Disease Control in Zhejiang Province, China.
main outcome measuresAlongside the care cascade, we examined: (1) reported number of presumptive DRTB patients; (2) percentage of presumptive patients with drug susceptibility testing (DST) records; (3) percentage of DRTB/rifampicin-resistant (RR) patients registered; (4) percentage of RR/multidrug-resistant TB (MDRTB) patients that received anti-DRTB treatment; and (5) percentage of RR/MDRTB patients cured/completed treatment among those treated. Multivariate logistic regressions were conducted to explore the impacts of DRTB policies after adjusting for other factors.
resultsThe number of reported presumptive DRTB patients and the percentage with DST records largely increased during 2015-2018, and the percentage of registered patients who received anti-DRTB treatment also increased from 59.0% to 86.5%. Patients under the policies of equipping GeneXpert plus expanded criteria for DST had a higher likelihood of being registered compared with no GeneXpert (adjusted OR (aOR)=2.57, 95% CI: 1.20 to 5.51), while for treatment initiation the association was only significant when further expanding the registration criteria (aOR=2.38, 95% CI: 1.19 to 4.79). Patients with registered residence inside Zhejiang were more likely to be registered (aOR=1.96, 95% CI: 1.52 to 2.52), treated (aOR=3.83, 95% CI: 2.78 to 5.28) and complete treatment (aOR=1.92, 95% CI: 1.03 to 3.59) compared with those outside.
conclusionThe policy changes on DST and registration have effectively improved DRTB case finding and care. Nevertheless, challenges remain in servicing vulnerable groups such as migrants and improving equity in the access to TB care. Future policies should provide comprehensive support for migrants to complete treatment at their current place of residence.
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