Journal Article

Trends in Multidrug-Resistant <i>Mycobacterium tuberculosis</i> in Relation to Sputum Smear Positivity in Hong Kong, 1989–1999

Kai Man Kam, Chi Wai Yip, Lai Wa Tse, Oi Chi Leung, Lai Ping Sin, Mei Yuk Chan and Wai Sum Wong

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 3, pages 324-329
Published in print February 2002 | ISSN: 1058-4838
Published online February 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/324164
Trends in Multidrug-Resistant Mycobacterium tuberculosis in Relation to Sputum Smear Positivity in Hong Kong, 1989–1999

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We studied retrospectively the territory-wide occurrence and trends of multidrug-resistant tuberculosis (MDR-TB) in Hong Kong over an 11-year period during which a short-course directly observed therapy (“DOTS-Plus”) strategy has been in operation. The overall MDR rate was 2.1% (primary, 1.4% and acquired, 9.5%) and declined at 0.08% per year: smear-positive primary MDR cases declined at yearly rate of -0.065% (R2 = .23), and smear-negative primary MDR cases increased at 0.035% yearly. With declining rates of smear positivity, sputum culture has become the mainstay of detection of MDR-TB. Although the overall notification rates showed the elderly (age >65 years) age group to be most affected, the occurrence of MDR-TB has been consistently highest in the 35–65 year age group (60.4% of MDR caseload). We demonstrated declining rates of sputum smear positivity of MDR-TB in a DOTS-plus environment and that a centralized laboratory database is essential in gathering epidemiological information for identifying particular risk groups and monitoring trends of MDR-TB in a community.

Journal Article.  4289 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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