Prevalence and epidemic pattern of ecdemic multidrug-resistant tuberculosis during 2012- 2022 in Hangzhou, China

Background To assess the prevalence and epidemic pattern of multidrug-resistant (MDR) tuberculosis in Hangzhou City, Zhejiang Province, China during 2012–2022. Methods All the TB cases undergoing drug susceptibility testing (DST) during 2012–2022 were included in this study. De-identified information was extracted from the electronic database Tuberculosis Information Management System (TBIMS) for analysis of drug resistance prevalence in Hangzhou and ecdemic Multidrug-resistant TB (MDR-TB) which originated from other regions. Chi-square tests were used to compare drug resistance rates between different groups, while Chi-square tests for trend were used to evaluate the change of drug resistance rates over the years of 2012–2022. The sources and destinations of ecdemic MDR-TB were illustrated using a Sankey diagram. Results Of 21,127 cases included in this study, 1119 (5.3%) were MDR. A significant decline in MDR-TB rates was observed during 2012–2022. There was a significant difference in MDR-TB rates among immigrant population and local residents in Hangzhou City. Of 1119 MDR-TB cases, 515(46%) were ecdemic MDR-TB cases, of which 277(53.8%) were from other parts of Zhejiang Province and 238(46.2%) were from other provinces in China. Anhui, Jiangxi and Sichuan were among top three provinces which were the source of ecdemic MDR-TB cases. Three districts including Xiaoshan, Shangcheng and Linping districts had the most cases in Hangzhou. The proportion of ecdemic MDR-TB cases in Binjiang, Xiaoshan, Qiantang and Linping districtalso exceeded 30% of total cases. Conclusions MDR-TB prevalence has been declining in Hangzhou. Migrant population contributed to a significant portion of cases in Hangzhou. Interventions should be tailed to local and migrant residents.