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Observational Study
. 2025 Jul 16:13:1611459.
doi: 10.3389/fpubh.2025.1611459. eCollection 2025.

Rifampicin-resistant tuberculosis in Fujian Province, Southeast China: a retrospective analysis of drug resistance screening and treatment outcomes, 2019-2024

Yinfa Zhou  1 , Zhisong Dai  1   2 , Shufang Lin  1   2 , Daiquan Chen  1 , Jian Lin  1 , Kun Chen  1 , Yongming Lin  1 , Yanqin Deng  1   2
Affiliations
Observational Study

Rifampicin-resistant tuberculosis in Fujian Province, Southeast China: a retrospective analysis of drug resistance screening and treatment outcomes, 2019-2024

Yinfa Zhou et al. Front Public Health. .

Abstract

Backgrounds: Rifampicin-resistant tuberculosis (RR-TB) remains a major challenge to global TB control efforts. In Fujian Province, Southeast China, where RR-TB prevalence has been notably high, understanding epidemiological trends and treatment outcomes is crucial for optimizing interventions. This study aimed to analyze RR-TB characteristics, resistance patterns, and treatment outcomes to inform evidence-based control strategies.

Methods: An observational study was conducted utilizing data from China's National Tuberculosis Information Management System, focusing on bacteriologically confirmed tuberculosis cases reported in Fujian Province during 2019-2024. Epidemiological characteristics, drug resistance and outcomes of RR-TB were described as frequency (n) and percentage (%). Risk factors for unsuccessful outcomes were assessed using univariate and multivariate logistic regression.

Results: A total of 1,368 RR-TB patients were detected, with an overall resistance rate of 3.7%. The RR rate showed a steady decline year by year (χ2 = 76.214, p < 0.001), mainly due to the decrease in new TB cases (χ2 = 60.966, p < 0.001). RR-TB patients exhibited higher co-resistance to isoniazid (71.9% vs. 6.3%, p < 0.001) and ofloxacin (29.8% vs. 1.8%, p < 0.001) compared to rifampicin-sensitive TB. Of 1,056 RR-TB patients initiated on treatment, 720 had outcome data, revealing a low success rate (58.6%) due to high loss to follow-up (31.1%) and mortality (9.3%). Multivariate analysis identified male sex (AOR = 1.67, 95% CI: 1.11-2.52, p = 0.014), age ≥45 years (AOR = 2.27, 95% CI: 1.58-3.26, p < 0.001), high-risk group status (AOR = 1.42, 95% CI: 1.04-1.94, p = 0.026), and occupation as farmer/worker (AOR = 2.17, 95% CI: 1.10-4.26, p = 0.025) as independent risk factors of unsuccessful treatment.

Conclusion: Fujian Province has demonstrated a steady decline in rifampicin resistance rates, primarily driven by reductions in new TB cases. However, treatment inclusion rate and success rate remains suboptimal, highlighting the need for targeted interventions-including enhanced adherence support, intensive follow-up, and adverse event management-particularly for high-risk groups such as older males and manual laborers. These findings can guide tailored strategies to further reduce RR-TB burden in similar settings.

Keywords: epidemiology; regression analysis; rifampicin-resistant; treatment outcome; tuberculosis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
RR-TB found by year, Fujian province, Southeast China, 2019-2024.
Figure 2
Figure 2
Regional disparities in rifampicin resistance rates, Fujian province, Southeast China, 2019-2024.
See this image and copyright information in PMC

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