Prevalence and epidemiological pattern of drug-resistant tuberculosis among migrant populations in Wenzhou City, China, 2014-2023: implications for public health strategies

Lianpeng Wu¹Xiyue Cai²Shuya Xu³Xuefeng Lin⁴Shuangliao Wu^1*Xueqin Xu^1*

• ¹The Ding Li Clinical College of Wenzhou Medical University, Department of Clinical Laboratory Medicine, Wenzhou Central Hospital, Wenzhou, Zhejiang Province, China
• ²Medical Management Office, Wenzhou Municipal Public Hospital Management Center, Wenzhou, China
• ³Department of Tuberculosis Clinic, The Ding Li Clinical College of Wenzhou Medical University, Wenzhou Central Hospital, Wenzhou, China
• ⁴Department of Clinical Laboratory Medicine, Yueqing People's Hospital, Wenzhou, China

Objective: This study aimed to analyze the epidemiological characteristics and trends of notified multidrug-resistant tuberculosis (MDR-TB) in Wenzhou City, China, from 2014 to 2023, with a focus on differences between migrant and local populations among reported TB cases. Methods: This was a facility-based retrospective cohort study that included all bacteriologically confirmed TB cases notified between 1 January 2014 and 31 December 2023 in the Tuberculosis Information Management System (TBIMS) of the Chinese Center for Disease Control and Prevention and the hospital’s laboratory information system, provided they had available phenotypic drug-susceptibility testing (pDST) results. Pearson’s chi-square test was used to compare drug-resistance rates between groups, the trend chi-square test was applied to assess temporal changes, and a Sankey diagram was employed to illustrate the origins and intra-city distribution of MDR-TB among the migrant population. Results: Among 10 993 notified TB patients, 734 (6.68%) were classified as MDR-TB. The proportion of MDR-TB among notified cases declined over the study period (P < 0.001). Nearly half (352/734; 47.96%) of the notified MDR-TB patients were migrants; 226 (64.21%) originated from elsewhere in Zhejiang Province, and 126 (35.79%) came from outside the province. Guizhou, Jiangxi and Sichuan were the leading external contributors. Within Wenzhou, Yueqing City, Yongjia County and Ouhai District reported the highest numbers of migrant MDR-TB notifications. Conclusion: The proportion of MDR-TB among notified TB cases in Wenzhou City has steadily decreased. Migrants account for almost half of these notified MDR-TB cases. Surveillance-driven and migrant-targeted interventions should be prioritised to further reduce MDR-TB transmission.