Transregional movement of multidrug-resistant tuberculosis in north China: an underlying threat to tuberculosis control

Due to unbalanced distribution of health care resource in China, tuberculosis patients, especially multidrug-resistant tuberculosis (MDR-TB), prefer to suffer transregional movement for seeking better health care service in the first-tier cities. Here, we performed a study on the current status of transregional movement of tuberculosis in northern China by reviewing the medical record of TB patients hospitalized in Beijing Chest Hospital from 2011 to 2015. From 2011 to 2015, the proportion of non-Beijing in-patients had increased from 55.0% (996/1810) to 67.2% (1860/2769). In addition, we found that the rate of re-treated among non-Beijing group was significantly higher than that among Beijing-group. Compared with the proportion of pulmonary TB patients from non-Beijing, there were more extra-pulmonary TB patients from non-Beijing. In addition, 10.5% (164/1568) of Beijing in-patients and 26.5% (491/1858) of non-Beijing in-patients had MDR tuberculosis, and statistical analysis revealed that there was significantly higher proportion of MDR cases among non-Beijing group than Beijing group. In conclusion, our data demonstrate that an increasing proportion of TB patients from northern China seek health care in Beijing. In view of higher prevalence of MDR-TB cases among these patients, the transregional movement of MDR-TB will lead to ongoing MDR TB transmission in the community.