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We investigated the drug resistance of Mycobacterium tuberculosis isolates from patients with tuberculosis (TB) and HIV, and those diagnosed with only TB in Sichuan, China. TB isolates were obtained from January 2018 to December 2020 and subjected to drug susceptibility testing (DST) to 11 anti-TB drugs and to GeneXpert MTB/RIF testing. The overall proportion of drug-resistant TB (DR-TB) isolates was 32.1% (n = 10 946). HIV testing was not universally available for outpatient TB cases, only 29.5% (3227/10 946) cases had HIV testing results. The observed proportion of multidrug-resistant TB (MDR-TB) isolates was almost double than that of the national level, with approximately 1.5% and 0.1% of the isolates being extensively drug resistant and universally drug resistant, respectively. The proportions of resistant isolates were generally higher in 2018 and 2019 than in 2020. Furthermore, the sensitivities of GeneXpert during 2018–2020 demonstrated a downward trend (80.9, 95% confidence intervals (CI) 76.8–85.0; 80.2, 95% CI 76.4–84.1 and 75.4, 95% CI 70.7–80.2, respectively). Approximately 69.0% (7557/10 946) of the TB cases with DST results were subjected to GeneXpert detection. Overall, the DR-TB status and the use of GeneXpert in Sichuan have improved, but DR-TB challenges remain. HIV testing for all TB cases is recommended.
We aimed to investigate the associations of Dietary Approaches to Stop Hypertension (DASH)-style diet and Mediterranean-style diet with blood pressure (BP) in less-developed ethnic minority regions (LEMR).
Dietary intakes were assessed by a validated FFQ. Dietary quality was assessed by the DASH-style diet score and the alternative Mediterranean-style diet (aMED) score. The association between dietary quality and BP was evaluated using multivariate linear regression model. We further examined those associations in subgroups of BP level.
A total of 81 433 adults from the China Multi-Ethnic Cohort (CMEC) study were included in this study.
In the overall population, compared with the lowest quintile, the highest quintile of DASH-style diet score was negatively associated with systolic BP (SBP) (coefficient –2·78, 95 % CI –3·15, –2·41; Pfor trend < 0·001), while the highest quintile of aMED score had a weaker negative association with SBP (coefficient –1·43, 95 % CI –1·81, –1·05; Pfor trend < 0·001). Both dietary indices also showed a weaker effect on diastolic BP (coefficient for DASH-style diet –1·06, 95 % CI –1·30, –0·82; coefficient for aMED –0·43, 95 % CI –0·68, –0·19). In the subgroup analysis, both dietary indices showed a stronger beneficial effect on SBP in the hypertension group than in either of the other subgroups.
Our results indicated that the healthy diet originating from Western developed countries can also have beneficial effects on BP in LEMR. DASH-style diet may be a more appropriate recommendation than aMED as part of a dietary strategy to control BP, especially in hypertensive patients.
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