{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T14:15:51Z","timestamp":1766067351981,"version":"3.41.2"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T00:00:00Z","timestamp":1622160000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017577","name":"Basic Public Welfare Research Program of Zhejiang Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017577","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100017531","name":"Medical and Health Research Project of Zhejiang Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100017531","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015807","name":"Hangzhou Municipal Health and Family Planning Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> To date, too little attention has been paid to monitoring and estimating the risk of incident multidrug-resistant tuberculosis (MDR-TB) among individuals with a previous tuberculosis history (PTBH). The purpose of this study was to assess the incidence of and risk factors for MDR-TB in those individuals.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Between 2005 and 2020, a large, retrospective, population-based cohort study was performed in Hangzhou, China. A multivariable Cox regression model was used to evaluate independent predictors of incident MDR-TB among individuals with PTBH.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The incidence density of MDR-TB was 22.6 per 1,000 person-years (95% confidence level and an interval of 20.9\u201324.3) for individuals with PTBH. The incidence of MDR-TB increased significantly in individuals who<\/jats:p><jats:p>\u2022 were under 60 years old.<\/jats:p><jats:p>\u2022 were male.<\/jats:p><jats:p>\u2022 had a history of direct contact.<\/jats:p><jats:p>\u2022 came from low-income families.<\/jats:p><jats:p>\u2022 worked in high-risk occupations.<\/jats:p><jats:p>\u2022 lived in rural areas.<\/jats:p><jats:p>\u2022 had a retreatment TB history.<\/jats:p><jats:p>\u2022 had an unfavorable outcome in their previous treatment (<jats:italic>P<\/jats:italic> &amp;lt; 0.05).<\/jats:p><jats:p>In addition, we found that the following factors were significantly linked to the MDR-TB risk among individuals with PTBH (<jats:italic>P<\/jats:italic> &amp;lt; 0.05):<\/jats:p><jats:p>\u2022 sociodemographic factors such as the 21\u201330 and 31\u201340 year age groups, or a history of direct contact.<\/jats:p><jats:p>\u2022 clinical factors like passive modes of TB case finding (PMTCF), human immunodeficiency virus infection, unfavorable treatment outcomes, retreated TB history, non-standardized treatment regimens of retreatment TB patients, and duration of pulmonary cavities (DPC).<\/jats:p><jats:p>\u2022 microbiological factors, such as duration of positive sputum culture.<\/jats:p><jats:p>We also found that the 21\u201330 year age group, low family income, and PMTCF were significantly linked to incident MDR-TB only in males with PTBH, whilst the 41\u201350 year age group, extended treatment course, and DPC were significantly associated with female MDR-TB only.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The incidence of MDR-TB was high, with a higher rate among subjects with a history of direct contact and unfavorable treatment outcomes. There was a gender difference in the incidence density and risk factors of MDR-TB among individuals with PTBH. Long-term monitoring and gender-specific risk-factor modifications should be given to individuals with PTBH.<\/jats:p>","DOI":"10.3389\/fpubh.2021.644347","type":"journal-article","created":{"date-parts":[[2021,5,28]],"date-time":"2021-05-28T07:29:35Z","timestamp":1622186975000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Incidence Density and Predictors of Multidrug-Resistant Tuberculosis Among Individuals With Previous Tuberculosis History: A 15-Year Retrospective Cohort 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