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Meta-Analysis
. 2022 Jun 16;17(6):e0270003.
doi: 10.1371/journal.pone.0270003. eCollection 2022.

Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis

Ying Xi  1 , Wei Zhang  2 , Rui-Jun Qiao  1 , Jun Tang  1
Affiliations
Meta-Analysis

Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis

Ying Xi et al. PLoS One. .

Abstract

Background: Since multidrug-resistant tuberculosis (MDR-TB) is a significant public health problem worldwide, identifying associated risk factors is critical for developing appropriate control strategies.

Methods: A systematic review and meta-analysis was conducted for identifying factors independently predicting MDR-TB. The random-effects model was used to determine pooled odds ratios (ORs) and respective 95% confidence intervals (CIs) for the related factors.

Results: Of the 2301 retrieved reports, 28 studies were analyzed, assessing 3152 MDR-TB and 52715 DS-TB cases. Totally 22 related factors were analyzed. The pooled ORs were 1.478 (95%CI 1.077-2.028) for positive sputum AFB smear, 1.716 (95%CI 1.149-2.564) for lung cavity, 6.078 (95%CI 2.903-12.725) for previous TB disease and 5.427 (95%CI 3.469-8.490) for a history of anti-TB therapy. All Z test p values were below 0.05, indicating these parameters were significantly associated with MDR-TB.

Conclusions: Positive sputum AFB smear, lung cavity, previously diagnosed TB and a history of anti-TB therapy are significant risk factors for MDR-TB, which are independent of the clinical setting worldwide. Increased attention should be paid to cases with such parameters to achieve more effective TB control and avoid MDR-TB through the development of a global policy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study flowchart.
Fig 2
Fig 2. Forest plots showing associations of sputum AFB smear.
(A), lung cavity visible on radiograph (B), previous TB disease (C) and previous anti-TB treatment (D) with multidrug-resistant TB.
See this image and copyright information in PMC

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