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Meta-Analysis
. 2022 Jun 30;17(6):e0270272.
doi: 10.1371/journal.pone.0270272. eCollection 2022.

Prevalence of multidrug-resistant tuberculosis in East Africa: A systematic review and meta-analysis

Kindu Alem Molla  1 , Melese Abate Reta  2 , Yonas Yimam Ayene  1
Affiliations
Meta-Analysis

Prevalence of multidrug-resistant tuberculosis in East Africa: A systematic review and meta-analysis

Kindu Alem Molla et al. PLoS One. .

Abstract

Background: The rate of multidrug-resistant tuberculosis is increasing at an alarming rate throughout the world. It is becoming an emerging public health problem in East Africa. The prevalence of multidrug-resistant tuberculosis among pulmonary tuberculosis positive individuals in the region has not been thoroughly investigated.

Aim: The aim of this systematic review and meta-analysis is to estimate the pooled prevalence of multidrug-resistant tuberculosis among newly diagnosed and previously treated pulmonary tuberculosis cases in East African countries.

Methods: English published articles were systematically searched from six electronic databases: PubMed, EMBASE, Scopus, Science direct, Web of Science, and Google scholar. The pooled prevalence of multidrug-resistant tuberculosis and associated risk factors were calculated using Der Simonian and Laird's random Effects model. Funnel plot symmetry visualization confirmed by Egger's regression asymmetry test and Begg rank correlation methods was used to assess publication bias. A total of 16 articles published from 2007 to 2019 were included in this study. STATA 14 software was used for analysis.

Results: Out of 1025 articles identified citations, a total of 16 articles were included in final meta-analysis. The pooled prevalence of multidrug-resistant tuberculosis among newly diagnosed tuberculosis cases and previously treated tuberculosis patients was 4% (95%CI = 2-5%) and 21% (95%CI: 14-28%), respectively. Living conditions, lifestyles (smoking, alcohol use, and drug abuse), previous medical history, diabetes history, and human immunodeficiency virus infection were risk factors contributing to the higher prevalence of multidrug-resistant tuberculosis in East Africa.

Conclusion: The review found a significant prevalence of multidrug-resistant tuberculosis in the region. An early diagnosis of tuberculosis and rapid detection of drug-resistant Mycobacterium tuberculosis is a critical priority to identify patients who are not responding to the standard treatment and to avoid transmission of resistant strains. It is also very important to strengthen tuberculosis control and improve monitoring of chemotherapy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart diagram showing study screening and selection procedure.
Fig 2
Fig 2. Meta funnel plot for publication bias.
Prevalence estimate of MDR-TB among newly diagnosed TB cases in East Africa, 2007 to 2019. Abbreviation: t: arcsine transformed prevalence estimate of MDR-TB and se of t, standard error of t.
Fig 3
Fig 3. Meta funnel plot for publication bias.
Prevalence estimate of MDR-TB among previously treated TB cases in East Africa, 2007 to 2019. Abbreviation: t: arcsine transformed prevalence estimate of MDR-TB and se of t, standard error of t.
Fig 4
Fig 4. Forest plot showing the prevalence of MDR-TB among new diagnosed TB cases in East Africa, 2007 to 2019.
Abbreviation: ES: Effect size; CI: Confidence interval.
Fig 5
Fig 5. Forest plot showing the prevalence of MDR-TB among previously treated TB cases in East Africa, 2007 to 2019.
Abbreviation: ES: Effect size; CI: Confidence interval.
See this image and copyright information in PMC

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References

    1. Phelan J, De Sessions PF, Tientcheu L, Perdigao J, Machado D, Hasan R, et al.: Methylation in Mycobacterium tuberculosis is lineage specific with associated mutations present globally. Scientific reports 2018, 8(1):1–7. - PMC - PubMed
    1. Biadglegne F, Mulu A, Rodloff AC, Sack U: Diagnostic performance of the Xpert MTB/RIF assay for tuberculous lymphadenitis on fine needle aspirates from Ethiopia. Tuberculosis 2014, 94(5):502–505. doi: 10.1016/j.tube.2014.05.002 - DOI - PubMed
    1. Lukoye D, Adatu F, Musisi K, Kasule GW, Were W, Odeke R, et al.: Anti-tuberculosis drug resistance among new and previously treated sputum smear-positive tuberculosis patients in Uganda: results of the first national survey. PloS one 2013, 8(8):e70763. doi: 10.1371/journal.pone.0070763 - DOI - PMC - PubMed
    1. Eshetie S, Gizachew M, Dagnew M, Kumera G, Woldie H, Ambaw F, et al.: Multidrug resistant tuberculosis in Ethiopian settings and its association with previous history of anti-tuberculosis treatment: a systematic review and meta-analysis. BMC infectious diseases 2017, 17(1):1–12. - PMC - PubMed
    1. Floyd K, Glaziou P, Zumla A, Raviglione M: The global tuberculosis epidemic and progress in care, prevention, and research: an overview in year 3 of the End TB era. The Lancet Respiratory Medicine 2018, 6(4):299–314. doi: 10.1016/S2213-2600(18)30057-2 - DOI - PubMed

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