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Review
. 2024 Mar 16:35:100430.
doi: 10.1016/j.jctube.2024.100430. eCollection 2024 May.

Epidemiology of first- and second-line drugs-resistant pulmonary tuberculosis in Iran: Systematic review and meta-analysis

Sara Abbasian  1 , Hamid Heidari  2 , Danyal Abbasi Tadi  3 , Jalil Kardan-Yamchi  4 , Asieh Taji  5 , Atieh Darbandi  6 , Parisa Asadollahi  7 , Abbas Maleki  7 , Hossein Kazemian  7
Affiliations
Review

Epidemiology of first- and second-line drugs-resistant pulmonary tuberculosis in Iran: Systematic review and meta-analysis

Sara Abbasian et al. J Clin Tuberc Other Mycobact Dis. .

Abstract

Drug resistance among Mycobacterium tuberculosis (MTB) strains is a growing concern in developing countries. We conducted a comprehensive search for relevant studies in Iran on PubMed, Scopus, and Embase until June 12, 2020. Our study focused on determining the prevalence of antibiotic resistance in MTB isolates, with subgroup analyses based on year, location, and drug susceptibility testing (DST) methods. Statistical analyses were performed using STATA software. Our meta-analysis included a total of 47 articles. Among new TB cases, we found the following prevalence rates: Any-resistance to first-line drugs: 31 % (95 % CI, 24-38), mono-drug resistance: 15 % (95 % CI, 10-22), and multidrug resistance to first-line drugs: 6 % (95 % CI, 4-8). There was a significant variation in the rate of MDR among new TB cases based on the year of publication, location, and DST methods (P < 0.0001). We observed substantial variability in multidrug-resistant TB rates among new cases across the studies. Stratified analyses revealed that publication years and DST methods significantly affected resistance rates. Studies from southern and central Iran reported higher any-drug resistance rates, suggesting regional differences. Among retreatment cases, the prevalence rates were as follows: Any resistance: 68 % (95 % CI 58-78), mono-resistance: 19 % (95 % CI 7-34), multidrug resistance: 28 % (95 % CI 15-43). Our study revealed that the prevalence of drug-resistant TB (DR-TB) among TB cases in Iran is higher than the global average. Particularly, MDR-TB among retreatment TB cases is a significant public health issue.

Keywords: Drug resistance; First- and second-line drugs; Iran; Systematic review and meta-analysis; Tuberculosis.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flow Diagram Showing the Study Selection Process.
Fig. 2
Fig. 2
Prevalence of Multi Drug Resistant TB among new cases in Iran.
Fig. 3
Fig. 3
Prevalence of Multi Drug Resistant TB among retreated cases in Iran.
Fig. 4
Fig. 4
Prevalence of first line drug TB among new cases in Iran based on published year.
Fig. 5
Fig. 5
Prevalence of Extensively Drug Resistant TB among new cases in Iran.
See this image and copyright information in PMC

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References

    1. Alene KA, Wangdi K, Clements ACJTm, disease i. Impact of the COVID-19 pandemic on tuberculosis control: an overview. 2020; 5(3): 123. - PMC - PubMed
    1. Dookie N, Padayatchi N, Naidoo KJCID. Tuberculosis elimination in the era of coronavirus disease 2019 (COVID-19): a moving target. Oxford University Press US; 2022. p. 509-10. - PMC - PubMed
    1. Marais BJJAddr. The global tuberculosis situation and the inexorable rise of drug-resistant disease. 2016; 102(3-9). - PubMed
    1. Organization WH. Guidelines for surveillance of drug resistance in tuberculosis: World Health Organization; 2009.
    1. Faksri K, Kaewprasert O, Ong RT-H, Suriyaphol P, Prammananan T, Teo Y-Y, et al. Comparisons of whole-genome sequencing and phenotypic drug susceptibility testing for Mycobacterium tuberculosis causing MDR-TB and XDR-TB in Thailand. 2019; 54(2): 109-16. - PubMed

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