Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome
Abstract Introduction The emergence of MDR-TB remained a major public health threat particularly in developing countries. With increased prevalence and complexity of treatment, the burden of MDR-TB challenged the country. It is of an important; the epidemiology of drug resistant TB is not well under...
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | Tropical Diseases, Travel Medicine and Vaccines |
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| Online Access: | http://link.springer.com/article/10.1186/s40794-018-0065-5 |
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| author | Tadele Girum Ebrahim Muktar Kifle Lentiro Habtamu Wondiye Misgun Shewangizaw |
| author_facet | Tadele Girum Ebrahim Muktar Kifle Lentiro Habtamu Wondiye Misgun Shewangizaw |
| author_sort | Tadele Girum |
| collection | DOAJ |
| description | Abstract Introduction The emergence of MDR-TB remained a major public health threat particularly in developing countries. With increased prevalence and complexity of treatment, the burden of MDR-TB challenged the country. It is of an important; the epidemiology of drug resistant TB is not well understood. There are few studies conducted to assess the prevalence, determinants and treatment outcome of MDR-TB with inconclusive finding. Therefore, we aimed to conduct a systematic review and meta-analysis on Epidemiology of MDR-TB in Ethiopia, So that policy makers and other stalk holders could have pooled evidence on the problem to make a decision. Methods The review was conducted through a systematic literature search of articles published between 1997 and 2017. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled rate of MDR-TB prevalence, determinants and treatment outcome was estimated with a random-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot. Results The 34 studies that were retained for final analysis enrolled a total of 7461 TB or MDR-TB patients. We found that 2.18% (95% CI 1.44–2.92%) of newly diagnosed and 21.07% (95% CI 11.47–30.67%) of previously treated patients have MDR-TB with overall prevalence of 7.24% (95% CI 6.11–8.37). History of previous treatment is the major determinant (pooled OR = 4.78 (95% CI 3.16–6.39)), while contact history and adherence also contributed. In this review the pooled death computed among 5 articles showed that 12.25% (95% CI 9.39–15.11%) of MDR-TB patients were died in the course of treatment. Complication, drug side effects and HIV infection were the main determinants for the death. Conclusion and recommendation The prevalence is by far higher than the previous reports. It is mainly associated with history of previous treatment along with contact history. However, the treatment outcomes are comparable with previous studies, yet it is a concern. Comorbidities, drug side effects and HIV sero-positivity were the determinants. Thus, proper treatment of drug susceptible TB and early detection and treatment of MDR-TB before complication develops along with prevention of drug side effect and contacts with MDR-TB cases are very important. |
| first_indexed | 2024-12-13T10:43:47Z |
| format | Article |
| id | doaj.art-41c2a1899b6e4312b925d282741bdc0e |
| institution | Directory Open Access Journal |
| issn | 2055-0936 |
| language | English |
| last_indexed | 2024-12-13T10:43:47Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Tropical Diseases, Travel Medicine and Vaccines |
| spelling | doaj.art-41c2a1899b6e4312b925d282741bdc0e2022-12-21T23:50:21ZengBMCTropical Diseases, Travel Medicine and Vaccines2055-09362018-06-014111210.1186/s40794-018-0065-5Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcomeTadele Girum0Ebrahim Muktar1Kifle Lentiro2Habtamu Wondiye3Misgun Shewangizaw4Department of Public health, college of Medicine and Health Sciences, Wolkite UniversityDepartment of Public health, college of Medicine and Health Sciences, Wolkite UniversityDepartment of Public health, college of Medicine and Health Sciences, Wolkite UniversityInstitute of Public health, college of Medicine and Health Sciences, Bahir Dar UniversityDepartment of Public health, college of Medicine and Health Sciences, Arba Minch UniversityAbstract Introduction The emergence of MDR-TB remained a major public health threat particularly in developing countries. With increased prevalence and complexity of treatment, the burden of MDR-TB challenged the country. It is of an important; the epidemiology of drug resistant TB is not well understood. There are few studies conducted to assess the prevalence, determinants and treatment outcome of MDR-TB with inconclusive finding. Therefore, we aimed to conduct a systematic review and meta-analysis on Epidemiology of MDR-TB in Ethiopia, So that policy makers and other stalk holders could have pooled evidence on the problem to make a decision. Methods The review was conducted through a systematic literature search of articles published between 1997 and 2017. Five bibliographic databases and libraries: PubMed/Medline, Global Health Database, Embase, the Cochrane Library, and African Index Medicus were used. After cleaning and sorting, analysis was performed using STATA version 11. The pooled rate of MDR-TB prevalence, determinants and treatment outcome was estimated with a random-effects model. Heterogeneity was assessed by the I2 and publication bias through funnel plot. Results The 34 studies that were retained for final analysis enrolled a total of 7461 TB or MDR-TB patients. We found that 2.18% (95% CI 1.44–2.92%) of newly diagnosed and 21.07% (95% CI 11.47–30.67%) of previously treated patients have MDR-TB with overall prevalence of 7.24% (95% CI 6.11–8.37). History of previous treatment is the major determinant (pooled OR = 4.78 (95% CI 3.16–6.39)), while contact history and adherence also contributed. In this review the pooled death computed among 5 articles showed that 12.25% (95% CI 9.39–15.11%) of MDR-TB patients were died in the course of treatment. Complication, drug side effects and HIV infection were the main determinants for the death. Conclusion and recommendation The prevalence is by far higher than the previous reports. It is mainly associated with history of previous treatment along with contact history. However, the treatment outcomes are comparable with previous studies, yet it is a concern. Comorbidities, drug side effects and HIV sero-positivity were the determinants. Thus, proper treatment of drug susceptible TB and early detection and treatment of MDR-TB before complication develops along with prevention of drug side effect and contacts with MDR-TB cases are very important.http://link.springer.com/article/10.1186/s40794-018-0065-5MDR-TBTuberculosisDrug resistanceTreatment outcome |
| spellingShingle | Tadele Girum Ebrahim Muktar Kifle Lentiro Habtamu Wondiye Misgun Shewangizaw Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome Tropical Diseases, Travel Medicine and Vaccines MDR-TB Tuberculosis Drug resistance Treatment outcome |
| title | Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome |
| title_full | Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome |
| title_fullStr | Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome |
| title_full_unstemmed | Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome |
| title_short | Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: a systematic review and meta-analysis of the prevalence, determinants and treatment outcome |
| title_sort | epidemiology of multidrug resistant tuberculosis mdr tb in ethiopia a systematic review and meta analysis of the prevalence determinants and treatment outcome |
| topic | MDR-TB Tuberculosis Drug resistance Treatment outcome |
| url | http://link.springer.com/article/10.1186/s40794-018-0065-5 |
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