Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysis

Background: Drug-resistant tuberculosis continues to be a global public health threat. Ethiopia is one of the high-burden countries for tuberculosis and multi-drug resistant tuberculosis. The estimated annual incidents of tuberculosis were 119 per 100,000 populations in 2021 and the prevalence of mu...

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Principais autores: Maritu Demelash, Endalkachew Nibret, Tamirat Hailegebriel, Zebasil Minichil, Daniel Mekonnen
Formato: Artigo
Idioma:English
Publicado em: Elsevier 2023-09-01
coleção:Heliyon
Assuntos:
Acesso em linha:http://www.sciencedirect.com/science/article/pii/S2405844023067622
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author Maritu Demelash
Endalkachew Nibret
Tamirat Hailegebriel
Zebasil Minichil
Daniel Mekonnen
author_facet Maritu Demelash
Endalkachew Nibret
Tamirat Hailegebriel
Zebasil Minichil
Daniel Mekonnen
author_sort Maritu Demelash
collection DOAJ
description Background: Drug-resistant tuberculosis continues to be a global public health threat. Ethiopia is one of the high-burden countries for tuberculosis and multi-drug resistant tuberculosis. The estimated annual incidents of tuberculosis were 119 per 100,000 populations in 2021 and the prevalence of multi-drug resistance tuberculosis is about 0.7% among newly diagnosed cases in Ethiopia. On time detection of rifampicin resistance is essential for the management of the disease and earlier treatment initiation. Among the different diagnostic tests; Xpert is widely used for the rapid detection of Mycobacterium tuberculosis and rifampicin resistant in the country. The prevalence of rifampicin resistance-pulmonary tuberculosis varied from locality to locality and the estimated national prevalence of rifampicin resistance pulmonary tuberculosis is not available in the country. Therefore, the aim of this meta-analysis was to summarize the results of available studies and generate pooled prevalence estimate of rifampicin resistance pulmonary tuberculosis in Ethiopia. Methods: Literature search was carried out using PubMed and Scopus public databases. Original articles conducted in Ethiopia and those containing a prevalence report of rifampicin resistance pulmonary tuberculosis diagnosed by Xpert Mycobacterium tuberculosis/rifampicin resistance assay were included in the meta-analysis. All retrospective and prospective studies published until May 2022 were screened in the study. The methodological qualities of included article were assessed using Joanna Briggs Institute quality assessment tool for cross-sectional studies. Random effect model was used to determine the pooled prevalence of rifampicin resistance pulmonary tuberculosis. Subgroup analysis and regression were carried out across regional states and study designs. Heterogeneity across studies was assessed using I2 test. The data were analyzed using STATA version 14. Result: A total of 1570 titles were identified and 34 studies met the inclusion criteria. Of the total 17,292 pulmonary tuberculosis patients who were identified from the included articles, 1669 were rifampicin resistance pulmonary tuberculosis. The pooled prevalence of rifampicin resistant among pulmonary tuberculosis patients diagnosed with Xpert Mycobacterium tuberculosis/rifampicin resistance assay was 9.67% (95% CI: 8.11–11.24). The highest pooled prevalence was from Oromia11.84% (95% CI: 4.49–19.2%) and the lowest rifampicin resistance was identified in Amhara Regional State, 8.51% (95% CI: 5.96–11.06%). The pooled prevalence rates of rifampicin resistant among pulmonary tuberculosis patients were 10.18% (95% CI: 6.85–13.51) and 9.57% (95% CI: 7.68–11.47) in prospective and retrospective types of cross-sectional studies. Conclusion: Our study showed that the pooled prevalence of rifampicin resistance among pulmonary tuberculosis patients was 9.67%. This showed that the occurrence of rifampicin resistance pulmonary tuberculosis among Mycobacterium tuberculosis patients remains high in Ethiopia. Regional state wise, rifampicin resistance variation was small. Further meta-analysis of factors associated with rifampicin resistance among pulmonary tuberculosis patients as well as among extrapulmonary Mycobacterium tuberculosis cases should be carried out.
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spelling doaj.art-7873ccbe19c840c6a7fcf7fb944eac892023-10-01T06:00:06ZengElsevierHeliyon2405-84402023-09-0199e19554Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysisMaritu Demelash0Endalkachew Nibret1Tamirat Hailegebriel2Zebasil Minichil3Daniel Mekonnen4Department of Biology, College of Science, Bahir Dar University, Bahir Dar, EthiopiaDepartment of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia; Institute of Biotechnology (IOB), Bahir Dar University, Bahir Dar, EthiopiaDepartment of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia; Institute of Biotechnology (IOB), Bahir Dar University, Bahir Dar, Ethiopia; Corresponding author. Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia.Department of Biology, College of Science, Bahir Dar University, Bahir Dar, EthiopiaInstitute of Biotechnology (IOB), Bahir Dar University, Bahir Dar, Ethiopia; Department of Medical Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, EthiopiaBackground: Drug-resistant tuberculosis continues to be a global public health threat. Ethiopia is one of the high-burden countries for tuberculosis and multi-drug resistant tuberculosis. The estimated annual incidents of tuberculosis were 119 per 100,000 populations in 2021 and the prevalence of multi-drug resistance tuberculosis is about 0.7% among newly diagnosed cases in Ethiopia. On time detection of rifampicin resistance is essential for the management of the disease and earlier treatment initiation. Among the different diagnostic tests; Xpert is widely used for the rapid detection of Mycobacterium tuberculosis and rifampicin resistant in the country. The prevalence of rifampicin resistance-pulmonary tuberculosis varied from locality to locality and the estimated national prevalence of rifampicin resistance pulmonary tuberculosis is not available in the country. Therefore, the aim of this meta-analysis was to summarize the results of available studies and generate pooled prevalence estimate of rifampicin resistance pulmonary tuberculosis in Ethiopia. Methods: Literature search was carried out using PubMed and Scopus public databases. Original articles conducted in Ethiopia and those containing a prevalence report of rifampicin resistance pulmonary tuberculosis diagnosed by Xpert Mycobacterium tuberculosis/rifampicin resistance assay were included in the meta-analysis. All retrospective and prospective studies published until May 2022 were screened in the study. The methodological qualities of included article were assessed using Joanna Briggs Institute quality assessment tool for cross-sectional studies. Random effect model was used to determine the pooled prevalence of rifampicin resistance pulmonary tuberculosis. Subgroup analysis and regression were carried out across regional states and study designs. Heterogeneity across studies was assessed using I2 test. The data were analyzed using STATA version 14. Result: A total of 1570 titles were identified and 34 studies met the inclusion criteria. Of the total 17,292 pulmonary tuberculosis patients who were identified from the included articles, 1669 were rifampicin resistance pulmonary tuberculosis. The pooled prevalence of rifampicin resistant among pulmonary tuberculosis patients diagnosed with Xpert Mycobacterium tuberculosis/rifampicin resistance assay was 9.67% (95% CI: 8.11–11.24). The highest pooled prevalence was from Oromia11.84% (95% CI: 4.49–19.2%) and the lowest rifampicin resistance was identified in Amhara Regional State, 8.51% (95% CI: 5.96–11.06%). The pooled prevalence rates of rifampicin resistant among pulmonary tuberculosis patients were 10.18% (95% CI: 6.85–13.51) and 9.57% (95% CI: 7.68–11.47) in prospective and retrospective types of cross-sectional studies. Conclusion: Our study showed that the pooled prevalence of rifampicin resistance among pulmonary tuberculosis patients was 9.67%. This showed that the occurrence of rifampicin resistance pulmonary tuberculosis among Mycobacterium tuberculosis patients remains high in Ethiopia. Regional state wise, rifampicin resistance variation was small. Further meta-analysis of factors associated with rifampicin resistance among pulmonary tuberculosis patients as well as among extrapulmonary Mycobacterium tuberculosis cases should be carried out.http://www.sciencedirect.com/science/article/pii/S2405844023067622Xpert MTB/RIF assayPulmonary tuberculosisRifampicin resistanceMeta-analysisEthiopia
spellingShingle Maritu Demelash
Endalkachew Nibret
Tamirat Hailegebriel
Zebasil Minichil
Daniel Mekonnen
Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysis
Heliyon
Xpert MTB/RIF assay
Pulmonary tuberculosis
Rifampicin resistance
Meta-analysis
Ethiopia
title Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysis
title_full Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysis
title_fullStr Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysis
title_full_unstemmed Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysis
title_short Prevalence of rifampicin resistant pulmonary tuberculosis using geneXpert assay in Ethiopia, a systematic review and meta-analysis
title_sort prevalence of rifampicin resistant pulmonary tuberculosis using genexpert assay in ethiopia a systematic review and meta analysis
topic Xpert MTB/RIF assay
Pulmonary tuberculosis
Rifampicin resistance
Meta-analysis
Ethiopia
url http://www.sciencedirect.com/science/article/pii/S2405844023067622
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