학술논문
Epidemiology of extensively drug-resistant tuberculosis among patients with multidrug-resistant tuberculosis: A systematic review and meta-analysis.
Document Type
Academic Journal
Author
Diriba G; Ethiopian Public Health Institute, Addis Ababa, Ethiopia. Electronic address: getud2020@gmail.com.; Alemu A; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.; Yenew B; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.; Tola HH; Selale University, College of Health Sciences, Department of Public Health, Addis Ababa, Ethiopia.; Gamtesa DF; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.; Mollalign H; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.; Eshetu K; USAID Eliminate TB Project, Management Sciences for Health, Addis Ababa, Ethiopia.; Moga S; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.; Abdella S; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.; Tollera G; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.; Kebede A; Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia.; Dangisso MH; Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Source
Publisher: Elsevier Country of Publication: Canada NLM ID: 9610933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-3511 (Electronic) Linking ISSN: 12019712 NLM ISO Abbreviation: Int J Infect Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: To estimate the pooled proportion of extensively drug-resistant tuberculosis (XDR-TB) and pre-extensively drug-resistant tuberculosis (pre-XDR-TB) in patients with multidrug-resistant TB (MDR-TB).
Methods: We systematically searched articles from electronic databases: MEDLINE (PubMed), ScienceDirect, and Google Scholar. We also searched gray literature from the different literature sources main outcome of the review was either XDR-TB or pre-XDR-TB in patients with MDR-TB. We used the random-effects model, considering the substantial heterogeneity among studies. Heterogeneity was assessed by subgroup analyses. STATA version 14 was used for analysis.
Results: A total of 64 studies that reported on 12,711 patients with MDR-TB from 22 countries were retrieved. The pooled proportion of pre-XDR-TB was 26% (95% confidence interval [CI]: 22-31%), whereas XDR-TB in MDR-TB cases was 9% (95% CI: 7-11%) in patients treated for MDR-TB. The pooled proportion of resistance to fluoroquinolones was 27% (95% CI: 22-33%) and second-line injectable drugs was 11% (95% CI: 9-13%). Whereas the pooled resistance proportions to bedaquiline, clofazimine, delamanid, and linezolid were 5% (95% CI: 1-8%), 4% (95% CI: 0-10%), 5% (95% CI; 2-8%), and 4% (95% CI: 2-10%), respectively.
Conclusion: The burden of pre-XDR-TB and XDR-TB in MDR-TB were considerable. The high burdens of pre-XDR-TB and XDR-TB in patients treated for MDR-TB suggests the need to strengthen TB programs and drug resistance surveillance.
Competing Interests: Declaration of competing interests The authors have no competing interests to declare.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Methods: We systematically searched articles from electronic databases: MEDLINE (PubMed), ScienceDirect, and Google Scholar. We also searched gray literature from the different literature sources main outcome of the review was either XDR-TB or pre-XDR-TB in patients with MDR-TB. We used the random-effects model, considering the substantial heterogeneity among studies. Heterogeneity was assessed by subgroup analyses. STATA version 14 was used for analysis.
Results: A total of 64 studies that reported on 12,711 patients with MDR-TB from 22 countries were retrieved. The pooled proportion of pre-XDR-TB was 26% (95% confidence interval [CI]: 22-31%), whereas XDR-TB in MDR-TB cases was 9% (95% CI: 7-11%) in patients treated for MDR-TB. The pooled proportion of resistance to fluoroquinolones was 27% (95% CI: 22-33%) and second-line injectable drugs was 11% (95% CI: 9-13%). Whereas the pooled resistance proportions to bedaquiline, clofazimine, delamanid, and linezolid were 5% (95% CI: 1-8%), 4% (95% CI: 0-10%), 5% (95% CI; 2-8%), and 4% (95% CI: 2-10%), respectively.
Conclusion: The burden of pre-XDR-TB and XDR-TB in MDR-TB were considerable. The high burdens of pre-XDR-TB and XDR-TB in patients treated for MDR-TB suggests the need to strengthen TB programs and drug resistance surveillance.
Competing Interests: Declaration of competing interests The authors have no competing interests to declare.
(Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)