Epidemiology of multidrug-resistant tuberculosis (MDR-TB) in Ethiopia: A systematic review and meta-analysis of the prevalence, determinants and treatment outcome

被引：52
作者：
Girum T. [1 ]
Muktar E. [1 ]
Lentiro K. [1 ]
Wondiye H. [2 ]
Shewangizaw M. [3 ]
机构：
[1] Wolkite University, Department of Public health, College of Medicine and Health Sciences, Wolkite City
[2] Bahir Dar University, Institute of Public health, College of Medicine and Health Sciences, Bahir Dar City
[3] Arba Minch University, Department of Public health, College of Medicine and Health Sciences, Arba Minch City
来源：
Tropical Diseases, Travel Medicine and Vaccines | / 4卷 / 1期
关键词：
Drug resistance; MDR-TB; Treatment outcome; Tuberculosis;
D O I：
10.1186/s40794-018-0065-5
中图分类号：
学科分类号：
摘要：
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 7461TB 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. © 2018 The Author(s).
引用
收藏
相关论文
共 61 条
[21]  
Agonafir M., Lemma E., Wolde-Meskel D., Goshu S., Santhanam A., Phenotypic and genotypic analysis of multidrug-resistant tuberculosis in Ethiopia, Int J Tuberc Lung Dis, 14, 10, pp. 1259-1265, (2010)
[22]  
Abate D., Taye B., Abisino M., Bidglign S., Epidemiology of anti-tuberculosis drug resistance patterns and trends in tuberculosis referral hospital in Addis Ababa. Ethiopia, BMC Res notes, 5, (2012)
[23]  
Abebe G., Abdissa K., Abdissa A., Apers L., Agonafir M., Relatively low primary drug resistant tuberculosis in southwestern Ethiopia, BMC Res Notes, 5, (2012)
[24]  
Tessema B., Beer J., Emmrich F., Sack U., Rodloff A.C., First and second line anti-tuberculosis drug resistance in Northwest Ethiopia, Int J Tuberc Lung Dis, 16, pp. 805-811, (2012)
[25]  
Yimer S.A., Agonafir M., Derese Y., Sani Y., Bjune G.A., Holm-Hansen C., Primary drug resistance to anti-tuberculosis drugs in major towns of Amhara region, Ethiopia, APMIS, 120, 6, pp. 503-509, (2012)
[26]  
Hussein B., Debebe T., Wilder-Smith A., Ameni G., Drug susceptibility test on mycobacterium tuberculosis isolated from pulmonary tuberculosis patients in three sites of Ethiopia, A Afr J Microbiol Res, 7, 9, pp. 791-796, (2013)
[27]  
Biadglegne F., Tessema B., Sack U., Rodloff A.C., Drug resistance of mycobacterium tuberculosis isolates from tuberculosis lymphadenitis patients in Ethiopia, Indian J Med Res, 140, 1, pp. 116-122, (2014)
[28]  
Esmael A., Ali I., Agonafir M., Endris M., Getahun M., Yarega Z., Et al., Drug resistance pattern of mycobacterium tuberculosis in eastern Amhara regional state, Ethiopia J Microb Biochem Technol, 6, 2, pp. 75-79, (2014)
[29]  
Daniel G., Mariam H., Phenotypic and genotypic determination of drug susceptibility and molecular characteri zati on of mycobacteri um tuberculosi s isolates at Debre Berhan referral hospital, Ethiopia, Ethiopia: AAU, (2014)
[30]  
Seyoum B., Demissie M., Worku A., Bekele S., Aseffa A., Prevalence and drug resistance patterns of mycobacterium tuberculosis among new smear positive pulmonary tuberculosis patients in eastern Ethiopia, Tuberc Res Treat, 2014, pp. 1-7, (2014)
1234567