Epidemiology of extensively drug-resistant tuberculosis among patients with multidrug-resistant tuberculosis: A systematic review and meta-analysis.

Autor:	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.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2023 Jul; Vol. 132, pp. 50-63. Date of Electronic Publication: 2023 Apr 16.
DOI:	10.1016/j.ijid.2023.04.392
Abstrakt:	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.)
Databáze:	MEDLINE
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