Epidemiology of extensively drug-resistant tuberculosis among patients with multidrug-resistant tuberculosis: A systematic review and meta-analysis.
Int J Infect Dis
; 132: 50-63, 2023 Jul.
Article
en En
| MEDLINE
| ID: mdl-37072053
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.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Tuberculosis Resistente a Múltiples Medicamentos
/
Tuberculosis Extensivamente Resistente a Drogas
/
Mycobacterium tuberculosis
Tipo de estudio:
Screening_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Int J Infect Dis
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
Año:
2023
Tipo del documento:
Article