Prevalence of and risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries: systematic review and meta-analysis

Jimma, Worku; Ghazisaeedi, Marjan; Shahmoradi, Leila; Abdurahman, Ahmed Abdulahi; Kalhori, Sharareh R. Niakan; Nasehi, Mahshid; Yazdi, S H Hoseini; Safdari, Reza

doi:10.1590/0037-8682-0002-2017

Cited by 20 publications

(21 citation statements)

References 26 publications

(47 reference statements)

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“…And previous treatment was a major predictor of MDR-TB in this study. Similar ndings were found in a number of studies from different countries including the Ethiopia, East Shoa(11), Amhara regional state(32), Addis Ababa(10), Iran and neighboring countries (38),Iran (27),Nepal (39),China(26),Sub-Saharan countries review(9), retrospective study in Nigeria(40), Equatorial Guinea(34), Tanzania(33), USA(4). Systematic review and meta-analysis in Ethiopia(12) revealed previous treatment was a major determinant of MDR-TB, systematic review in Europe (41).…”

Section: Discussionsupporting

confidence: 78%

Determinants of Multi-Drug Resistant Tuberculosis Among Patients Attending Anti-Tuberculosis Treatment From Peripheral Districts, Southern Ethiopia, 2019: a Case Control Study

Digesa

Beyene

Betre

2020

Preprint

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Background: The emergence of multi-drug resistant tuberculosis (MDR-TB) is a challenge for global prevention and control of the disease. MDR-TB case management is difficult because it exposes to further economic and social costs that the patients face while seeking help and treatment. Ethiopia is one of the 30 MDR-TB burden countries. There is little research evidence of MDR-TB from the peripheral parts of the country.Objective: The study was designed to identify determinants of MDR-TB among patients attending anti tuberculosis treatment from peripheral districts, Southern Nations, Nationalities and People Region, Ethiopia, 2019. Methods: Hospital based case control study was conducted from March to April, 2019 in Southern Ethiopia. Cases were confirmed MDR-TB patients, while controls were those who declared cured or completed first line ant-tuberculosis treatment. The study participants were recruited by stratified random sampling. The data were entered into Epi data 4.4.3, cleaned and analyzed by SPSS 24. Bivariate and multivariable analyses was used to identify determinants of MDR-TB. Determinants with P-value <0.05 were declared as having significant association with MDR-TB and adjusted odd ratio with 95% CI was used to measure degree of association. Result: A total of 180 study participants were recruited (90 cases and 90 controls) and participated in this study. The median age for cases and controls was 29 and 30.5 years respectively. More than two third (78.89%) of case participants were from rural and 49(54.44%) of the controls were from rural. Uneducated [AOR:5.18, 95%CI (1.69-15.80)], rural resident [AOR:2.60,95%CI(1.14-6.88)], body mass index(BMI)<18.5kg/m2[AOR:3.11,95%CI(1.41-6.88], pulmonary tuberculosis[AOR:3.98,95%CI(1.11-14.22)], contact history with tuberculosis patient [AOR:3.99,95%CI (1.75-9.07)] and history of previous treatment[AOR:9.5,95%CI(4.08-22)] were found independent determinants of MDR-TB.Conclusions and Recommendation: Uneducated, rural residence, body mass index <18.5kg/m2, pulmonary tuberculosis, contact history with tuberculosis patient and history of previous treatment were associated with MDR-TB. A community level education to enhance public awareness about MDR-TB, nutritional counseling and support, strengthening contact tracing and directly observed treatment strategies with treatment adherence interventions were recommended.

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Section: Discussionsupporting

confidence: 78%

Determinants of Multi-Drug Resistant Tuberculosis Among Patients Attending Anti-Tuberculosis Treatment From Peripheral Districts, Southern Ethiopia, 2019: a Case Control Study

Digesa

Beyene

Betre

2020

Preprint

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“…There are different factors affecting the incidence of TB in various areas, such as weather, epidemiological transition, drug resistance, HIV, migration, and poverty. These factors might increase the incidence of TB (5,6,15).…”

Section: Discussionmentioning

confidence: 99%

“…During two decades, the TB incidence rate in Iran declined from 36 per 100000 in 1990 to 17 per 100000 in 2010, but it is not enough to reach the STB goal; hence, TB control is a prime concern for public health among policymakers. One of the important causes of this situation is the common frontier with three countries in which TB is a public health problem, i.e., Pakistan, Iraq, and Afghanistan (5,6).…”

Section: Introductionmentioning

confidence: 99%

Which Type of Univariate Forecasting Methods Is Appropriate for Prediction of Tuberculosis Cases in Razavi Khorasan Province? A Need for Surveillance and Biosurveillance Systems

et al. 2019

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Background: TB surveillance and preventing the further spread of the disease need the full knowledge of the biological characteristics influencing TB and detecting mathematical patterns to interpret the mechanism of TB spread. These models can provide explanations and knowledge of the dynamics of diseases and can be used for forecasting the ensuing values. To determine the possible number of patients, the time ahead is vital for decision making in public health. However, it is essential to determine forecasts' accuracy utilizing genuine forecasts. Thus, we obtained the TB cases from April 2007 until March 2018 in Razavi Khorasan province to develop a fit model and forecast the number of TB cases for the next 24 months. Methods: We considered a time series of monthly incidence counts of TB in Razavi Khorasan province from April 2007 until March 2018. The data included total TB, pulmonary TB, new pulmonary TB, retreatment TB, and extrapulmonary TB cases. For choosing models and forecasting, we use about 20% of all data (24 data) for testing and the rest for training the model. The optimization of parameters was done automatically according to the smallest root mean squared error for these time-series analysis techniques with STATA. The models were EWMAs models (single exponential and double exponential smoothers) and totally, we compared the quality of forecasts provided by EWMAs models through the stand-alone measurement (RMSE). Results: The patterns of raw series of total TB, pulmonary TB, and new pulmonary TB were almost the same. They illustrated slowly downward trends with oscillation around the trend that was a property of cyclic trend. For retreatment TB and extrapulmonary TB cases, reductions occurred over time although with no pattern. The results of statistical models indicated that the values of smoothing constants of all series were near zero that indicated a very smooth series with slowly changing counts. Total TB, pulmonary TB, and new pulmonary TB series had double exponential patterns with noisy and long-standing trend and they might be increasing in the 24 months ahead. Retreatment TB and extrapulmonary TB series had simple exponential patterns with noisy and without secular trends; they might be with no changes in the 24 months ahead. Conclusions: The end TB strategy, MDG 6, target 8 is to stop and start to inverse the incidence of TB by 2015 and we joined this strategy in January 2006. However, TB control remains one of the main public health concerns. In recent years, our country has experienced immigrants from neighboring countries, sanctions or/and attacks with category C of biological agents in moving toward tuberculosis elimination. Our implementation requires changes in strategies and activities that should evolve over time. The findings of this study are helpful in achieving this goal.

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“…Domestic and foreign research reports indicated MDR-TB was closely related to a number of factors such as sociodemographic factors, economic level, and past anti-TB treatment courses, [4][5][6][7][8][9][10][11][12][13][14] and these factors may differ by region or country. MDR-TB risk factors were not yet determined in Anhui province.…”

mentioning

confidence: 99%

<p>Determining <em>Mycobacterium tuberculosis</em> Drug Resistance and Risk Factors for Multidrug-Resistant Tuberculosis in Sputum Smear-Positive Tuberculosis Outpatients in Anhui Province, China, 2015–2016</p>

Yao¹,

Yan²,

Li³

et al. 2020

IDR

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These authors contributed equally to this work Background: Multidrug-resistant tuberculosis (MDR-TB) is currently a major problem in China. The prevention and treatment work for MDR-TB patients started late in Anhui province.To determine the prevalence of MDR-TB in sputum smear-positive TB patients (SSPTBPs) and analyze the risk factors for MDR-TB in Anhui province, we conducted an investigation of drug resistance among SSPTB outpatients from September 2015 to August 2016. Methods: A stratified cluster-randomized sampling method was used to obtain a representative sample. It was estimated that 2290 new cases and 440 previously treated cases of SSPTBPs needed to be recruited from 40 survey sites. Isolates were tested for resistance to six first-line and second-line anti-TB drugs. Information from patient questionnaire survey was used to identify factors linked to MDR-TB. Results: Finally, a total of 3047 SSPTBPs were recruited from 40 survey sites; of these, 2530 specimens were successfully cultured and had drug susceptibility testing done. The proportions of rifampin resistant (RR)-TB were 11.42% (289/2530, 95% CI: 10.18-12.66%), 7.64% (163/2133, 95% CI: 6.38-8.62%) and 31.74% (126/397,.60%) in all cases, new cases and previously treated cases, respectively, and the proportions of confirmed MDR-TB were 7.63% (193/2530, 95% CI: 6.59-8.66%), 4.97% (106/2133, 95% CI: 4.05-5.89%) and 21.91% (87/397, 95% CI: 17.83-26.00%), respectively. The ofloxacin resistance rate in previously treated SSPTBPs reached 21.66% (95% CI: 17.33-26.75%). Patients who had received two or more anti-TB treatment courses were significantly associated with MDR-TB compared to patients who have received one anti-TB course. Conclusion: MDR-TB prevalence was high among SSPTBPs in Anhui province, and past anti-TB treatment course was associated with MDR-TB.

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Prevalence of and risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries: systematic review and meta-analysis

Cited by 20 publications

References 26 publications

Determinants of Multi-Drug Resistant Tuberculosis Among Patients Attending Anti-Tuberculosis Treatment From Peripheral Districts, Southern Ethiopia, 2019: a Case Control Study

Determinants of Multi-Drug Resistant Tuberculosis Among Patients Attending Anti-Tuberculosis Treatment From Peripheral Districts, Southern Ethiopia, 2019: a Case Control Study

Which Type of Univariate Forecasting Methods Is Appropriate for Prediction of Tuberculosis Cases in Razavi Khorasan Province? A Need for Surveillance and Biosurveillance Systems

<p>Determining <em>Mycobacterium tuberculosis</em> Drug Resistance and Risk Factors for Multidrug-Resistant Tuberculosis in Sputum Smear-Positive Tuberculosis Outpatients in Anhui Province, China, 2015–2016</p>

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