Prevalence of Multidrug Resistant Tuberculosis (MDR-TB) in East Africa: a Systematic Review and Meta- Analysis

Abstract

Background: The rate of multidrug resistant tuberculosis is increasing at an alarming rate throughout the world. It is becoming an emerging public health problem in East Africa. Prevalence of MDR-TB among TB positive individuals in the region has not been synthesized. Determining the pooled prevalence of MDR-TB among newly diagnosed and previously treated TB cases in East Africa is the main objective of this review.Methods: In this systematic review and meta-analysis, the researcher searched six electronic databases: Google scholar, PubMed, EMBASE, Scopus, Science direct and Web of Science. Funnel plot symmetry visualization confirmed by Egger’s regression asymmetry test and Begg rank correlation methods was used to assess publication bias. The pooled prevalence estimate was calculated using Der Simonian and Laird’s random Effects model. A total of 16 articles published in East Africa from 2007 and 2019 were included in this study. STATA software (version 14, Texas, USA) was used for analysis. Results: Out of 1025 articles identified citations, a total of 16 articles published in East Africa from 2007 and 2019 were included in this meta-analysis. The pooled prevalence of MDR-TB among newly diagnosed TB cases and previously treated TB patients to be 4% (95%CI=2-5%) and 21% (95%CI: 14-28%), respectively. Living conditions, lifestyles (smoking, alcohol use, and drug abuse), previous medical history, diabetes history and HIV infection risk factors contribute to higher prevalence of MDR-TB in East Africa.Conclusion: An early diagnosis of tuberculosis and rapid detection of drug resistant Mycobacterium tuberculosis is a serious concern to identify patients who are not responding to the standard treatment and to avoid spreading of resistant strains. It is also very essential to strengthen tuberculosis control and improved monitoring of chemotherapy.