Prevalence of multidrug‐resistant tuberculosis in Latin America and the Caribbean: a systematic review and meta‐analysis

Abstract

Objectives To evaluate the prevalence of multidrug‐resistant tuberculosis (MDR‐TB) in individuals living in Latin America and the Caribbean (LAC). Methods We searched the MEDLINE, Embase and Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) databases until 08 August 2019 for all studies on the subject, without time or language restrictions. Original studies reporting the prevalence of infection with Mycobacterium tuberculosis resistant to isoniazid and rifampicin simultaneously (MDR) in LAC, the prevalence of resistance in cases with no previous treatment (new cases) and the prevalence of resistance in previously treated cases were selected. Considering the expected heterogeneity between studies, all analyses were performed using the random effects model, and heterogeneity was assessed using the I2 statistic. Results We included 91 studies from 16 countries. The estimated overall prevalence was 13.0% (95% CI 12.0–14.0%), and the heterogeneity between studies was substantial (I2 = 96.1%). In the subgroup analyses, it was observed that the prevalence of MDR‐TB among new cases was 7.0% (95% CI 6.0–7.0%) and in previously treated cases was 26.0% (95% CI 24.0–28.0%). Conclusions This review highlights multidrug resistance to antituberculosis drugs in LAC, indicating that prevention strategies have not been effective. Government institutions should invest heavily in strategies for early diagnosis and the rapid availability of effective treatments and prioritise adequate protection for health professionals. In addition, screening programmes should be adopted to prevent secondary cases.

Genealogy of Resistant Tuberculosis in Latin America and the Caribbean until 2020

“…The overall prevalence of MDR-TB according to a metanalysis published in 2020 [15] was 13%, but it reached 28% in those patient populations previously treated cases for tuberculosis. The reported prevalence have been increased when studied from period ending in 2010 to 2018 [15]. Colombia, Mexico, and Dominican Republic, in data published in 2020, have a reported overall prevalence of MDR-TB of around 20% [15], with more of 30% of attributed to a previous failed or inadequate treatment.…”

“…The reported prevalence have been increased when studied from period ending in 2010 to 2018 [15]. Colombia, Mexico, and Dominican Republic, in data published in 2020, have a reported overall prevalence of MDR-TB of around 20% [15], with more of 30% of attributed to a previous failed or inadequate treatment. In the United States, data reports around 1% of MDR-TB of the total of tuberculosis patients identified [16], being considered a low burden country for MDR-TB.…”

“…When talking about MDR-TB in America, previous publications signaled Countries as Peru, Ecuador and Brazil for most of the cases reported [14]. The overall prevalence of MDR-TB according to a metanalysis published in 2020 [15] was 13%, but it reached 28% in those patient populations previously treated cases for tuberculosis. The reported prevalence have been increased when studied from period ending in 2010 to 2018 [15].…”

COVID-19 in Latin America and the caribbean region: Symptoms and morbidities in the epidemiology of infection

“…The mortality rate from transmissible diseases was 58/100,000 people and even more in the poorer countries of the region. In Haiti, the incidence of tuberculosis is seven times that of the rest of the LA and CA regions [ 9 , 10 ]. In 2006, 50% of all dengue cases in LA and the CA occurred in Brazil, and malaria was endemic in 21 countries [ 11 , 12 ].…”

Atualizações Em Doenças Tropicais Negligenciadas

“…Além da aquisição de nova resistência (resistência adquirida), os indivíduos podem ser infectados com cepas resistentes aos medicamentos como resultado da transmissão (resistência primária). A resistência adquirida pode ser evitada garantindo-se a adesão à terapia otimizada, enquanto o controle da resistência primária requer inter-venções para bloquear a transmissão (LANGE et al, 2018;KHAN et al, 2019;TENGAN et al, 2020).…”