Pattern of drug resistant Mycobacterium tuberculosis in the west and northwest of Iran, a meta-analysis

Khalil Ansarin; Leyla Sahebi

doi:10.18502/ijm.v14i3.9754

Khalil Ansarin Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Leyla Sahebi Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences,Tehran, Iran

DOI: https://doi.org/10.18502/ijm.v14i3.9754

Keywords: Drug resistance; Tuberculosis; Meta-analysis

Abstract

Background and Objectives: Drug-resistant tuberculosis (Tb) is a major public health issue across the world. Therefore, it is crucial to determine its pattern in different regions of the world. The aim of this study was to review the prevalence of drug resistant TB in the west and northwest of Iran.

Materials and Methods: A systematic literature search was performed to identify studies (2010 to 2021) in Google Schol- ar, PubMed, Thomson Reuters, Scientific Information Database (SID), Cochrane Library, and Medical Library (MedLib) databases. The patterns of any drug-resistant Mycobacterium tuberculosis (MTB); resistance to isoniazid (INH), rifampicin (RMP), streptomycin (SMP), ethambutol (EMB), and multiple drug resistance (MDR) were reviewed in tuberculosis in the west and northwest of Iran.

Results: In this review, 7 studies met the eligibility criteria for a meta-analysis. The pooled proportion of any drug resistant TB was 13% (CI 95%: 9.0, 17.0) (43.0% in re-treatment group). The pooled prevalence of any drug resistant TB was more than 1.5 times higher in men compared to women (15% vs. 9.0%). The pooled prevalence (%) of resistance to INH, RMP, SMP, EMB and MDR-TB was 11.0%, 12.0%, 13.0%, 6.0%, and 6.0%, respectively. Kermanshah Province (a province in the west of Iran) showed a high prevalence of any type of drug resistance and MDR-TB (15.9% and 20.0%, respectively).

Conclusion: It seems that the western provinces of Iran have a different pattern of drug resistance compared to the northwest- ern provinces. Considering the extent of Iran and the neighboring countries, it is recommended that the pattern of tuberculo- sis drug resistance be reviewed separately in different provinces or regions of Iran. Drug resistance in the re-treatment group was more than three times that of all patients with TB drug resistance. The burden of drug resistance reduces significantly with better control and management of TB drug treatment and preventing re-infection.