Abstract
ObjectiveDrug-resistant tuberculosis (DR-TB) is a major global public health threat. India, as it shares a large fraction of the world’s TB burden, is currently at a critical phase due to the rise of drug resistance. Monitoring the prevalence and patterns of drug resistance is essential to measure the progress of TB control programmes. We aimed to systematically review Indian studies on the prevalence and patterns of DR-TB among various treatment types and risk groups. MethodsA systematic search was conducted on PubMed, Google Scholar, IndMed, major TB journals and other databases for English language articles published till March 2018 that estimated the prevalence of DR TB in new, previously treated, presumptive multidrug resistance (MDR), paediatric and HIV co-infected pulmonary TB patients. Two authors independently conducted the search, assessed study quality, and extracted the relevant data. Pooled prevalence of DR-TB and its types were calculated by DerSimonian–Laird random effects meta-analysis. Heterogeneity was investigated by sub-group and sensitivity analyses. ResultsNinety non-duplicate studies were included. The prevalence of MDR, any drug resistance and extensive drug resistance was 3.5%, 24.9% and 0.06% (among new) and 26.7%, 58.4% and 1.3% (among previously treated), respectively. MDR prevalence among presumptive MDR, paediatric and HIV co-infected TB patients was 23.3%, 5.1% and 18.8%, respectively. MDR prevalence among new TB patients was highest in Maharashtra and lowest in Telangana. There was high heterogeneity between the studies. Study period, place of study and zone were significantly associated with MDR prevalence. ConclusionsIndia suffers from a significant burden of DR-TB. Its patterns and prevalence are very heterogeneous across time, region and setting. Implementation of universal drug susceptibility testing in all districts and continuous DR-TB surveillance is crucial to ensure programmatic success.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
