Prevalence of Antibiotic-Resistant Pulmonary Tuberculosis in Bangladesh: A Systematic Review and Meta-Analysis.

Shoumik Kundu,Md Asiful Islam,Mahfuza Marzan,Siew Hua Gan

doi:10.3390/antibiotics9100710

Shoumik Kundu, Md Asiful Islam + Show 2 more

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https://doi.org/10.3390/antibiotics9100710

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Abstract

Resistance to anti-tuberculosis (anti-TB) antibiotics is a major public health concern for many high-TB burden countries in Asia, including Bangladesh. Therefore, to represent the overall drug-resistance pattern against TB in Bangladesh, a systematic review and meta-analysis was conducted. Databases such as PubMed, Scopus, and Google Scholar were searched to identify studies related to antibiotic-resistant TB. A total of 24 studies covering 13,336 patients with TB were secured and included. The random-effects model was used to calculate the summary estimates. The pooled prevalence of any, mono, multi, poly, and extensive anti-TB antibiotic-resistances were 45.3% [95% CI: 33.5–57.1], 14.3% [95% CI: 11.4–17.2], 22.2% [95% CI: 18.8–25.7], 7.7% [95% CI: 5.6–9.7], and 0.3% [95% CI: 0.0–1.0], respectively. Among any first and second-line anti-TB drugs, isoniazid (35.0%) and cycloserine (44.6%) resistances were the highest, followed by ethambutol (16.2%) and gatifloxacin (0.2%). Any, multi, and poly drug-resistances were higher in retreatment cases compared to the newly diagnosed cases, although mono drug-resistance tended to be higher in newly diagnosed cases (15.7%) than that in retreatment cases (12.5%). The majority (82.6%) of the included studies were of high quality, with most not exhibiting publication bias. Sensitivity analyses confirmed that all outcomes are robust and reliable. It is concluded that resistance to anti-TB drugs in Bangladesh is rampant and fast growing. Therefore, the implementation of a nationwide surveillance system to detect suspected and drug-resistant TB cases, as well as to ensure a more encompassing treatment management by national TB control program, is highly recommended.

Highlights

IntroductionTuberculosis (TB) is a communicable infectious disease caused by the Mycobacterium tuberculosis
Tuberculosis (TB) is a communicable infectious disease caused by the Mycobacterium tuberculosis. it mainly affects the lungs, it may involve other parts of the body
The World Health Organization (WHO) estimates that approximately one-fourth of the world’s population is infected with Mycobacterium tuberculosis which can progress to TB

Summary

Introduction

Tuberculosis (TB) is a communicable infectious disease caused by the Mycobacterium tuberculosis. It mainly affects the lungs (pulmonary TB), it may involve other parts of the body (extra-pulmonary TB). The World Health Organization (WHO) estimates that approximately one-fourth of the world’s population is infected with Mycobacterium tuberculosis which can progress to TB. It has been estimated that 10 million people were infected by TB, with 1.2 million fatalities due to non-human immunodeficiency virus (HIV) TB in 2018. TB burden is not uniformly distributed throughout. The top eight countries account for almost 67% cases (86% in 2018 alone) of the total TB patients globally, where Bangladesh ranks 7th in the list and is responsible for 4% of the total worldwide TB cases [1]

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