Abstract:
BACKGROUND : Tuberculosis (TB) remains a significant global public health issue, despite
advances in diagnostic technologies, substantial global efforts, and the availability of effective
chemotherapies. Mycobacterium tuberculosis, a species of pathogenic bacteria resistant to currently
available anti-TB drugs, is on the rise, threatening national and international TB-control efforts. This
systematic review and meta-analysis aims to estimate the pooled prevalence of drug-resistant TB
(DR-TB) in Ethiopia. MATERIALS AND METHODS : A systematic literature search was undertaken using
PubMed/MEDLINE, HINARI, theWeb of Science, ScienceDirect electronic databases, and Google
Scholar (1 January 2011 to 30 November 2020). After cleaning and sorting the records, the data were
analyzed using STATA 11. The study outcomes revealed the weighted pooled prevalence of any
anti-tuberculosis drug resistance, any isoniazid (INH) and rifampicin (RIF) resistance, monoresistance
to INH and RIF, and multidrug-resistant TB (MDR-TB) in newly diagnosed and previously treated
patients with TB. RESULTS : A total of 24 studies with 18,908 patients with TB were included in the final
analysis. The weighted pooled prevalence of any anti-TB drug resistance was 14.25% (95% confidence
interval (CI): 7.05–21.44%)), whereas the pooled prevalence of any INH and RIF resistance was found
in 15.62% (95%CI: 6.77–24.47%) and 9.75% (95%CI: 4.69–14.82%) of patients with TB, respectively. The
pooled prevalence for INH and RIF-monoresistance was 6.23% (95%CI: 4.44–8.02%) and 2.33% (95%CI:
1.00–3.66%), respectively. MDR-TB was detected in 2.64% (95%CI: 1.46–3.82%) of newly diagnosed
cases and 11.54% (95%CI: 2.12–20.96%) of retreated patients with TB, while the overall pooled
prevalence of MDR-TB was 10.78% (95%CI: 4.74–16.83%). CONCLUSIONS : In Ethiopia, anti-tuberculosis
drug resistance is widespread. The estimated pooled prevalence of INH and RIF-monoresistance
rates were significantly higher in this review than in previous reports. Moreover, MDR-TB in newly
diagnosed cases remained strong. Thus, early detection of TB cases, drug-resistance testing, proper and timely treatment, and diligent follow-up of TB patients all contribute to the improvement of
DR-TB management and prevention. Besides this, we urge that a robust, routine laboratory-based
drug-resistance surveillance system be implemented in the country.
