Prevalence of multidrug resistance tuberculosis in adult patients in India: A systematic review and meta-analysis

Jaykaran Charan; Nitish Tank; Tea Reljic; Surjit Singh; Pankaj Bhardwaj; Rimplejeet Kaur; Jagdish P Goyal; Ambuj Kumar

doi:10.4103/jfmpc.jfmpc_542_19

Prevalence of multidrug resistance tuberculosis in adult patients in India: A systematic review and meta-analysis

J Family Med Prim Care. 2019 Oct 31;8(10):3191-3201. doi: 10.4103/jfmpc.jfmpc_542_19. eCollection 2019 Oct.

Authors

Jaykaran Charan¹, Nitish Tank², Tea Reljic³, Surjit Singh¹, Pankaj Bhardwaj⁴, Rimplejeet Kaur⁵, Jagdish P Goyal⁶, Ambuj Kumar³

Affiliations

¹ Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
² Department of Pharmacology, GMERS Medical College, Himmatnagar, Gujarat, India.
³ Department of Comparative Effectiveness Research, University of South Florida, Tampa, FL, USA.
⁴ Department of Community and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
⁵ Department of Pharmacology, S. N. Medical College, Jodhpur, Rajasthan, India.
⁶ Department of Paediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

Abstract

Background: Multidrug resistance tuberculosis (MDR-TB) is an important public health problem for India but there is a paucity of data related to the prevalence of MDR-TB in India. This systematic review and meta-analysis was designed to synthesize evidence regarding the prevalence of MDR-TB in adult patients in India.

Methods: PubMed and Google Scholar were searched to find different observational studies reporting MDR-TB prevalence in India. Data related to MDR-TB prevalence were pooled for the analysis. PubMed was searched by using different MeSH words. Prevalence was reported with 95% confidence interval (CI). A separate analysis was done for new cases and previously treated cases. Random effect model was used and heterogeneity was assessed by I² and Cochran Q test.

Results: MDR-TB prevalence in new cases were 3% (95% CI 2%-5%, I² = 95.3%). There was difference in prevalence between different methods of measurement of MDR-TB and study designs. MDR-TB prevalence in previously treated cases was found to be 35% (95% CI 29%-41%, I² = 98.7%). Results vary with the method of measurement as well as the study design.

Conclusion: MDR-TB prevalence in previously treated patients was found higher compared to the reported values in national surveys. There is a need for large scale cross-sectional study to verify the findings observed in this review.

Keywords: India; multidrug resistance tuberculosis; prevalence; resistance; tuberculosis.