Prevalence of drug-resistant TB in Nigeria: A systematic review and meta-analysis
Abstract
Background
Drug-resistant
tuberculosis (TB) undermines control efforts and its burden is
poorly understood in resource-limited settings. We performed a
systematic review and meta-analysis to provide an up-to-date
summary of the extent of drug-resistant TB in Nigeria.
Methods
We searched PubMed, Scopus,
Embase, HINARI, AJOL, the Cochrane library, Web of Science, and
Google Scholar for reports published before January 31 2017,
that included any resistance, mono-resistance or multidrug
resistance to anti-TB drugs in Nigeria. Summary estimates were
calculated using random effects models.
Results
We identified 34 anti-TB
drug resistance surveys with 8002 adult TB patients consisting
of 2982 new and 5020 previously-treated cases. The prevalence
rate of any drug resistance among new TB cases was 32.0% (95% CI
24.0–40.0%; 734/2892) and among previously-treated cases,
the rate was 53.0% (95% CI 35.0–71.0%; 1467/5020).
Furthermore, multidrug resistance among new and
previously-treated cases was 6.0% (95% CI
4.0–8.0%;161/2502)and 32.0% (95%CI 20.0–44.0;
357/949), respectively. There was significant heterogeneity
between the studies (p<0.001, I2 tests). The prevalence of
drug-resistant TB varied according to methods of drug
susceptibility testing and geographic region of Nigeria.
Conclusion
The burden of
drug-resistant TB in Nigeria is high. We recommend that a
national anti-TB drug resistance survey be carried out, and
strategies for case detection and programmatic management of
drug-resistant TB in Nigeria need to be strengthened.
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Source:
PLOS ONE
