Ivan Surya Pradipta1, Lina Davies Forsman2, Judith Bruchfeld2, Eelko Hak3, Jan-Willem Alffenaar4. 1. University of Groningen, Groningen Research Institute of Pharmacy, Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTE2), Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands; Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Indonesia; University of Groningen, University Medical Centrum Groningen, Department of Clinical Pharmacy and Pharmacology, The Netherlands. Electronic address: ivanpradipta@unpad.ac.id. 2. Unit of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden. 3. University of Groningen, Groningen Research Institute of Pharmacy, Unit of Pharmaco-Therapy, -Epidemiology and -Economics (PTE2), Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. 4. University of Groningen, University Medical Centrum Groningen, Department of Clinical Pharmacy and Pharmacology, The Netherlands.
Abstract
OBJECTIVES: Since the risk of multidrug-resistant tuberculosis (MDR-TB) may depend on the setting, we aimed to determine the associations of risk factors of MDR-TB across different regions. METHODS: A systematic review and meta-analysis was performed with Pubmed and Embase databases. Information was retrieved on 37 pre-defined risk factors of MDR-TB. We estimated overall Mantel-Haenszel odds ratio as a measure of the association. RESULTS: Factors of previous TB disease and treatment are the most important risk factors associated with MDR-TB. There was also a trend towards increased risk of MDR-TB for patients 40 years and older, unemployed, lacking health insurance, smear positive, with non-completion and failure of TB treatment, showing adverse drug reaction, non-adherent, HIV positive, with COPD and with M. Tuberculosis Beijing infection. Effect modification by geographical area was identified for several risk factors such as male gender, married patients, urban domicile, homelessness and history of imprisonment. CONCLUSIONS: Assessment of risk factors of MDR-TB should be conducted regionally to develop the most effective strategy for MDR-TB control. Across all regions, factors associated with previous TB disease and treatment are essential risk factors, indicating the appropriateness of diagnosis, treatment and monitoring are an important requirements.
OBJECTIVES: Since the risk of multidrug-resistant tuberculosis (MDR-TB) may depend on the setting, we aimed to determine the associations of risk factors of MDR-TB across different regions. METHODS: A systematic review and meta-analysis was performed with Pubmed and Embase databases. Information was retrieved on 37 pre-defined risk factors of MDR-TB. We estimated overall Mantel-Haenszel odds ratio as a measure of the association. RESULTS: Factors of previous TB disease and treatment are the most important risk factors associated with MDR-TB. There was also a trend towards increased risk of MDR-TB for patients 40 years and older, unemployed, lacking health insurance, smear positive, with non-completion and failure of TB treatment, showing adverse drug reaction, non-adherent, HIV positive, with COPD and with M. Tuberculosis Beijing infection. Effect modification by geographical area was identified for several risk factors such as male gender, married patients, urban domicile, homelessness and history of imprisonment. CONCLUSIONS: Assessment of risk factors of MDR-TB should be conducted regionally to develop the most effective strategy for MDR-TB control. Across all regions, factors associated with previous TB disease and treatment are essential risk factors, indicating the appropriateness of diagnosis, treatment and monitoring are an important requirements.
Authors: Bertin C Bisimwa; Jean B Nachega; Robin M Warren; Grant Theron; John Z Metcalfe; Maunank Shah; Andreas H Diacon; Nadia A Sam-Agudu; Marcel Yotebieng; André N H Bulabula; Patrick D M C Katoto; Jean-Paul Chirambiza; Rosette Nyota; Freddy M Birembano; Eric M Musafiri; Sifa Byadunia; Esto Bahizire; Michel K Kaswa; Steven Callens; Zacharie M Kashongwe Journal: Clin Infect Dis Date: 2021-07-15 Impact factor: 9.079
Authors: Mahad Ahmed Khan; Wajeeha Bilal; Hanzla Asim; Zainab Syyeda Rahmat; Mohammad Yasir Essar; Shoaib Ahmad Journal: Ann Med Surg (Lond) Date: 2022-06-17
Authors: Ivan S Pradipta; Natasha Van't Boveneind-Vrubleuskaya; Onno W Akkerman; Jan-Willem C Alffenaar; Eelko Hak Journal: Antimicrob Resist Infect Control Date: 2019-07-12 Impact factor: 4.887
Authors: Joseph Baruch Baluku; Pallen Mugabe; Rose Mulwana; Sylvia Nassozi; Richard Katuramu; William Worodria Journal: Biomed Res Int Date: 2020-07-25 Impact factor: 3.411