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Risk factors of multidrug-resistant tuberculosis: A global systematic review and meta-analysis

Pradipta, I. S., Forsman, L. D., Bruchfeld, J., Hak, E. & Alffenaar, J-W., Dec-2018, In : Journal of infection. 77, 6, p. 469-478 10 p.

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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. (c) 2018 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)469-478
Number of pages10
JournalJournal of infection
Volume77
Issue number6
Early online date16-Sep-2018
Publication statusPublished - Dec-2018

    Keywords

  • MDR-TB, Risk factors, Tuberculosis control, Tuberculosis epidemiology, ACQUIRED DRUG-RESISTANCE, MYCOBACTERIUM-TUBERCULOSIS, TREATMENT FAILURE, CHINA, RELIABILITY, INFECTION, VIRULENCE, DISEASE

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