Extensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis

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dc.contributor.advisorNcayiyana, Jabulani
dc.contributor.advisorEngel, Mark E.
dc.contributor.authorKosmas, Petrus Ndiiluka
dc.date.accessioned2020-03-17T10:25:27Z
dc.date.available2020-03-17T10:25:27Z
dc.date.issued2019
dc.date.updated2020-03-16T14:47:44Z
dc.description.abstractBackground: There is a dearth of information regarding prevalence of extensively drugresistant tuberculosis (XDR-TB) in Africa. Although countries in Africa conduct national tuberculosis surveys on a regular basis, this information has not been systematically reviewed to ascertain the overall prevalence of XDR-TB in Africa. Methods: The study aimed to perform a systematic review and meta-analysis of the prevalence and factors associated with prevalence of pulmonary XDR-TB among adults in Africa. Eligible studies, published between 2006 and 2018, were sourced from various electronic databases including PubMed, Scopus, and Web of Science. Meta-analysis was performed using STATA (version 14.2) statistical software. The protocol of this review was registered with PROSPERO, reg No CRD42018117037. Result: A total of 6242 records were retrieved. Forty-eight studies were screened for eligibility and seven, which varied in terms of country setting and study design, were included. The prevalence of XDR-TB is 4% (95%CI 2-7) among participants tested for second-line anti-TB drug resistance, and 3% (95%1-6) among participants with drug resistant TB. The prevalence of XDR-TB was 7% (95%CI 1-18) among participants with MDR-TB. A few studies reported on the factors associated with the prevalence of XDR-TB. Discussion: The reported prevalence of XDR-TB among participants tested for second-line anti-TB drug resistance is low compared to WHO estimates. The systematic review underscores a dearth of studies depicting the reality regarding the prevalence of XDR-TB in Africa. Policymakers and stakeholders interested in drug-resistant TB should apply prudence when considering XDR-TB prevalence reported for Africa.
dc.identifier.apacitationKosmas, P. N. (2019). <i>Extensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/31604en_ZA
dc.identifier.chicagocitationKosmas, Petrus Ndiiluka. <i>"Extensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2019. http://hdl.handle.net/11427/31604en_ZA
dc.identifier.citationKosmas, P.N. 2019. Extensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/31604en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Kosmas, Petrus Ndiiluka AB - Background: There is a dearth of information regarding prevalence of extensively drugresistant tuberculosis (XDR-TB) in Africa. Although countries in Africa conduct national tuberculosis surveys on a regular basis, this information has not been systematically reviewed to ascertain the overall prevalence of XDR-TB in Africa. Methods: The study aimed to perform a systematic review and meta-analysis of the prevalence and factors associated with prevalence of pulmonary XDR-TB among adults in Africa. Eligible studies, published between 2006 and 2018, were sourced from various electronic databases including PubMed, Scopus, and Web of Science. Meta-analysis was performed using STATA (version 14.2) statistical software. The protocol of this review was registered with PROSPERO, reg No CRD42018117037. Result: A total of 6242 records were retrieved. Forty-eight studies were screened for eligibility and seven, which varied in terms of country setting and study design, were included. The prevalence of XDR-TB is 4% (95%CI 2-7) among participants tested for second-line anti-TB drug resistance, and 3% (95%1-6) among participants with drug resistant TB. The prevalence of XDR-TB was 7% (95%CI 1-18) among participants with MDR-TB. A few studies reported on the factors associated with the prevalence of XDR-TB. Discussion: The reported prevalence of XDR-TB among participants tested for second-line anti-TB drug resistance is low compared to WHO estimates. The systematic review underscores a dearth of studies depicting the reality regarding the prevalence of XDR-TB in Africa. Policymakers and stakeholders interested in drug-resistant TB should apply prudence when considering XDR-TB prevalence reported for Africa. DA - 2019 DB - OpenUCT DP - University of Cape Town KW - prevalence KW - tuberculosis KW - extensively drug-resistant tuberculosis KW - drug resistance KW - drug susceptibil LK - https://open.uct.ac.za PY - 2019 T1 - Extensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis TI - Extensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis UR - http://hdl.handle.net/11427/31604 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/31604
dc.identifier.vancouvercitationKosmas PN. Extensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2019 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/31604en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectprevalence
dc.subjecttuberculosis
dc.subjectextensively drug-resistant tuberculosis
dc.subjectdrug resistance
dc.subjectdrug susceptibil
dc.titleExtensively drug-resistant tuberculosis in Africa: prevalence and factors associated: a systematic review and meta-analysis
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPH
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