The prevalence of Mycobacterium tuberculosis and rifampicin-resistance strains using GeneXpert-MTB/RIF assay in Ethiopia: a systematic review and meta-analysis.

Abstract

<h4>Background</h4>The spread of tuberculosis (TB), including strains resistant to at least rifampicin and/or isoniazid, remains a major public health problem in developing nations, yet few comprehensive and comparative data on TB have been produced. The aim of this systematic review and meta-analysis is to determine the pooled prevalence of TB in general and rifampicin-resistant tuberculosis (RR-TB) among presumptive TB patients across different demographic groups in Ethiopia. A presumptive TB patient is someone who shows symptoms or risk factors suggestive of tuberculosis and therefore requires testing.<h4>Methods</h4>For this systematic reviews and meta-analysis PubMed, and Google Scholar databases were searched. In addition, relevant studies were also searched from the bibliographies of eligible studies and from other meta-analysis studies. A selection and inclusion-exclusion process for the required articles was made as per the study objectives and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and the Joanna Briggs Institute's (JBI) essential appraisal tools were followed during the entire protocol development. The pooled prevalence of TB in general and RR-TB among different demographic categories was estimated with a random-effects model on Statistical Software Package (STATA) version 14.0.<h4>Results</h4>A total of 39 research articles fulfilled the inclusion criteria for this systematic review and meta-analysis. The overall pooled prevalence estimates of TB in general and RR-TB were 15% (95% CI; 0.13-0.17) and 8% (95% CI; 0.07-0.10), respectively. The pooled prevalence of each pulmonary TB and extrapulmonary TB cases was equally 15%, and the pooled prevalence of RR-TB was 8% and 9%, respectively. The pooled prevalence of TB among male and female was 15%, and 13%, whereas RR-TB was detected in 10% and 9% of the TB cases, respectively. Among adults and children, the pooled prevalence of TB was 15% and 13%, whereas RR-TB was detected in 9% and 8% of the TB cases, respectively. The pooled prevalence of TB among newly diagnosed and previous treated TB cases was 13% and 22%, whereas RR-TB was 7% and 17%, respectively. Among HIV-positive cases, the pooled prevalence of TB was 20%, whereas the RR-TB was detected in 13% of TB-HIV cases.<h4>Conclusion</h4>This meta-analysis report concluded that the pooled prevalence of TB in general and RR-TB was high across various demographic categories in Ethiopia. Hence, the finding highlights the need to implement integrated intervention approaches such as early case detection, rapid diagnosis, treatment adherence support, and contact tracing to reduce the continued spreading of TB infections, with an emphasis on reducing the spread of drug- resistant TB strains.