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Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis

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  • Ying Xi
  • Wei Zhang
  • Rui-Jun Qiao
  • Jun Tang

Abstract

Background: Since multidrug-resistant tuberculosis (MDR-TB) is a significant public health problem worldwide, identifying associated risk factors is critical for developing appropriate control strategies. Methods: A systematic review and meta-analysis was conducted for identifying factors independently predicting MDR-TB. The random-effects model was used to determine pooled odds ratios (ORs) and respective 95% confidence intervals (CIs) for the related factors. Results: Of the 2301 retrieved reports, 28 studies were analyzed, assessing 3152 MDR-TB and 52715 DS-TB cases. Totally 22 related factors were analyzed. The pooled ORs were 1.478 (95%CI 1.077–2.028) for positive sputum AFB smear, 1.716 (95%CI 1.149–2.564) for lung cavity, 6.078 (95%CI 2.903–12.725) for previous TB disease and 5.427 (95%CI 3.469–8.490) for a history of anti-TB therapy. All Z test p values were below 0.05, indicating these parameters were significantly associated with MDR-TB. Conclusions: Positive sputum AFB smear, lung cavity, previously diagnosed TB and a history of anti-TB therapy are significant risk factors for MDR-TB, which are independent of the clinical setting worldwide. Increased attention should be paid to cases with such parameters to achieve more effective TB control and avoid MDR-TB through the development of a global policy.

Suggested Citation

  • Ying Xi & Wei Zhang & Rui-Jun Qiao & Jun Tang, 2022. "Risk factors for multidrug-resistant tuberculosis: A worldwide systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 17(6), pages 1-15, June.
    • Handle: RePEc:plo:pone00:0270003
    DOI: 10.1371/journal.pone.0270003
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