Jimma Worku, Ghazisaeedi Marjan, Shahmoradi Leila, Abdurahman Ahmed Abdulahi, Kalhori Sharareh Rostam Niakan, Nasehi Mahshid, Yazdi Sharifi, Safdari Reza
Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, International Campus, Tehran, Iran.
Department of Information Science, College of Natural Sciences, Jimma University, Ethiopia.
Rev Soc Bras Med Trop. 2017 May-Jun;50(3):287-295. doi: 10.1590/0037-8682-0002-2017.
Tuberculosis, in particular drug-resistant tuberculosis, is of global concern due to the high mortality and morbidity associated with it annually. The aim of this study was to determine the prevalence of and the risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries. Four databases (PubMed, BioMed Central, EMBASE, and Web of Science) were searched using key terms. Nineteen eligible articles were identified, of which 12 and seven were used for quantitative and qualitative analysis, respectively. The overall pooled estimate of the prevalence of multidrug-resistant tuberculosis, including both new and previously treated tuberculosis cases, in Iran, Iraq, Turkey and Pakistan was 16% (95% confidence interval [CI] 11-20). The patients with a previous tuberculosis treatment history (odds ratio [OR] = 6.45; 95% CI 5.12-7.79), those aged <45 years (OR = 1.57; 95% CI 1.12-2.03), and those who were males (OR = 1.83; 95% CI 1.19-2.48) had an increased pool risk of developing multidrug-resistant tuberculosis. The forest plot revealed that the pooled odds for the development of multidrug- resistant tuberculosis were 2.01 (95% CI 1.65-2.36). Poor adherence to treatment was one of the predictors of unsuccessful treatment outcomes. Multidrug-resistant tuberculosis is a great concern for public health programs in many countries globally, including those included in this review. The risk factors for the development of multidrug-resistant tuberculosis, specifically a previous tuberculosis treatment history, should be targeted through the implementation of specialized interventions.
结核病，尤其是耐药结核病，因其每年导致的高死亡率和高发病率而受到全球关注。本研究的目的是确定伊朗及其周边国家耐多药结核病的患病率和危险因素。使用关键词检索了四个数据库（PubMed、BioMed Central、EMBASE和Web of Science）。确定了19篇符合条件的文章，其中12篇和7篇分别用于定量和定性分析。伊朗、伊拉克、土耳其和巴基斯坦耐多药结核病（包括新发病例和既往治疗病例）患病率的总体合并估计值为16%（95%置信区间[CI]11-20）。既往有结核病治疗史的患者（比值比[OR]=6.45；95%CI 5.12-7.79）、年龄<45岁的患者（OR=1.57；95%CI 1.12-2.03）以及男性患者（OR=1.83；95%CI 1.19-2.48）发生耐多药结核病的合并风险增加。森林图显示，发生耐多药结核病的合并比值比为2.01（95%CI 1.65-2.36）。治疗依从性差是治疗结果不佳的预测因素之一。耐多药结核病是全球许多国家公共卫生项目极为关注的问题，包括本综述中纳入的那些国家。耐多药结核病发生的危险因素，特别是既往结核病治疗史，应通过实施专门干预措施加以应对。
