Hajissa Khalid, Marzan Mahfuza, Idriss Mubarak Ibrahim, Islam Md Asiful
Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.
Department of Zoology, Faculty of Science and Technology, Omdurman Islamic University, P.O. Box 382, Omdurman 14415, Sudan.
Antibiotics (Basel). 2021 Jul 31;10(8):932. doi: 10.3390/antibiotics10080932.
Drug-resistant tuberculosis (DR-TB) is still one of the most critical issues impeding worldwide TB control efforts. The aim of this systematic review and meta-analysis was to give an updated picture of the prevalence of DR-TB in Sudan. A comprehensive systematic search was performed on four electronic databases (PubMed, Scopus, Web of Science and Google Scholar) to identify all published studies reporting prevalence data of DR-TB in Sudan. Sixteen eligible studies published during 2002-2020 were included. Using meta-analysis of proportions, the pooled prevalence of TB cases with resistance to any anti-TB drugs was 47.0% (95% CI: 35.5-58.6%). The overall prevalence of mono, multi, poly and extensive drug resistance were estimated to be 16.2% (95% CI: 9.0-23.4%), 22.8% (95% CI: 16.0-29.7%), 6.8% (95% CI: 0.5-13.0%) and 0.7% (95% CI: 0-2.1%), respectively. Considering any first-line anti-TB drugs, the resistance prevalence was highest for isoniazid (32.3%) and streptomycin (31.7%), followed by rifampicin (29.2%). In contrast, resistance against second-line drugs was reported for only two antibiotics, namely, ofloxacin (2.1%) and kanamycin (0.7%). Of note, the resistance profile of the previously treated patients was found to be remarkably high compared with the newly diagnosed TB patients. The relatively high prevalence estimation of anti-TB drug resistance warrants strengthening TB control and treatment strategies in Sudan.
耐多药结核病（DR-TB）仍然是阻碍全球结核病防控工作的最关键问题之一。本系统评价和荟萃分析的目的是更新苏丹耐多药结核病的流行情况。对四个电子数据库（PubMed、Scopus、科学网和谷歌学术）进行了全面的系统检索，以确定所有报告苏丹耐多药结核病流行率数据的已发表研究。纳入了2002年至2020年期间发表的16项符合条件的研究。使用比例荟萃分析，对任何抗结核药物耐药的结核病病例的合并流行率为47.0%（95%CI：35.5-58.6%）。单耐药、多耐药、泛耐药和广泛耐药的总体流行率估计分别为16.2%（95%CI：9.0-23.4%）、22.8%（95%CI：16.0-29.7%）、6.8%（95%CI：0.5-13.0%）和0.7%（95%CI：0-2.1%）。考虑任何一线抗结核药物，异烟肼（32.3%）和链霉素（31.7%）的耐药率最高，其次是利福平（29.2%）。相比之下，仅报告了两种二线药物的耐药情况，即氧氟沙星（2.1%）和卡那霉素（0.7%）。值得注意的是，与新诊断的结核病患者相比，先前治疗患者的耐药情况明显更高。抗结核药物耐药率的相对较高估计值表明苏丹需要加强结核病防控和治疗策略。
