Toft Asbjørn Langeland, Dahl Victor Næstholt, Sifna Armando, Ige Olusoji Mayowa, Schwoebel Valérie, Souleymane Mahamadou Bassirou, Piubello Alberto, Wejse Christian
Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; Center for Global Health, Aarhus University (GloHAU), Aarhus, Denmark.
Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark; Center for Global Health, Aarhus University (GloHAU), Aarhus, Denmark.
Int J Infect Dis. 2022 Nov;124 Suppl 1:S107-S116. doi: 10.1016/j.ijid.2022.08.015. Epub 2022 Aug 22.
We aimed to investigate published data on treatment outcomes of multidrug-resistant (MDR)/rifampicin-resistant tuberculosis (TB) in Central and West Africa because these, to the best of our knowledge, are sparsely available.
Systematic review and meta-analysis.
A total of 14 studies were included, representing 4268 individuals in 14 of the 26 countries. Using a random-effects model meta-analysis, we observed a pooled success rate of 80.8% (95% confidence interval [CI] 56.0-93.3) for the Central African subgroup and 69.2% (95% CI 56.3-79.7) for the West African subgroup (P = 0.0522). The overall treatment success for all studies was 74.6% (95% CI 65.0-82.2). We found high heterogeneity among included studies (I = 96.1%). The estimated proportion of successfully treated individuals with MDR/rifampicin-resistant TB was considerably higher than the global estimate provided by the World Health Organization (59%), reaching the 2015 World Health Organization target of at least 75% treatment success for MDR-TB.
The use of shorter treatment regimens and the standardized treatment conditions, including directly observed therapy in these studies, could have contributed to a high treatment success. Yet, the available literature was not fully representative of the regions, possibly highlighting the sparse resources in many of these countries. The review was registered at PROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42022353163).
我们旨在调查中非和西非耐多药/利福平耐药结核病治疗结果的已发表数据，因为据我们所知，这些数据很少。
系统评价和荟萃分析。
共纳入14项研究，代表26个国家中14个国家的4268名个体。使用随机效应模型荟萃分析，我们观察到中非亚组的综合成功率为80.8%（95%置信区间[CI]56.0 - 93.3），西非亚组为69.2%（95%CI 56.3 - 79.7）（P = 0.0522）。所有研究的总体治疗成功率为74.6%（95%CI 65.0 - 82.2）。我们发现纳入研究之间存在高度异质性（I = 96.1%）。耐多药/利福平耐药结核病成功治疗个体的估计比例明显高于世界卫生组织提供的全球估计值（59%），达到了世界卫生组织2015年耐多药结核病治疗成功率至少75%的目标。
在这些研究中使用较短的治疗方案和标准化的治疗条件，包括直接观察治疗，可能有助于提高治疗成功率。然而，现有文献并不完全代表这些地区，这可能凸显了这些国家中许多国家资源匮乏的情况。该评价已在PROSPERO（https://www.crd.york.ac.uk/prospero/）（CRD42022353163）注册。
