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Risk factors associated with drug-resistant tuberculosis in Ethiopia: A systematic review and meta-analysis
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  • Ayinalem Alemu,
  • Zebenay Workneh Bitew,
  • Getu Diriba,
  • Balako Gumi
Ayinalem Alemu
Ethiopian Public Health Institute Addis Ababa Ethiopia
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Zebenay Workneh Bitew
St Paul's Hospital Millennium Medical College
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Getu Diriba
Ethiopian Public Health Institute Addis Ababa Ethiopia
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Balako Gumi
Aklilu Lemma Institute of Pathobiology Addis Ababa University Addis Ababa Ethiopia
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The emergence of drug-resistant tuberculosis (DR-TB) is becoming a challenge to the national TB control programs including Ethiopia. Different risk factors are associated with the emergence of DR-TB. Identifying these risk factors in a local setting is important to strengthen the effort to prevent and control DR-TB. Thus, this study aimed to assess the risk factors associated with drug-resistant TB in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist was followed to conduct this study. We systematically searched the articles from electronic databases and gray literature sources. We used the Joanna Briggs Institute Critical Appraisal tools to assess the quality of studies. Data were analyzed using STATA version 15. We estimated the pooled OR along with 95%CI for each risk factor. The heterogeneity of the studies was assessed using the forest plot and I 2 heterogeneity test. Besides, we explored the presence of publication bias through visual inspection of the funnel plot and Egger’s regression test. After intense searching, we found 2238 articles, and 27 eligible studies were included in the final analysis. Based on the pooled analysis of the odds ratio, unemployment (OR; 2.71, 95% CI; 1.64, 3.78), having a history of the previous TB (OR; 4.83, 95% CI; 3.02, 6.64), having contact with a known TB patient (OR; 1.72, 95% CI; 1.05, 2.40), having contact with a known MDR-TB patient (OR; 2.54, 95% CI; 1.46, 3.63), and having pulmonary TB (OR; 1.80, 95% CI; 1.14, 2.45) were found to be the risk factors of drug-resistant TB. While older age TB patients (OR; 0.77, 95% CI; 0.60, 0.95) including age above 45 years OR; (0.76, 95% CI; 0.55, 0.97), and males (OR; 0.86, 95% CI; 0.76, 0.97) were found to had lower risk of DR-TB compared to their counterparts. A previous history of TB treatment is a major risk factor for acquiring DR-TB in Ethiopia that might be due to poor adherence during the first-line anti TB treatment. Besides, having contact with a known TB patient, having contact with a known MDR-TB patient, having pulmonary TB, and being unemployed were the risk factors of DR-TB in Ethiopia. Thus, active screening of TB contacts for DR-TB might help to detect DR-TB cases as early as possible and could help to mitigate its further transmission across the community.
14 Sep 2021Submitted to Transboundary and Emerging Diseases
14 Sep 2021Submission Checks Completed
14 Sep 2021Assigned to Editor
20 Sep 2021Reviewer(s) Assigned
08 Oct 2021Review(s) Completed, Editorial Evaluation Pending
08 Oct 2021Editorial Decision: Revise Minor
15 Oct 20211st Revision Received
15 Oct 2021Submission Checks Completed
15 Oct 2021Assigned to Editor
18 Oct 2021Reviewer(s) Assigned
26 Oct 2021Review(s) Completed, Editorial Evaluation Pending
27 Oct 2021Editorial Decision: Accept
19 Nov 2021Published in Transboundary and Emerging Diseases. 10.1111/tbed.14378