Prevalence and Patterns of Drug-Resistant Tuberculosis in India: Evidence from the last 2.5 decades

Abstract

Drug-resistant tuberculosis (DR-TB) is a problem that dissuades the tuberculosis control and prevention efforts worldwide. A big portion of the world’s TB burden is seen in India. We aimed to produce valuable evidence on the prevalence and patterns of DR-TB pan India for a period of last 2.5 decades. We systematically searched PubMed, Google Scholar and major TB journals for studies published between 1996 till 2020, which reported the prevalence of DR-TB in India. We included sub-groups of pulmonary, extrapulmonary, and paediatric patients in our analysis considering the paucity of data in these sub-groups. We used random effects to estimate prevalence of DR-TB and its types, and I² statistic to assess heterogeneity. A total of 789 studies were screened, of which 132 non-duplicate studies were included. Any drug resistance, multi- and extensive-drug resistance was seen in 33.67%, 11.69% and 1.61% cases, respectively. Multi-drug resistance (MDR) among new TB patients and previously treated patients was 1.03% and 23.87%. MDR prevalence among pulmonary, extrapulmonary, and paediatric groups was 11.43%, 11.91%, 9.06% respectively. There was high heterogeneity between the studies. We conclude that continuous DR-TB surveillance is crucial to ensure programmatic success and to control the spread of DR-TB.