Treatment outcomes for multidrug- and rifampicin-resistant tuberculosis in Central and West Africa: a systematic review and meta-analysis

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  • Asbjørn Langeland Toft
  • ,
  • Victor Næstholt Dahl
  • Armando Sifna, Bandim Health Project
  • ,
  • Olusoji Mayowa Ige, Univ Coll Hosp, University College Hospital, Ibadan, University of Ibadan
  • ,
  • Valérie Schwoebel, Independent Consultant. Formerly: EuroTB & International Union Against Tuberculosis and Lung Disease (The Union)
  • ,
  • Mahamadou Bassirou Souleymane, Damien Foundation
  • ,
  • Alberto Piubello, Damien Foundation
  • ,
  • Christian Wejse

OBJECTIVES: We aimed to investigate published data on treatment outcomes of MDR/RR-TB in Central and West Africa as these, to our knowledge, are sparsely available.

METHODS: Systematic review and meta-analysis RESULTS: 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%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 2=96.1%]. The estimated proportion of successfully treated MDR/RR-TB individuals was considerably higher than the global estimate provided by the WHO (59%) reaching the 2015 WHO target of at least 75% treatment success for MDR-TB.

CONCLUSIONS: The use of shorter treatment regimens and the standardized treatment conditions including DOT 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/) (CRC42022350645).

Original languageEnglish
JournalInternational Journal of Infectious Diseases
ISSN1201-9712
DOIs
Publication statusE-pub ahead of print - 22 Aug 2022

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