Middle East Mycobacterium tuberculosis Antibiotic Resistance: A Systematic Review and Meta-Analysis

Background: The global control of the drug resistance tuberculosis has remained as major challenge. The present study was the first review study in the Middle East region in order to determine levels of Mycobacterium tuberculosis resistance to the first-line anti-TB drugs among both new and previously treated cases. Materials and Methods: The computer-assisted search was performed by using PubMed, Google Scholar, Scopus databases and related keywords. Within the time span of 1981-2014, a total of 480 articles were collected on the antibiotic resistance rates of M. tuberculosis in different countries of the Middle East region. About 63 relevant articles were selected by applying inclusion and exclusion criteria. Results: By using meta-analyses, we determined mono drug resistance, any drug resistance, and multidrug resistance (MDR-TB) rates in both new and previously treated TB patients living in different parts of the Middle East. Other aspects related to patients, antimicrobial resistance, and methods used to assess the resistance rate were also analyzed. Conclusion: The present study revealed that in comparison with the global average rate, the prevalence rate of drug resistant TB, especially MDR-TB, may be increasing in the Middle East. Therefore, in order to prevent the spread of drug-resistant isolates, detecting primary resistance to anti-TB drugs with the use of new rapid diagnostic methods is necessary.