Rifampicin-resistant tuberculosis in Iran: A systematic review and meta-analysis

Document Type : Review Article


1 Applied Microbiology research center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

2 Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

3 Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

4 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

5 Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran


Rifampicin (RIF)-resistant strain of Mycobacterium tuberculosis is an important barrier to effective tuberculosis (TB) treatment and prevention. The present study aimed to determine the frequency of RIF-resistant TB among patients with confirmed TB. Pubmed/Medline, Embase, Web of Science, and Scopus were searched for relevant articles published between January 1980 and January 2020. We pooled data with random-effects models when appropriate. After screening 1608 citations, 30 studies covering 8215 patients with TB were included. The pooled frequency of RIF-resistance among all patients with TB was 8.0% (95% CI 4.0–12.0). Our sub-group analysis showed that 4.0% of newly diagnosed cases and 36.0% of previously-treated TB patients from different settings in Iran were RIF-resistant. Our study showed that the frequency of RIF-resistance among patients with TB was 8.0%. Programmatic implementation of rapid drug susceptibility testing (DST) such as the Xpert MTB/RIF assay as a primary diagnostic test for persons suspected of having a RIF-resistant TB would be helpful for the control of the drug resistance. 


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