Isoniazid-resistant tuberculosis in Iran: A systematic review

Area of Science:

• Medical Microbiology
• Epidemiology
• Public Health

Background:

• Isoniazid (INH) is a primary drug for tuberculosis (TB) treatment.
• INH resistance poses a major challenge to TB control programs.
• Understanding INH resistance prevalence in Iran is crucial for effective national TB control.

Purpose of the Study:

• To determine the prevalence of isoniazid (INH)-resistant tuberculosis (TB) in Iran.
• To synthesize existing data on INH resistance in the Iranian TB population.
• To inform national TB control strategies regarding INH resistance.

Main Methods:

• A systematic literature search was conducted across multiple databases (Embase, Medline, Cochrane, Iranian databases).
• Studies published between March 1999 and July 2015 focusing on INH-resistant TB in Iran were included.
• A meta-analysis was performed using Comprehensive Meta-analysis software (V2.2, Biostat) on data from 21 eligible studies.

Main Results:

• The meta-analysis included 21 studies conducted across various regions of Iran.
• Prevalence of INH resistance was found to be 12.8% in new TB cases.
• A significantly higher prevalence of INH resistance was observed in previously treated TB cases at 40.1%.

Conclusions:

• High rates of INH resistance in Iranian TB patients necessitate improved case management.
• Effective treatment regimens and advanced diagnostic facilities are essential to combat emerging INH-resistant TB.
• The findings highlight the urgent need for enhanced strategies within Iran's National TB Control Program.