CONTRIBUTING FACTORS LINKED TO THE INCREASED RISK OF MULTI-DRUG- RESISTANT TUBERCULOSIS IN PAKISTAN, META-ANALYSIS.

J Peop Univ Med Health Sci. 2025:15(2), 245-253.http://doi.org/10.46536/jpumhs/2025/15.02.647

Abstract

BACKGROUND: One of the most important public health issues related to tuberculosis (TB) is the
growing problem of multidrug-resistant TB (MDR-TB), especially in high-burden countries like
Pakistan. MDR-TB is defined as tuberculosis caused by strains which are resistant to at least two of
the most used first-line treatments for TB. There are many factors supporting the emergence and
spread of MDR-TB in Pakistan including socio-economic status, healthcare infrastructure, treatment
compliance levels, and even population movement. OBJECTIVE: This aim of this meta-analysis is
looking into demographic details along with previous treatment history, somatic illnesses, surrounding
environment, and other relevant factors to assess their contribution towards the development and
progression of MDR-TB in Pakistan. METHODS: We reviewed literature published from 2000 to
2024. The studies included in this meta-analysis featured both cross-sectional and cohort designs of
varying sample sizes. Multiple databases related to medicine and public health were searched for
relevant articles. Information including age, sex, education, job title, previous tuberculosis
management, other existing health illnesses, and their housing conditions were gathered. RESULTS:
The most significant risk factors are a history of treatment for TB, low educational level, poor
compliance with treatment, lack of employment, and close contact with MDR-TB patients. The most
affected age group is 20 to 40 years, with an almost equal predominance of males. The most common
reported comorbidities are diabetes, CKD, and HIV, that also raise the risk of developing MDR-TB.
Moreover, crowded living arrangements and restricted healthcare access were identified as prominent
drivers of the problem. CONCLUSION: This meta-analysis calls for complete strategies to address
MDR-TB in Pakistan. It is essential to counteract socio-economic disparities, enhance TB medication
adherence, and enhance household screening and prevention measures to manage the transmission of
MDR-TB efficiently. Public health activities should target high-risk populations, especially those with
a past history of TB infection or comorbid conditions.