Systematic review of the prevalence of Mycobacterium tuberculosis resistance in Saudi Arabia.

Aim: To quantitatively estimate the prevalence of resistance of Mycobacterium tuberculosis (TB) to first line agents in Saudi Arabia. Methods: The overall prevalence of M. tuberculosis resistance was calculated using meta-analysis. Results: We included 22 studies from Saudi Arabia that were published from 1979 to 2013. A high degree of heterogeneity among studies was observed. Based on random effect methodology, the prevalence (and 95% CI) of the resistance rates were: INH 10.13 (8.13-12.11), rifampicin 5.41 (4.21-6.61), ethambutol 1.29 (1.83-2.37) and streptomycin 6.5 (4.9-8.1), and multi-drug resistant was 6.7 (5.1-8.3). Conclusion: The prevalence of resistance to anti-tuberculous agents was highest for INH followed by streptomycin and rifampicin. Multi-drug resistant tuberculosis remains at 6.7%. The data support the recommendations to use four anti-tuberculous agents as empiric therapy.