Prevalence of multidrug-resistant tuberculosis (MDR-TB) in India: A mini systematic review and meta-analysis (2016–2022)

India carries the highest global burden of tuberculosis and multidrug-resistant tuberculosis (MDR-TB) (26%). There remains an uncertainty around the population-based estimates of MDR-TB in India. Applying a systematic review approach, we searched PubMed and Scopus to identify studies reporting the prevalence of MDR-TB among new and/or previously treated patients (cases) at any site in India and published during 2016–2022. Of 341 retrieved articles, we could select only 10 and excluded many as they were either unrelated or had limitations. From the meta-analysis of available studies, we found the pooled prevalence of MDR-TB among new cases as 3.9% (95% (CI 2.2–6.1) and as 13.4% (95% CI 8.8–18.7) among previously treated cases. Overall, it was 6.7% (95% CI 4.2–9.6). Albeit with a wider confidence intervals, the prevalence figures calculated from the present study are comparable to those reported by the National Anti-TB Drug Resistance Survey. Among selected studies, the majority were from North India and the recent data on prevalence are lacking for other Indian regions. This mini-review highlights the need for the Indian National TB Elimination Program to make provisions for regional periodic prevalence surveys for careful designing of MDR-TB control strategies.