title: Prevalence of drug-resistant tuberculosis in Iran: systematic review and meta-analysis.
abstract: BACKGROUND
  The spread of multidrug-resistant tuberculosis (MDR-TB) is a major public health problem worldwide. Although drug resistance is common in some countries and rare in others, the extent of this condition is not precisely known in Iran.
  
  
  METHODS
  We searched several databases including PubMed, Web of Science, Scopus, Iran Medex, and Scientific Information Database to identify studies addressing drug-resistant tuberculosis in Iran. A total of 19 reports published from different regions of Iran from March 1999-May 2013 were included in this study.
  
  
  RESULTS
  The meta-analyses revealed that 23% (95% confidence interval [CI], 21.8-24.2) of new cases and 65.6% (95% CI, 62.5-68.5) of previously treated cases were resistant to at least 1 drug. Furthermore, MDR-TB was found in 5.1% (95% CI, 4.4-5.8) of new cases, whereas it was found in 33.7% (95% CI, 30.8-36.7) of retreatment cases. The highest rate of resistance in new and previously treated cases was seen against streptomycin (19%) and isoniazid (47%), respectively.
  
  
  CONCLUSIONS
  The results of the present study underscore the need for further enforcement of TB control strategies. Drug susceptibility testing, establishing advanced diagnostic facilities, and continuous monitoring of drug resistance are recommended for prevention and control of MDR-TB.
authors.affiliation: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mj.nasiri@sbmu.ac.ir.
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Nasiri
authors.affiliation: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Dabiri
authors.affiliation: Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Darban-Sarokhalil
authors.affiliation: Chemical and Biological Engineering, University of British Columbia (UBC), Vancouver, BC, Canada.
authors.forename: Maryam
authors.initials: M
authors.lastname: Rezadehbashi
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Samin
authors.initials: S
authors.lastname: Zamani
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology; D006801:Humans; D007492:Iran / Q000453:epidemiology; D007538:Isoniazid / Q000494:pharmacology; D015995:Prevalence; D013307:Streptomycin / Q000494:pharmacology; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D013307:Streptomycin
keywords: Drug resistance; Iran; Tuberculosis