title: Isoniazid-resistant tuberculosis in Iran: A systematic review.
abstract: Isoniazid (INH) is one of the most potent anti-tuberculosis (TB) agents. INH resistance is an obstacle to the treatment of TB disease and the National TB control Program (NTP). We aimed to determine the true prevalence of INH-resistant TB in Iran. Several databases including Embase, Medline, Cochrane library and Iranian databases were searched to identify studies addressing INH-resistant tuberculosis in Iran. We identified 156 articles, of which 129 records were excluded based on their titles and abstracts. In a secondary screening, we assessed the eligibility of 27 full-text articles of which, 6 did not report usage data. Finally, 21 studies published from different regions of Iran from March 1999 until July 2015 were included in this study. Comprehensive meta-analysis (V2.2, Biostat) software was used to analyze the data. The meta-analysis showed that 12.8% (95% CI 9.4-15.8; I(2) = 87.8; P < 0.001 test for heterogeneity) of new TB cases and 40.1% (95% CI 28.5-53.0; I(2) = 88.2; P < 0.001 test for heterogeneity) of previously treated cases were resistant to INH. High prevalence of INH resistance among TB patients has been reported in many health-care settings, suggesting that better management of such cases, use of effective treatment regimens and establishing advanced diagnostic facilities are needed to avoid further emergence of INH-resistant TB.
authors.affiliation: Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Javad Nasiri
authors.affiliation: Department of Medical Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza Salimi
authors.initials: AS
authors.lastname: Chirani
authors.affiliation: Department of Drug and Food Control, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Amin
authors.affiliation: Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Raheleh
authors.initials: R
authors.lastname: Halabian
authors.affiliation: Applied Microbiology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran. Electronic address: imanifouladi.a@gmail.com.
authors.forename: Abbas Ali
authors.initials: AA
authors.lastname: Imani Fooladi
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D024881:Drug Resistance, Bacterial; D006801:Humans; D007492:Iran / Q000453:epidemiology; D007538:Isoniazid / Q000009:adverse effects / Q000627:therapeutic use*; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000472:pathogenicity; D015995:Prevalence; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid
keywords: Analysis; Iran; Isoniazid; Tuberculosis