Multidrug resistant tuberculosis treatment outcome in children in developing and developed countries: A systematic review and meta-analysis

BACKGROUND: We aimed to compare and contrast the proportions of treatment outcome between developing and developed countries in children treated for multidrug resistance tuberculosis (MDR-TB). METHODS: We conducted a systematic review and meta-analysis of articles published on children treated for MDR-TB. We searched published articles from electronic databases: PubMed/Medline, EMBASE, Scopus and Web of Science for English articles without restricting publication year. We employed random-effects meta-analysis model to estimate the pooled proportions of treatment success, death, treatment failure and lost to follow up. RESULTS: We pooled data of 1,343 children obtained from 17 included studies, and the overall pooled treatment success was 77.0% (95% Confidence Interval (CI), 69.0-85.0). Pooled treatment success in developing countries was 73.0% (63.0-83.0), while in developed countries 87.0% (81.0-94.0). The overall pooled treatment failure was 3.0% (1.0-6.0), while death 8.0% (4.0-11.0) and lost to follow up 10.0% (6.0-4). CONCLUSION: MDR-TB treatment success in children is well achieved in both developed and developing countries by currently available drugs. Improving MDR-TB treatment programme is vital to achieve the maximum treatment successful. Promoting research on pediatric MDR-TB treatment outcome could also help to fill evidence gap.