02432nas a2200217   4500000000100000008004100001260001200042653002000054653001800074653002500092653001500117100001600132700001300148700001600161245012100177856015300298300000800451490000700459520173400466022001402200       2024                            d  c12/202410aDrug Resistance10aMeta-analysis10aMycobacterium leprae10aPrevalence1 aZivarifar H1 aAhrari F1 aKarbalaei M00aComputational investigation of the global prevalence of multidrug resistant : A systematic review and meta-analysis.  uhttps://www.sciencedirect.com/science/article/pii/S2405579424000822/pdfft?md5=ee5a762e9b33f158b2ec5fafb7ed4303&pid=1-s2.0-S2405579424000822-main.pdf  a1-80 v373 a<p><strong>Background: </strong>Leprosy is a chronic infectious disease caused by () However, the emergence of drug-resistant strains of this bacterium, especially multidrug-resistant (MDR) strains, is a serious concern. This study aimed to evaluate the global prevalence of MDR and its implications.</p>

<p><strong>Methods: </strong>Using PRISMA guidelines, we systematically reviewed ISI Web of Science, MEDLINE, and EMBASE up to August 2023 to assess the prevalence of MDR . We included human clinical trials on MDR , as well as excluded reviews, animal studies, and unavailable full texts. Data was analyzed using Comprehensive Meta-Analysis software, and publication bias was addressed using Egger's, Begg's tests, and the trim-fill method.</p>

<p><strong>Results: </strong>Overall, 861 articles were initially identified, of which 28 met the methodological criteria for inclusion in the quantitative synthesis. Statistically, the combined prevalence of drug resistant was approximated at 11.7&nbsp;% (95&nbsp;% CI: 7.7-17.3; : 90.79; value&nbsp;=&nbsp;0.01). Specific drug resistance rates included 7.4&nbsp;% to dapsone and 5.1&nbsp;% to rifampin, among others. The global rate for MDR was measured at 2.2&nbsp;% (95&nbsp;% CI: 1.2-3.9; : 82.68; value&nbsp;=&nbsp;0.01). Factors such as bacterial density and the lepromatous phase were associated with elevated DR risk (OR: 2.69; 95&nbsp;% CI: 1.35-2.48). A systematic assessment of publication bias indicated a minimal impact on the general results.</p>

<p><strong>Conclusions: </strong>The increasing prevalence of MDR globally requires urgent and strategic interventions to prevent further spread, which in turn is effective in treating leprosy patients.</p>
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