2026-10-13T21:02:06Z https://api.figshare.com/v2/oai

oai:figshare.com:article/34016962 2026-09-28T17:38:46Z category_7 category_21 category_64 category_106 category_132 category_134 portal_5 item_type_3 month_year_09_2026

Publication bias using Egger’s test. Muluneh Assefa (12029676) Mitkie Tigabie (16274405) Abebaw Setegn (19485456) Yenesew Mihret Wondmagegn (19485459) Azanaw Amare (6589409) Getu Girmay (19068230) Sirak Biset (12400926) Wesam Taher Almagharbeh (21604373) Medicine Biotechnology Cancer Science Policy Infectious Diseases Virology valuable evidence synthesis preferred reporting items egger &# 8217 2019 &# 8211 2005 &# 8211 relatively higher prevalence analysis </ p 3 %, respectively overall pooled prevalence tb across studies resistant tuberculosis cases single study conducted tb among mdr single studies subgroup analysis resistant tuberculosis pooled prevalence pooled proportions significant prevalence xlink "> tukey transformation systematic reviews systematic review study year study aimed strengthened surveillance relevant articles oromia reported local strains i2 statistic funnel plot forest plot extracted data effects model effect size confidence interval computed using challenging problems better management become one addis ababa 69 %) 656 new 07 %). <div> BackgroundThe burden of pre-extensively drug-resistant tuberculosis (Pre-XDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) cases in Ethiopia has become one of the most challenging problems for monitoring the treatment of patients with multidrug-resistant tuberculosis (MDR-TB). This study aimed to provide a valuable evidence synthesis on the pooled prevalence of Pre-XDR and XDR-TB among MDR-TB patients in Ethiopia. MethodologyThis study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Extracted data from relevant articles were analyzed using STATA version 17.0. The pooled estimate of the effect size was computed using a restricted maximum likelihood random-effects model, considering a 95% confidence interval, and a forest plot was used to visualize the proportion of Pre-XDR and XDR-TB. Because the Pre-XDR and XDR-TB cases are rare, the Freeman-Tukey double arcsine transformation was applied to estimate the pooled proportions. The I2 statistic and Galbraith plot confirmed heterogeneity. A univariate meta-regression, sensitivity, and subgroup analyses were conducted to identify the source of heterogeneity. Egger’s test and funnel plot were used to check publication bias. ResultsEight studies comprising 1,518 MDR-TB patients, with 656 new and 862 previously treated cases, were included. Among those, 52 Pre-XDR and 13 XDR-TB cases were identified. According to the Freeman-Tukey transformation, the overall pooled prevalence of Pre-XDR-TB was 3% (95% CI: 2%-5%, I2 = 43.69%) and XDR-TB was 1% (95% CI: 0%-4%, I2 = 54.07%). In the subgroup analysis, the prevalence of Pre-XDR-TB across studies from multiple regions of Ethiopia was 7% (95% CI: 3%-13%), and in Addis Ababa, it was 3% (95% CI: 2%-4%). Single studies in the Amhara, Tigray, and Oromia regions reported Pre-XDR-TB prevalence of 6%, 5%, and 3%, respectively. The pooled prevalence of XDR-TB in Addis Ababa was 1% (95% CI: 0%-2%). A single study conducted in Oromia reported a relatively higher prevalence of XDR-TB; 10% (95% CI: 3%-26%). Regarding the study year, the XDR-TB prevalence was 3% (95% CI: 0%-11%) in 2005–2018 and 1% (95% CI: 0%-2%) in 2019–2024. A statistically significant publication bias was observed in XDR-TB prevalence (p = 0.024). ConclusionThere is a significant prevalence of Pre-XDR and XDR-TB cases among MDR-TB patients in Ethiopia. It highlights the need for strengthened surveillance in all regions and expanded drug susceptibility testing of local strains for better management of MDR-TB patients.</div> 2026-09-28T18:02:49Z Dataset Dataset 10.1371/journal.pntd.0014744.t002 https://figshare.com/articles/dataset/_p_Publication_bias_using_Egger_s_test_p_/34016962 CC BY 4.0