Computational investigation of the global prevalence of multidrug resistant Mycobacterium leprae: A systematic review and meta-analysis

Background

Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) 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 M. leprae and its implications.

Methods

Using PRISMA guidelines, we systematically reviewed ISI Web of Science, MEDLINE, and EMBASE up to August 2023 to assess the prevalence of MDR M. leprae. We included human clinical trials on MDR M. leprae, 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.

Results

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 M. leprae was approximated at 11.7 % (95 % CI: 7.7–17.3; I²: 90.79; p value = 0.01). Specific drug resistance rates included 7.4 % to dapsone and 5.1 % to rifampin, among others. The global rate for MDR M. leprae was measured at 2.2 % (95 % CI: 1.2–3.9; I²: 82.68; p value = 0.01). Factors such as bacterial density and the lepromatous phase were associated with elevated DR M. leprae risk (OR: 2.69; 95 % CI: 1.35–2.48). A systematic assessment of publication bias indicated a minimal impact on the general results.

Conclusions

The increasing prevalence of MDR M. leprae globally requires urgent and strategic interventions to prevent further spread, which in turn is effective in treating leprosy patients.