Role of Molecular Epidemiology on Tuberculosis Control in the Middle East Countries: a Systematic Review and Meta-Analysis

Tuberculosis (TB) is a public health problem in developing countries and yet the numbers of people with the disease are abundant. Early detection of transmission sources and effective treatment of the cases is essential to control the disease which will be possible by application of molecular epidemiology approaches. Studies conducted based on Mycobacterial Interspersed Repetitive Units-Variable Number of Tandem Repeats (MIRU-VNTR) method in Muslim Middle East countries were evaluated to determine their role in TB control. All studies from January 2005 to April 2016 were systematically reviewed in four electronic databases and finally 16 articles were found eligible to be included in this study. The mean clustering rate was determined as 44% and the recent transmission rate was 12.3 to 78.8% with average of 33%. The results showed that both reactivation and recent transmission were important in developing new cases of TB in Middle East countries; but, reactivation plays a more critical role. Regarding to ongoing war and immigration in the region along with the increasing of drug-resistant TB, in the case of improper supervision in the future, the disease, especially drug- resistant TB, will be problematic.