Introduction: Anti-tuberculosis drug resistance is a major public health problem that threatens the progress made in tuberculosis care and control worldwide. There is a paucity of evidence that assessed studies on the treatment of multidrug-resistant tuberculosis (MDR-TB), which focus on the effectiveness of the directly observed treatment, short-course (DOTS)-Plus program. Therefore, it is crucial to assess and summarize the overall treatment outcomes for MDR-TB patients enrolled in the DOTS-Plus program in recent years.

Objective: The objective of this study was to thus assess and summarize the available evidence for MDR-TB treatment outcomes under DOTS-Plus.

Method: A systematic review and meta-analysis of published literature was conducted. Original studies were identified using the databases MEDLINE®/PubMed®, Hinari, and Google Scholar. Those articles published in the last ten years that meet our inclusion criteria were analyzed. Heterogeneity across studies was assessed using the Cochran’s Q test and I ² statistics. Pooled estimates of treatment outcomes were computed using the random effect model. Sub group analysis was made as a result of high heterogeneity,

Result: Based on the 39 observational studies included in the meta-analysis, it was determined that 15764 patients reported treatment outcomes. Of these, the pooled prevalence, 53.76% (95% CI: 47.84, 59.67%) successfully completed full treatment (cured or treatment completed). The treatment outcome was worse in extensively drug resistant and HIV co-infected patients; 38.00 (21.38, 54.61) and 49.54 (20.50, 78.57) respectively.

Conclusion: This study revealed that patients with MDR-TB exhibited a very low treatment success rate compared to the World Health Organization 2015 target of at least 75 to 90%. Almost 50% of the treated patients were having unsuccessful treatment outcome. Conducting further meta-analysis is recommended to identify factors contributing for the low treatment success rate.

Keywords: Tuberculosis, Multidrug resistance, Multidrug-resistant tuberculosis, Treatment outcomes