ArticleBMJ public health2026
Lineages of Mycobacterium tuberculosis complex associated with pulmonary drug-resistant tuberculosis in Africa: a systematic review.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
5 authors.
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Abstract
Introduction: The emergence of multidrug-resistant tuberculosis has eroded the gains made in the fight against tuberculosis. This review aims to provide current perspectives on the lineages of the Method: Primary studies were retrieved from PubMed, AJOL, Scopus and Africa Index Medicus databases, including worldwide science and Bielefeld Academic Search Engine websites. Retrieved articles were imported into Rayyan.ai for the selection and screening process. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist for analytical and cross-sectional studies. Articles published between 2013-2023, studies conducted among humans with pulmonary DR-TB that reported MTBC lineages or species were included. On the other hand, studies that reported lineages or species in animals and studies conducted outside Africa were excluded. An Excel sheet was developed and used for data extraction by two independent reviewers, and the extracted data were compared and discrepancies resolved through discussion. Two independent reviewers assessed the risk of bias by applying the eight items on the JBI checklist to each of the included studies. Result: A total of 491 articles were retrieved; however, 73 eligible articles were included in the final analysis after the selection and screening process. The characteristics of the selected studies show that the studies were from 21 countries, and varieties of molecular methods (IS6110-RFLP, MIRU-VNTR-16, Spoiligotyping and whole genome sequencing) were used in the included studies. Of the included studies, 75% were assessed to have low risk of bias using the JBI checklist, indicating that the overall quality of evidence is moderate to high. Across the continent, L4 was the dominant lineage 51% (8244/16 172) associated with DR-TB infection, which was followed by L2 41% (6649/16 172), L3 4.6% (741/16 172). Conclusion: PROSPERO registration number: CRD42024512834.
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