Frequency of Codon 306 Mutations in embB Gene of Mycobacterium tuberculosis Resistant to Ethambutol: A Systematic Review and Meta‑Analysis

Background: Ethambutol (EMB) resistance is a major concern in patients with tuberculosis (TB). The aim of this study was to determine the frequency rate of mutations in the embB306 gene of Mycobacterium tuberculosis (M. tuberculosis) resistant to EMB, based on a systematic review and meta‑analysis. Methods: Thirty‑seven original articles (1997–2015) that have been published in valid databases were considered for this research. The articles were systematically reviewed for the prevalence and rate of mutations in embB306 in EMB‑resistant M. tuberculosis. Data were analyzed using meta‑analysis and random effects models (CI 95%, P < 0.10). Results: With a 6,931 sample size in 37 original articles, the lowest rate was related to EMB resistance that was observed in 2014 with 0.05 (95% CI: 0.04–0.07) and the highest prevalence rate was 0.84 (95% CI: 0.68–1.01), observed in 1997. Lowest and highest prevalence rates of embB306 gene mutation in M. tuberculosis were 0.03 (95% CI: 0.01–0.07) in 2014 and 0.78 (95% CI: 0.71–1.84) in 2005, in the USA, respectively. Conclusions: The present study revealed the prevalence and association of mutations in the embB306 gene of M. tuberculosis with resistance to EMB. Detecting EMB‑resistant M. tuberculosis can help in controlling and correcting the administration of drugs for patients with TB.