Prevalence of Tuberculosis among People Who Use Drugs in Iran: A Systematic Review and Meta-analysis

Document Type : Review Article(s)


1 1. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran 2. Department of Epidemiology and Biostatistics, School of Public Health, Alborz University of Medical Sciences, Karaj, Iran

2 Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran

3 Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA

4 Student Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran



Background: Drug use, especially injecting drug use, is associated with a higher risk of tuberculosis (TB). This study aimed to 
systematically review the prevalence of TB among people who use drugs (PWUD) in Iran.
Methods: A systematic search was conducted in international and national databases. All studies that provided data on the 
prevalence of TB among PWUD based on screening tests and diagnosis from 1990 up to August 2019 were assessed. Metaanalysis was performed on the prevalence of active TB among people who inject drugs (PWID).
Findings: Overall, nine studies were included. The studies were carried out from 1994 to 2012 in seven out of the 31 provinces of 
Iran. Seven studies provided data on the prevalence of TB diagnosis among 1087 PWID. The pooled prevalence of TB diagnosis 
was 10.1% (95% CI: 4.5, 15.8) in studies carried out in hospitals and 0.54% (95% CI: 0.04, 1.04) in other settings.
Conclusion: The present review suggests an approximately 40 times higher prevalence of TB among PWID compared to the 
general population. However, most of the included studies were conducted on a subpopulation of drug users, and caution 
should be exercised when generalizing the findings.


Hossein Rafimanesh Rafimanesh: (Google Scholar) (PubMed)

Behrang Shadloo: (Google Scholar) (PubMed)

Masoumeh Amin-Esmaeili: (Google Scholar) (PubMed)

Yekta Rahimi: (Google Scholar) (PubMed)

Jaleh Gholami: (Google Scholar) (PubMed)

Afarin Rahimi-Movaghar: (Google Scholar) (PubMed)


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