Prevalence of Tuberculosis and its Association with Cigarette Smoking in Ethiopia: Meta Analysis and Systematic Review

Background: TB is the leading cause of death from an infectious disease in Ethiopia, killing more than 30 thousand people every year. Cigarette Smoking increases the risk of contracting tuberculosis (TB), increases the risk of recurrent TB and impairs the response to treatment of the disease. The association between smoking and tuberculosis (TB), which has been proven in multiple studies with different study population, has not yet received sufficient attention in terms of TB control in Ethiopia. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of tuberculosis and association with cigarette smoking in Ethiopia. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. Articles were systematically searched through different searching mechanisms. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for quality assessment of each individual study. A total of 10 studies was extracted and analyzed using STATA 14. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression was performed to identify the probable source of heterogeneity. Both Egger’s and Begg’s test were used to check publication bias. Moreover, the association between association between cigarette smoking and tuberculosis infection were tested. Results: The totals of 381 studies were retrieved and 10 studies were included in meta-analysis. The Meta analysis result showed that the pooled prevalence of Tuberculosis in Ethiopia was 18.44% (CI: 9.21, 27.67) with severe heterogeneity (I2=99.0%, p<0.001) with publication bias but by Trimming filled analysis showed that it is 18.438 which have no effect. Cigarette smoking is significantly associated with tuberculosis in Ethiopia, odds ratio 3.73 (95% CI: 2.08, 6.70). Conclusions: In Ethiopia, around one fifth of individuals were infected with tuberculosis. Individuals who smoke cigarette were more exposed to TB infection than non smokers in Ethiopia. Therefore, the government and health institutions should focus on awareness creation about risk of cigarette smoking to reduce TB infection.