The yield of tuberculosis contact investigation in low- and middle-income settings: a systematic review and meta-analysis

作者：Mariana Velleca, Mohsen Malekinejad, Cecily Miller, Lucía Abascal Miguel, Hailey Reeves, Philip C. Hopewell, Elizabeth Fair · 发表于：BMC Infectious Diseases · 年份：2021 · DOI：10.1186/s12879-021-06609-3 · 被引用次数：42 · 研究领域：Tuberculosis Research and Epidemiology、HIV/AIDS Research and Interventions、Healthcare Facilities Design and Sustainability

Abstract Background Contact investigation, the systematic evaluation of individuals in close contact with an infectious tuberculosis (TB) patient, is a key active case-finding strategy for global TB control. Better estimates of the yield of contact investigation can guide strategies to reduce the number of underreported and underdiagnosed TB cases, approximately three million cases per year globally. A systematic review (Prospero ID # CRD42019133380) and meta-analysis was conducted to update and enhance the estimates of the yield of TB contact investigation in low- and middle-income countries (LMIC). Pubmed, Web of Science, Embase and the WHO Global Index Medicus were searched for peer-reviewed studies (published between January 2006–April 2019); studies reporting the number of active TB or latent tuberculosis infection (LTBI) found through contact investigation were included. Pooled data were meta-analyzed using a random effects model and risk of bias was assessed. Results Of 1,644 unique citations obtained from database searches, 110 studies met eligibility criteria for descriptive data synthesis and 95 for meta-analysis. The pooled yields of contact investigation activities for different outcomes were: secondary cases of all active TB (defined as those bacteriologically confirmed or clinically diagnosed) 2.87% (2.61–3.14, I 2 97.79%), bacteriologically confirmed active TB 2.04% (1.77–2.31, I 2 98.06%), and LTBI 43.83% (38.11–49.55, I 2 99.36%). Yields are interpreted as th...