Tankeu Aurel T, Bigna Jean Joël, Nansseu Jobert Richie, Endomba Francky Teddy A, Wafeu Guy Sadeu, Kaze Arnaud D, Noubiap Jean Jacques
Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon.
Department of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon.
BMJ Open. 2017 Jun 9;7(6):e015170. doi: 10.1136/bmjopen-2016-015170.
Diabetes mellitus (DM) is an important risk factor for active tuberculosis (TB), which also adversely affect TB treatment outcomes. The escalating global DM epidemic is fuelling the burden of TB and should therefore be a major target in the strategy for ending TB. This review aims to estimate the global prevalence of DM in patients with TB.
This systematic review will include cross-sectional, case-control or cohort studies of populations including patients diagnosed with TB that have reported the prevalence of DM using one of the fourth standard recommendations for screening and diagnosis. This protocol is written in accordance with recommendations from the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols 2015 statement. Relevant abstracts published in English/French from inception to 31 December 2016 will be searched in PubMed, Excerpta Medica Database and online journals. Two investigators will independently screen, select studies, extract data and assess the risk of bias in each study. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate of the prevalence of diabetes across the studies. Heterogeneity will be assessed, and we will pool studies judged to be clinically homogenous. On the other hand, statistical heterogeneity will be evaluated by the χ² test on Cochrane's Q statistic. Funnel-plots analysis and Egger's test will be used to investigate publication bias. Results will be presented by continent or geographic regions.
This study is based on published data. An ethical approval is therefore not required. This systematic review and meta-analysis is expected to inform healthcare providers as well as general population on the co-occurrence of DM and TB. The final report will be published as an original article in a peer-reviewed journal, and will also be presented at conferences and submitted to relevant health authorities. We also plan to update the review every 5 years.
PROSPERO International Prospective Register of Systematic Reviews (CRD42016049901).
糖尿病（DM）是活动性结核病（TB）的一个重要危险因素，同时也会对结核病治疗结果产生不利影响。全球糖尿病流行趋势不断加剧，这正加重结核病负担，因此应成为终结结核病战略的主要目标。本综述旨在估算结核病患者中糖尿病的全球患病率。
本系统综述将纳入横断面研究、病例对照研究或队列研究，研究对象为已确诊结核病的人群，这些研究需按照筛查和诊断的第四版标准建议之一报告糖尿病患病率。本方案是根据《系统综述与Meta分析方案的首选报告项目2015声明》中的建议编写的。将在PubMed、医学文摘数据库和在线期刊中检索从创刊至2016年12月31日以英文/法文发表的相关摘要。两名研究人员将独立筛选、选择研究、提取数据并评估每项研究的偏倚风险。将通过随机效应Meta分析模型汇总各研究的特定估计值，以获得各项研究中糖尿病患病率的总体汇总估计值。将评估异质性，我们将汇总判断为临床同质的研究。另一方面，将通过Cochrane Q统计量的χ²检验评估统计异质性。将使用漏斗图分析和Egger检验来调查发表偏倚。结果将按大洲或地理区域呈现。
本研究基于已发表的数据。因此无需伦理批准。预计本系统综述和Meta分析将为医疗保健提供者以及普通人群提供有关糖尿病和结核病共病情况的信息。最终报告将作为原创文章发表在同行评审期刊上，也将在会议上展示并提交给相关卫生当局。我们还计划每5年更新一次综述。
国际系统综述前瞻性注册库（PROSPERO）（CRD42016049901）。
