Alemu Ayinalem, Bitew Zebenay Workneh, Diriba Getu, Seid Getachew, Moga Shewki, Abdella Saro, Gashu Emebet, Eshetu Kirubel, Tollera Getachew, Dangisso Mesay Hailu, Gumi Balako
Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia.
Heliyon. 2023 Jun 10;9(6):e17181. doi: 10.1016/j.heliyon.2023.e17181. eCollection 2023 Jun.
To estimate the prevalence of latent tuberculosis infection (LTBI) in chronic kidney disease (CKD) patients
This study was conducted following the PRISMA guidelines. We identified, 3694 studies from the whole search, and 59 studies were included. Each study's quality was assessed using JBI checklist. We employed STATA version 17 for statistical analysis. We assessed heterogeneity using I heterogeneity test. Publication bias was assessed using funnel plot and Egger's test. We estimated the pooled LTBI prevalence in CKD patients along with 95%CI.
The pooled prevalence of LTBI among CKD patients using data collected from 53 studies having 12,772 patients was 30.2% (95%CI; 25.5, 34.8). The pooled prevalence among pre-dialysis, hemodialysis, peritoneal dialysis, and renal transplanted patients was 17.8% (95%CI; 3.3, 32.4), 34.8% (95%CI; 29.1, 40.5), 25% (95%CI; 11, 38), and 16% (95%CI; 7, 25), respectively. The pooled prevalence of LTBI stratified by the laboratory screening methods was 25.3% (95%CI: 20.3-30.3) using TST, 28.0% (95%CI; 23.9-32.0) using QFT, and 32.6%, (95%CI: 23.7-41.5) using T-SPOT.
There is high prevalence of LTBI among CKD patients mainly in patients on dialysis. Thus, early diagnosis and treatment of LTBI in CKD patients should be performed to prevent active TB in CKD patients. CRD42022372441.
评估慢性肾脏病(CKD)患者中潜伏性结核感染(LTBI)的患病率
本研究按照PRISMA指南进行。我们从整个检索中识别出3694项研究,纳入了59项研究。使用JBI检查表评估每项研究的质量。我们采用STATA 17版进行统计分析。使用I²异质性检验评估异质性。使用漏斗图和Egger检验评估发表偏倚。我们估计了CKD患者中LTBI的合并患病率以及95%置信区间。
使用来自53项研究的12772名患者的数据,CKD患者中LTBI的合并患病率为30.2%(95%置信区间;25.5,34.8)。透析前、血液透析、腹膜透析和肾移植患者中的合并患病率分别为17.8%(95%置信区间;3.3,32.4)、34.8%(95%置信区间;29.1,40.5)、25%(95%置信区间;11,38)和16%(95%置信区间;7,25)。按实验室筛查方法分层的LTBI合并患病率,使用结核菌素皮肤试验(TST)为25.3%(95%置信区间:20.3 - 30.3),使用全血干扰素-γ释放试验(QFT)为28.0%(95%置信区间;23.9 - 32.0),使用结核感染T细胞检测(T-SPOT)为32.6%(95%置信区间:23.7 - 41.5)。
CKD患者中LTBI的患病率较高,主要见于透析患者。因此,应尽早对CKD患者进行LTBI的诊断和治疗,以预防CKD患者发生活动性结核病。CRD42022372441