耐多药结核病患者接触者中结核病感染的患病率：一项系统评价和荟萃分析。

Prevalence of tuberculosis infection among contacts of drug-resistant tuberculosis patients: A systematic review and meta-analysis.

作者信息

Akalu Temesgen Yihunie, Clements Archie C A, Gebreyohannes Eyob Alemayehu, Gilmour Beth, Alene Kefyalew Addis

机构信息

Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Australia.

Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Perth, Australia; Research and Enterprise, Queen's University Belfast, Belfast, United Kingdom.

出版信息

J Infect. 2024 Aug;89(2):106198. doi: 10.1016/j.jinf.2024.106198. Epub 2024 Jun 19.

DOI:10.1016/j.jinf.2024.106198

PMID:38906264

Abstract

INTRODUCTION

Contact investigations with drug-susceptible tuberculosis (DS-TB) patients have demonstrated a high prevalence of tuberculosis infection (TBI). However, the prevalence of TBI among individuals in close contact with drug-resistant tuberculosis (DR-TB) patients is poorly understood. This systematic review and meta-analysis aimed to determine the prevalence of TBI among household and non-household contacts of DR-TB patients.

METHOD AND ANALYSIS

We searched five databases (Medline, Embase, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) from inception to 2 June 2023. All studies that reported the prevalence of TBI among DR-TB contacts were included in the study. A random-effects meta-analysis was conducted to estimate the pooled prevalence of TBI with a 95% confidence interval (CI). Sub-group analyses were conducted using study characteristics as covariates.

RESULTS

Thirty studies involving 7659 study participants from 19 countries were included. The pooled prevalence of TBI among DR-TB contacts was 36.52% (95% CI: 30.27-42.77). The sub-group analysis showed considerable heterogeneity in the estimates, with the highest prevalence reported in Southeast Asia (80.74%; 95% CI: 74.09-87.39), household contacts (38.60%; 95% CI: 30.07-47.14), lower-middle-income countries (LMICs) (54.72; 95% CI: 35.90, 73.55), children (43.27%; 95% CI: 25.50, 61.04), and studies conducted between 2004 and 2012 (45.10; 95% CI: 32.44, 57.76).

CONCLUSION

The prevalence of TBI among DR-TB contacts was high, with substantial regional variations. Further research is needed to determine the drug susceptibility status of TBI in DR-TB contacts.

PROTOCOL REGISTRATION

The protocol is registered in PROSPERO (CRD42023390339).

摘要

引言

对药物敏感型肺结核（DS-TB）患者进行的接触者调查显示，结核感染（TBI）的患病率很高。然而，与耐多药肺结核（DR-TB）患者密切接触的个体中TBI的患病率尚不清楚。本系统评价和荟萃分析旨在确定DR-TB患者的家庭和非家庭接触者中TBI的患病率。

方法与分析

我们检索了从数据库建立至2023年6月2日的五个数据库（Medline、Embase、Scopus、Web of Science和护理学与健康相关文献累积索引（CINAHL））。所有报告DR-TB接触者中TBI患病率的研究均纳入本研究。采用随机效应荟萃分析来估计TBI的合并患病率及95%置信区间（CI）。以研究特征作为协变量进行亚组分析。

结果

纳入了来自19个国家的30项研究，共7659名研究参与者。DR-TB接触者中TBI的合并患病率为36.52%（95%CI：30.27-42.77）。亚组分析显示估计值存在相当大的异质性，东南亚地区报告的患病率最高（80.74%；95%CI：74.09-87.39），家庭接触者（38.60%；95%CI：30.07-47.14），中低收入国家（LMICs）（54.72；95%CI：35.90，73.55），儿童（43.27%；95%CI：25.50，61.04），以及2004年至2012年期间开展的研究（45.10；95%CI：32.44，57.76）。