非传染性疾病在肺结核患者家庭接触者中的流行情况：系统评价和个体参与者数据荟萃分析。
Prevalence of non-communicable diseases among household contacts of people with tuberculosis: A systematic review and individual participant data meta-analysis.
机构信息
Institute for Global Health, University College London, London, UK.
MRC Clinical Trials Unit, Institute of Clinical Trials and Methodology, University College London, London, UK.
出版信息
Trop Med Int Health. 2024 Sep;29(9):768-780. doi: 10.1111/tmi.14038. Epub 2024 Jul 27.
OBJECTIVE
To investigate the prevalence of non-communicable diseases among household contacts of people with tuberculosis.
METHODS
We conducted a systematic review and individual participant data meta-analysis. We searched Medline, Embase and the Global Index Medicus from inception to 16 May 2023. We included studies that assessed for at least one non-communicable disease among household contacts of people with clinical tuberculosis. We estimated the non-communicable disease prevalence through mixed effects logistic regression for studies providing individual participant data, and compared it with estimates from aggregated data meta-analyses. Furthermore, we compared age and sex-standardised non-communicable disease prevalence with national-level estimates standardised for age and sex.
RESULTS
We identified 39 eligible studies, of which 14 provided individual participant data (29,194 contacts). Of the remaining 25 studies, 18 studies reported aggregated data suitable for aggregated data meta-analysis. In individual participant data analysis, the pooled prevalence of diabetes in studies that undertook biochemical testing was 8.8% (95% confidence interval [CI], 5.1%-14.9%, four studies). Age-and sex-standardised prevalence was higher in two studies (10.4% vs. 6.9% and 11.5% vs. 8.4%) than the corresponding national estimates and similar in two studies. Prevalence of diabetes mellitus based on self-report or medical records was 3.4% (95% CI 2.6%-4.6%, 14 studies). Prevalence did not significantly differ compared to estimates from aggregated data meta-analysis. There were limited data for other non-communicable diseases.
CONCLUSION
The prevalence of diabetes mellitus among household contacts was high while that of known diabetes was substantially lower, suggesting the underdiagnosis. tuberculosis household contact investigation offers opportunities to deliver multifaceted interventions to identify tuberculosis infection and disease, screen for non-communicable diseases and address shared risk factors.
目的
调查结核病患者家庭接触者中非传染性疾病的患病率。
方法
我们进行了系统评价和个体参与者数据荟萃分析。我们从建库到 2023 年 5 月 16 日在 Medline、Embase 和全球医学索引中进行了检索。我们纳入了评估至少一种非传染性疾病在结核病临床患者家庭接触者中的研究。我们通过混合效应逻辑回归估计了提供个体参与者数据的研究中非传染性疾病的患病率，并将其与汇总数据荟萃分析的估计值进行了比较。此外，我们将年龄和性别标准化的非传染性疾病患病率与年龄和性别标准化的国家水平估计值进行了比较。
结果
我们确定了 39 项符合条件的研究，其中 14 项提供了个体参与者数据（29194 名接触者）。在其余 25 项研究中，有 18 项研究报告了适合汇总数据荟萃分析的汇总数据。在个体参与者数据分析中，进行生化检测的研究中糖尿病的总患病率为 8.8%（95%置信区间[CI]，5.1%-14.9%，四项研究）。在两项研究中，年龄和性别标准化的患病率高于两项国家估计值（10.4%比 6.9%和 11.5%比 8.4%），而在两项研究中则相似。基于自我报告或病历的糖尿病患病率为 3.4%（95%CI 2.6%-4.6%，14 项研究）。与汇总数据荟萃分析的估计值相比，患病率无显著差异。其他非传染性疾病的数据有限。
结论
家庭接触者中糖尿病患病率较高，而已知糖尿病患病率则明显较低，这表明存在漏诊情况。结核病家庭接触者调查为发现结核病感染和疾病、筛查非传染性疾病以及解决共同的风险因素提供了机会，可采取多种综合干预措施。
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