Kadariswantiningsih Ika Nindya, Ramadhan Roy Novri, Rampengan Derren David Christian Homenta
Department of Medical Microbiology, Universitas Airlangga, Surabaya, Indonesia
Clinical Microbiology Residency Program, Dr. Soetomo Regional Hospital/Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
BMJ Open. 2025 May 23;15(5):e098140. doi: 10.1136/bmjopen-2024-098140.
Extrapulmonary tuberculosis (EPTB) is a significant public health issue in Indonesia, a country with a high tuberculosis burden. EPTB accounts for 15%-20% of global TB cases, with the proportion rising in populations co-infected with HIV. In Indonesia, estimates of EPTB prevalence vary significantly due to inconsistencies in diagnostic criteria, population demographics and methodologies. These variations highlight the need for a systematic review to synthesise existing evidence and provide a comprehensive understanding of EPTB's epidemiology in Indonesia. This study aims to consolidate findings from various studies to identify prevalence trends, inform public health strategies and address knowledge gaps in diagnosing and managing EPTB.
This systematic review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines and has been registered with PROSPERO (Registration Number: CRD42024601175). A comprehensive search will be conducted in databases including PubMed, Google Scholar, ScienceDirect, Scopus and Southeast Asian Index Medicus to identify studies published between 2005 and 2024. Inclusion criteria include observational studies reporting EPTB prevalence in Indonesia based on clinical, microbiological or radiological diagnoses. Two independent reviewers will conduct study selection, data extraction and quality assessments using the Newcastle-Ottawa Scale. Data will be analysed using a random-effects model to estimate pooled prevalence, and subgroup analyses will explore variability by region, age and clinical setting. The study selection process will be documented using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram, and potential publication bias will be evaluated with funnel plots and the trim-and-fill method.
As this review involves secondary analysis of published data, no ethical approval is required. Findings will be disseminated through peer-reviewed journal publications and conference presentations.
肺外结核病（EPTB）是印度尼西亚一个重大的公共卫生问题，该国结核病负担沉重。EPTB占全球结核病病例的15%-20%，在合并感染艾滋病毒的人群中这一比例呈上升趋势。在印度尼西亚，由于诊断标准、人口统计学和方法的不一致，EPTB患病率的估计差异很大。这些差异凸显了进行系统评价以综合现有证据并全面了解印度尼西亚EPTB流行病学的必要性。本研究旨在整合各项研究的结果，以确定患病率趋势，为公共卫生策略提供信息，并解决EPTB诊断和管理方面的知识差距。
本系统评价将遵循系统评价和Meta分析方案的首选报告项目指南，并已在PROSPERO注册（注册号：CRD42024601175）。将在包括PubMed、谷歌学术、ScienceDirect、Scopus和东南亚医学索引在内的数据库中进行全面检索，以识别2005年至2024年期间发表的研究。纳入标准包括基于临床、微生物学或放射学诊断报告印度尼西亚EPTB患病率的观察性研究。两名独立的评审员将使用纽卡斯尔-渥太华量表进行研究选择、数据提取和质量评估。将使用随机效应模型分析数据以估计合并患病率，亚组分析将探讨按地区、年龄和临床环境的变异性。研究选择过程将使用系统评价和Meta分析的首选报告项目流程图记录，潜在的发表偏倚将通过漏斗图和修剪填充法进行评估。
由于本评价涉及对已发表数据的二次分析，无需伦理批准。研究结果将通过同行评审的期刊出版物和会议报告进行传播。
