Evidence map›Paper›PMID 24623906›Full record

SynthesisBulletin of the World Health Organization2014

Pre-treatment loss to follow-up in tuberculosis patients in low- and lower-middle-income countries and high-burden countries: a systematic review and meta-analysis.

Peter MacPherson, Rein M G J Houben, Judith R Glynn, Elizabeth L Corbett, Katharina Kranzer

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Bulletin of the World Health Organization, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03044158 (GeneXpert Performance Evaluation for Linkage to Tuberculosis Care), which is not on this map. Cited by 158 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
158citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03044158 nacompletednot on this mapstarted 2018, after this paper: background citation

GeneXpert Performance Evaluation for Linkage to Tuberculosis Care: The XPEL-TB Trial

TypeinterventionalSponsorUniversity of California, San FranciscoRan2018 to 2022Enrolled10,644ConditionsTuberculosis, Pulmonary, Rifampicin Resistant TuberculosisArmsGeneXpert I, Process re-design, Performance Feedback
3 · Its place in the literature

Who cites it

158 citing papers in PubMed, 10 syntheses or guidelines pooled it.

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  18. Private sector engagement in tuberculosis detection: a bibliometric analysis.Journal of clinical tuberculosis and other mycobacterial diseases · 2026
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98 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Peter MacPhersonDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, England .
Rein M G J HoubenDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, England .
Judith R GlynnDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, England .
Elizabeth L CorbettDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, England .
Katharina KranzerDepartment of Clinical Research, London School of Hygiene & Tropical Medicine, London, England .

Funding

Wellcome Trust 091769Wellcome Trust 100714Wellcome Trust 100890Wellcome Trust 101113Wellcome Trust WT089673
6 · The paper itself

Abstract

objectiveTo assess the magnitude of loss to follow-up in smear- or culture-positive tuberculosis patients before treatment initiation and outcomes among patients who were traced.

methodsOvid Medline and Global Health databases were searched for studies published between 1994 and January 2013 that described pre-treatment loss to follow-up in patients with smear- or culture-positive tuberculosis in routine national tuberculosis programmes (NTPs) in low- and lower-middle-income countries and in countries with a high burden of tuberculosis. Data on the proportion of patients who did not initiate treatment after their tuberculosis diagnosis were extracted from studies meeting inclusion criteria. Where available, data on causes and outcomes, including initiation of tuberculosis treatment at another facility, were investigated. Heterogeneity and publication bias were assessed and random-effects meta-analyses by subgroup (region) were performed.

findingsTwenty-three eligible studies were identified, with a total of 34 706 smear- or culture-positive tuberculosis patients from 14 countries (8 in Africa, 5 in Asia and 1 in the western Pacific). Most studies were retrospective and linked laboratory and treatment registers to identify pre-treatment loss to follow-up. Pre-treatment loss to follow-up varied from 4 to 38% and was common in studies from Africa (random-effects weighted proportion, WP: 18%; 95% confidence interval, CI: 13-22) and Asia (WP: 13%; 95% CI: 10-15).

conclusionPre-treatment loss to follow-up, common in most settings, can hinder tuberculosis control efforts. By not counting individuals who are lost to follow-up before treatment when reporting standard programme indicators, NTPs underestimate case detection rates and mortality and overestimate cure rates.

Indexed as

Developing CountriesLost to Follow-UpHumansTuberculosis

Identifiers

PMID24623906
PMCPMC3949536

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.