Evidence map›Paper›PMID 26266773›Full record

SynthesisAIDS (London, England)2015

Prevalence of tuberculosis in post-mortem studies of HIV-infected adults and children in resource-limited settings: a systematic review and meta-analysis.

Rishi K Gupta, Sebastian B Lucas, Katherine L Fielding, Stephen D Lawn

2 registry-linked trialsOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in AIDS (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 259 papers, 22 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
259citing papers in PubMed, 22 pooled it
17.1field-weighted citation impact, top 1% of its field
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.

NCT03302299 phase4completednot on this mapstarted 2017, after this paper: background citation

URBAN ARCH (3/5) Uganda Cohort TB Preventive Therapy for HIV-infected Alcohol Users in Uganda: an Evaluation of Safety Tolerability and Adherence

TypeinterventionalSponsorUniversity of California, San FranciscoRan2017 to 2021Enrolled302ConditionsTuberculosis, HIV/AIDS, Alcohol AbuseArmsIsoniazid 300 Mg ORAL TABLET, Pyridoxine 25 Mg Oral Tablet
NCT05633056 narecruitingnot on this mapstarted 2023, after this paper: background citation

Adaptive Evaluation of mHealth and Conventional Adherence Support Interventions to Optimize Outcome With New Treatment Regimens for Drug-resistant Tuberculosis and HIV in South Africa

TypeinterventionalSponsorColumbia UniversityRan2023 to 2029Enrolled360ConditionsMulti Drug Resistant Tuberculosis, HIV InfectionsArmsAdherence support intevention
3 · Its place in the literature

Who cites it

259 citing papers in PubMed, 22 syntheses or guidelines pooled it, 359 citations in OpenAlex.

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199 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

4 authors at 3 institutions in 3 countries.

Rishi K GuptaaDivision of Medicine, University College London bDepartment of Histopathology, Guy's & St Thomas' NHS Foundation Trust cDepartment of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health dDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK eDesmond Tutu HIV Centre, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Sebastian B Lucas
Katherine L Fielding
Stephen D Lawn
Desmond Tutu HIV Foundation · ZAGuy's and St Thomas' NHS Foundation Trust · GBUniversity College London · GB

Funding

Medical Research Council MR/K012126/1Medical Research Council MR/M007375/1Wellcome Trust 088590Wellcome Trust 100714
6 · The paper itself

Abstract

objectivesTuberculosis (TB) is estimated to be the leading cause of HIV-related deaths globally. However, since HIV-associated TB frequently remains unascertained, we systematically reviewed autopsy studies to determine the true burden of TB at death.

methodsWe systematically searched Medline and Embase databases (to end 2013) for literature reporting on health facility-based autopsy studies of HIV-infected adults and/or children in resource-limited settings. Using forest plots and random-effects meta-analysis, we summarized the TB prevalence found at autopsy and used meta-regression to explore variables associated with autopsy TB prevalence.

resultsWe included 36 eligible studies, reporting on 3237 autopsies. Autopsy TB prevalence was extremely heterogeneous (range 0-64.4%), but was markedly higher in adults [pooled prevalence 39.7%, 95% confidence interval (CI) 32.4-47.0%] compared to children (pooled prevalence 4.5%, 95% CI 1.7-7.4%). Post-mortem TB prevalence varied by world region, with pooled estimates in adults of 63.2% (95% CI 57.7-68.7%) in South Asia (n = 2 studies); 43.2% (95% CI 38.0-48.3) in sub-Saharan Africa (n = 9 studies); and 27.1% (95% CI 16.0-38.1%) in the Americas (n = 5 studies). Autopsy prevalence positively correlated with contemporary estimates of national TB prevalence. TB in adults was disseminated in 87.9% (82.2-93.7%) of cases and was considered the cause of death in 91.4% (95% CI 85.8-97.0%) of TB cases. Overall, TB was the cause of death in 37.2% (95% CI 25.7-48.7%) of adult HIV/AIDS-related deaths. TB remained undiagnosed at death in 45.8% (95% CI 32.6-59.1%) of TB cases.

conclusionsIn resource-limited settings, TB accounts for approximately 40% of facility-based HIV/AIDS-related adult deaths. Almost half of this disease remains undiagnosed at the time of death. These findings highlight the critical need to improve the prevention, diagnosis and treatment of HIV-associated TB globally.

Indexed as

AdolescentAdultAfrica South of the SaharaAgedAged, 80 and overAmericasAsiaAutopsyDeveloping CountriesFemaleHIV InfectionsHumansMaleMiddle AgedPrevalenceTuberculosis

Identifiers

PMID26266773
PMCPMC4568896
OpenAlexW2200954247

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.