SynthesisJournal of the International AIDS Society2018
High HIV and active tuberculosis prevalence and increased mortality risk in adults with symptoms of TB: a systematic review and meta-analyses.
Synthesis in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 5 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 5 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Burden of mortality and its predictors among TB-HIV co-infected patients in Ethiopia: Systematic review and meta-analysis.PloS one · 2024Pooled it
- Impact of diagnostic strategies for tuberculosis using lateral flow urine lipoarabinomannan assay in people living with HIV.The Cochrane database of systematic reviews · 2021Pooled it
- Impact of the diagnostic test Xpert MTB/RIF on patient outcomes for tuberculosis.The Cochrane database of systematic reviews · 2021Pooled it
- Utility of broad-spectrum antibiotics for diagnosing pulmonary tuberculosis in adults: a systematic review and meta-analysis.The Lancet. Infectious diseases · 2020Pooled it
- High HIV and active tuberculosis prevalence and increased mortality risk in adults with symptoms of TB: a systematic review and meta-analyses.Journal of the International AIDS Society · 2018Pooled it
- Prevalence of Mycobacterium tuberculosis by using Gene Xpert and associated factors among presumptive for pulmonary tuberculosis patients attending at Debre Berhan Comprehensive Specialized Hospital, North Shoa Zone Amhara, Ethiopia 2025.BMC infectious diseases · 2026Article
- Article
- Mortality and loss to follow-up among Tuberculosis patients on treatment in Meru County, Kenya: a retrospective cohort study.PLOS global public health · 2025Article
- Article
- Proportion of active tuberculosis among HIV-infected children after antiretroviral therapy in Ethiopia: A systematic review and meta-analysis.PLOS global public health · 2024Article
- Identifying people with tuberculosis and linking to care: finding the missing millions - meet the guest editors.BMC global and public health · 2023Article
- Interventions to reduce deaths in people living with HIV admitted to hospital in low- and middle-income countries: A systematic review.PLOS global public health · 2023Article
- Missed opportunities for diagnosis and treatment in patients with TB symptoms: a systematic review.Public health action · 2022Review
- Screening Adults for HIV Testing in the Outpatient Department: An Assessment of Tool Performance in Malawi.AIDS and behavior · 2022Article
- Drug resistance characteristics ofEpidemiology and infection · 2022Article
- Clinical Evaluation of Active Tuberculosis-Related Deaths in Shenzhen, China: A Descriptive Study.International journal of general medicine · 2021Article
- Tuberculosis in Hospitalized Patients With Human Immunodeficiency Virus: Clinical Characteristics, Mortality, and Implications From the Rapid Urine-based Screening for Tuberculosis to Reduce AIDS Related Mortality in Hospitalized Patients in Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out.Scientific reports · 2020Article
- Article
- Guidance for Studies Evaluating the Accuracy of Tuberculosis Triage Tests.The Journal of infectious diseases · 2019Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 4 countries.
Funding
Abstract
introductionHIV and tuberculosis (TB) remain leading causes of preventable death in low- and middle-income countries (LMICs). The World Health Organization (WHO) recommends HIV testing for all individuals with TB symptoms, but implementation has been suboptimal. We conducted a systematic literature review and meta-analyses to estimate HIV and TB prevalence, and short-term (two to six months) mortality, among adults with TB symptoms at community- and facility level.
methodsWe searched Embase, Global Health and MEDLINE databases, and reviewed conference abstracts for studies reporting simultaneous HIV and TB screening of adults in LMICs published between January 2003 and December 2017. Meta-analyses were performed to estimate prevalence of HIV, undiagnosed TB and mortality risk at different health system levels.
resultsSixty-two studies including 260,792 symptomatic adults were identified, mostly from Africa and Asia. Median HIV prevalence was 19.2% (IQR: 8.3% to 40.4%) at community level, 55.7% (IQR: 20.9% to 71.2%) at primary care level and 80.7% (IQR: 73.8% to 84.6%) at hospital level. Median TB prevalence was 6.9% (IQR: 3.3% to 8.4%) at community, 20.5% (IQR: 11.7% to 46.4%) at primary care and 36.4% (IQR: 22.9% to 40.9%) at hospital level. Median short-term mortality was 22.6% (IQR: 15.6% to 27.7%) among inpatients, 3.1% (IQR: 1.2% to 4.2%) at primary care and 1.6% (95% CI: 0.45 to 4.13, n = 1 study) at community level.
conclusionsAdults with TB symptoms have extremely high prevalence of HIV infection, even when identified through community surveys. TB prevalence and mortality increased substantially at primary care and inpatient level respectively. Strategies to expand symptom-based TB screening combined with HIV and TB testing for all symptomatic individuals should be of the highest priority for both disease programmes in LMICs with generalized HIV epidemics. Interventions to reduce short-term mortality are urgently needed.
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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.