Evidence map›Paper›PMID 39361564›Full record

ArticlePLOS global public health2024

Burden of tuberculosis in underserved populations in South Africa: A systematic review and meta-analysis.

Lydia M L Holtgrewe, Ann Johnson, Kate Nyhan, Jody Boffa, Sheela V Shenoi, Aaron S Karat, J Lucian Davis, Salome Charalambous

Abstract read
In one paragraph

Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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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

8 authors.

Lydia M L HoltgreweDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0003-3692-0469
Ann JohnsonDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.
Kate NyhanHarvey Cushing / John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, United States of America.
Jody BoffaThe Aurum Institute, Johannesburg, Gauteng Province, South Africa.
Sheela V ShenoiDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0001-7654-4344
Aaron S KaratTuberculosis Centre, London School of Hygiene & Tropical Medicine, City of London, United Kingdom.ORCID https://orcid.org/0000-0001-9643-664X
J Lucian DavisDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.ORCID https://orcid.org/0000-0002-8629-9992
Salome CharalambousDepartment of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Identifying case-finding strategies to reduce tuberculosis (TB) incidence in high-burden countries requires better knowledge of the disease burden in key contributing populations and settings. To inform South Africa's National Tuberculosis Strategic Plan 2023-2028, we conducted a systematic review of active TB disease and latent TB infection (LTBI) prevalence and incidence in underserved populations, defined as those living in informal settlements, townships, or impoverished communities. We identified articles published from January 2010 to December 2023, assessed study quality, and conducted a meta-analysis to estimate pooled TB and LTBI prevalence stratified by HIV status. We calculated prevalence ratios for underserved populations compared to the overall South African population. The search yielded 726 unique citations. We identified 22 studies reporting TB prevalence (n = 12), TB incidence (n = 5), LTBI prevalence (n = 5), and/or LTBI incidence (n = 2) eligible for the review, including six high-quality studies. Meta-analysis demonstrated a high prevalence of TB disease among persons living without HIV (2.7% 95% CI 0.1 to 8.5%) and persons living with HIV (PLWH) (22.7%, 95% CI 15.8 to 30.4%), but heterogeneity was high (I2 = 95.5% and 92.3%, p-value<0.00). LTBI prevalence was high among persons living without HIV (44.8%, 95% 42.5 to 47%) with moderate heterogeneity (I2 = 14.6%, p-value = 0.31), and lower among PLWH (33%, 95% CI 22.6 to 44.4%) based on one study. Compared to the national average, underserved populations of persons living without HIV had a 4-fold higher TB prevalence and a 3.3-fold higher LTBI prevalence. Underserved PLWH had a 31-fold higher TB prevalence than the national average, but similar LTBI prevalence as measured in one study. Our findings illustrate that underserved populations in South Africa have a substantially higher TB and LTBI prevalence than the general population, making targeted TB interventions potentially beneficial. More research is needed to explore the heterogeneous TB epidemiology in South Africa.

Identifiers

PMID39361564
PMCPMC11449336

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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.