SynthesisBMC health services research2025
Review: missed tuberculosis cases in India: a systematic analysis of diagnostic, treatment, and reporting gaps.
Synthesis in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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.
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Who cites it
3 citing papers in PubMed.
- Evaluating the nationwide availability of essential diagnostics for tuberculosis toward achieving a TB-free India.Microbiology spectrum · 2026Article
- Improving tuberculosis contact investigation in Chhattisgarh, India: early findings from operational research.Public health action · 2026Article
- Civil society perspectives on tuberculosis care for people living with HIV in Brazil: A study informed by Social Representations Theory.PLOS global public health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIndia aims to eliminate tuberculosis (TB) by 2025. Despite ongoing efforts to transform TB care, numerous factors contribute to the persistence of missing cases in India. To gain insight into this issue, we performed a comprehensive review to identify the factors responsible for these missing cases, segregating them into patient- and provider-related factors, with reference to the layers of the onion model.
methodsWe conducted a comprehensive literature review using relevant search strings in the MEDLINE, Scopus, and Web of Science databases from 2000 to 2024. Given the heterogeneity of the included studies, a qualitative rather than quantitative data analysis approach was considered. For the quality evaluation of studies, we employed a modified version of the Critical Appraisal Skills Program (CASP) checklist.
resultsOf the 253 articles identified, 25 studies that met the criteria for “missing cases” were selected for analysis. Based on the objectives of this review, we identified patient-related factors contributing to missing cases, including geographical displacement due to migration or occupational reasons, alcoholism, illiteracy, personal commitments, side effects to Anti-Tubercular Treatment (ATT), depressive symptoms, perceived social stigma, reluctance to reveal prior treatment history, and no record keeping. Provider-related factors highlighted were inadequate communication and sputum sample collection, exhaustion of pharmaceutical supplies, patient loss to follow-up, ACF versus PCF, inadequacy of diagnostic tests, lack of history taking, misclassification, and issues related to Ni-KSHAY notification. Based on this layer-wise model of missing factors, we discuss pertinent challenges along with plausible strategies and recommendations to stem the rise in missing cases within the Indian context.
conclusionOur novel findings with reference to the onion model allow for systematic highlighting and addressing of the key patient and provider factors that are fuelling missing cases. The results revealed that provider factors predominantly contributed to the missing case TB scenario. Improved accessibility to services, provider training, and competency building (i.e., handling samples, co-morbid patients, and case notifications), along with improving diagnostic infrastructure, would serve to strengthen the cause of TB elimination.
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