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Does tuberculosis screening improve individual outcomes? A systematic review

BACKGROUND: To determine if tuberculosis (TB) screening improves patient outcomes, we conducted two systematic reviews to investigate the effect of TB screening on diagnosis, treatment outcomes, deaths (clinical review assessing 23 outcome indicators); and patient costs (economic review). METHODS: P...

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Autores principales: Telisinghe, L, Ruperez, M, Amofa-Sekyi, M, Mwenge, L, Mainga, T, Kumar, R, Hassan, M, Chaisson, L.H, Naufal, F, Shapiro, A.E, Golub, J.E, Miller, C, Corbett, E.L, Burke, R.M, MacPherson, P, Hayes, R.J, Bond, V, Daneshvar, C, Klinkenberg, E, Ayles, H.M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473670/
https://www.ncbi.nlm.nih.gov/pubmed/34604724
http://dx.doi.org/10.1016/j.eclinm.2021.101127
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author Telisinghe, L
Ruperez, M
Amofa-Sekyi, M
Mwenge, L
Mainga, T
Kumar, R
Hassan, M
Chaisson, L.H
Naufal, F
Shapiro, A.E
Golub, J.E
Miller, C
Corbett, E.L
Burke, R.M
MacPherson, P
Hayes, R.J
Bond, V
Daneshvar, C
Klinkenberg, E
Ayles, H.M
author_facet Telisinghe, L
Ruperez, M
Amofa-Sekyi, M
Mwenge, L
Mainga, T
Kumar, R
Hassan, M
Chaisson, L.H
Naufal, F
Shapiro, A.E
Golub, J.E
Miller, C
Corbett, E.L
Burke, R.M
MacPherson, P
Hayes, R.J
Bond, V
Daneshvar, C
Klinkenberg, E
Ayles, H.M
author_sort Telisinghe, L
collection PubMed
description BACKGROUND: To determine if tuberculosis (TB) screening improves patient outcomes, we conducted two systematic reviews to investigate the effect of TB screening on diagnosis, treatment outcomes, deaths (clinical review assessing 23 outcome indicators); and patient costs (economic review). METHODS: Pubmed, EMBASE, Scopus and the Cochrane Library were searched between 1/1/1980-13/4/2020 (clinical review) and 1/1/2010-14/8/2020 (economic review). As studies were heterogeneous, data synthesis was narrative. FINDINGS: Clinical review: of 27,270 articles, 18 (n=3 trials) were eligible. Nine involved general populations. Compared to passive case finding (PCF), studies showed lower smear grade (n=2/3) and time to diagnosis (n=2/3); higher pre-treatment losses to follow-up (screened 23% and 29% vs PCF 15% and 14%; n=2/2); and similar treatment success (range 68-81%; n=4) and case fatality (range 3-11%; n=5) in the screened group. Nine reported on risk groups. Compared to PCF, studies showed lower smear positivity among those culture-confirmed (n=3/4) and time to diagnosis (n=2/2); and similar (range 80-90%; n=2/2) treatment success in the screened group. Case fatality was lower in n=2/3 observational studies; both reported on established screening programmes. A neonatal trial and post-hoc analysis of a household contacts trial found screening was associated with lower all-cause mortality. Economic review: From 2841 articles, six observational studies were eligible. Total costs (n=6) and catastrophic cost prevalence (n=4; range screened 9-45% vs PCF 12-61%) was lower among those screened. INTERPRETATION: We found very limited patient outcome data. Collecting and reporting this data must be prioritised to inform policy and practice. FUNDING: WHO and EDCTP.
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spelling pubmed-84736702021-10-01 Does tuberculosis screening improve individual outcomes? A systematic review Telisinghe, L Ruperez, M Amofa-Sekyi, M Mwenge, L Mainga, T Kumar, R Hassan, M Chaisson, L.H Naufal, F Shapiro, A.E Golub, J.E Miller, C Corbett, E.L Burke, R.M MacPherson, P Hayes, R.J Bond, V Daneshvar, C Klinkenberg, E Ayles, H.M EClinicalMedicine Research paper BACKGROUND: To determine if tuberculosis (TB) screening improves patient outcomes, we conducted two systematic reviews to investigate the effect of TB screening on diagnosis, treatment outcomes, deaths (clinical review assessing 23 outcome indicators); and patient costs (economic review). METHODS: Pubmed, EMBASE, Scopus and the Cochrane Library were searched between 1/1/1980-13/4/2020 (clinical review) and 1/1/2010-14/8/2020 (economic review). As studies were heterogeneous, data synthesis was narrative. FINDINGS: Clinical review: of 27,270 articles, 18 (n=3 trials) were eligible. Nine involved general populations. Compared to passive case finding (PCF), studies showed lower smear grade (n=2/3) and time to diagnosis (n=2/3); higher pre-treatment losses to follow-up (screened 23% and 29% vs PCF 15% and 14%; n=2/2); and similar treatment success (range 68-81%; n=4) and case fatality (range 3-11%; n=5) in the screened group. Nine reported on risk groups. Compared to PCF, studies showed lower smear positivity among those culture-confirmed (n=3/4) and time to diagnosis (n=2/2); and similar (range 80-90%; n=2/2) treatment success in the screened group. Case fatality was lower in n=2/3 observational studies; both reported on established screening programmes. A neonatal trial and post-hoc analysis of a household contacts trial found screening was associated with lower all-cause mortality. Economic review: From 2841 articles, six observational studies were eligible. Total costs (n=6) and catastrophic cost prevalence (n=4; range screened 9-45% vs PCF 12-61%) was lower among those screened. INTERPRETATION: We found very limited patient outcome data. Collecting and reporting this data must be prioritised to inform policy and practice. FUNDING: WHO and EDCTP. Elsevier 2021-09-22 /pmc/articles/PMC8473670/ /pubmed/34604724 http://dx.doi.org/10.1016/j.eclinm.2021.101127 Text en © 2021 The Author(s) https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Research paper
Telisinghe, L
Ruperez, M
Amofa-Sekyi, M
Mwenge, L
Mainga, T
Kumar, R
Hassan, M
Chaisson, L.H
Naufal, F
Shapiro, A.E
Golub, J.E
Miller, C
Corbett, E.L
Burke, R.M
MacPherson, P
Hayes, R.J
Bond, V
Daneshvar, C
Klinkenberg, E
Ayles, H.M
Does tuberculosis screening improve individual outcomes? A systematic review
title Does tuberculosis screening improve individual outcomes? A systematic review
title_full Does tuberculosis screening improve individual outcomes? A systematic review
title_fullStr Does tuberculosis screening improve individual outcomes? A systematic review
title_full_unstemmed Does tuberculosis screening improve individual outcomes? A systematic review
title_short Does tuberculosis screening improve individual outcomes? A systematic review
title_sort does tuberculosis screening improve individual outcomes? a systematic review
topic Research paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8473670/
https://www.ncbi.nlm.nih.gov/pubmed/34604724
http://dx.doi.org/10.1016/j.eclinm.2021.101127
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