Tuberculosis in household contacts of tuberculosis patients in sub-Saharan African countries: A systematic review and meta-analysis

BACKGROUND: The Mycobacterium tuberculosis complex causes tuberculosis, a severe public health problem. Close contacts of someone who has active pulmonary tuberculosis were at a greater risk of contracting the disease. Despite the large number of primary research available in Sub-Saharan African nations, there are no systematic reviews or meta-analyses that estimate the pooled prevalence of tuberculosis among tuberculosis patients' household contacts (HHC). Thus, this study aimed to estimate the pooled prevalence of tuberculosis in a household contact of tuberculosis patients in the sub-Saharan African region. METHODS: Potential papers were systematically searched from electronic databases (PubMed, Google scholar and web of science). To analyze the quality of the papers featured, we used the Joanna Briggs Institute Critical Appraisal methods. Data were analyzed using STATA Version 16. RESULT: After screening 373 studies, the final analysis includes 20 articles from twelve countries. The overall prevalence of tuberculosis among household contacts was 3.29 % (95 % CI; 2.35 %-4.23 %). The overall prevalence rate of active tuberculosis in children aged less than five years was 2.60 % (95 % CI; 1.81 %-3.39 %). When the index patient age was less than 18 years old, the pooled prevalence of active TB in HHC was 2.64 % (95 % CI; 1.46 %-3.81 %). The pooled proportion of HIV in index TB patients was 53.12 % (95 % CI, 39.73 %-66.51 %). The overall pooled prevalence of HIV in household contacts was 7.75 % (95 % CI, 4.21 %-11.29 %). CONCLUSION: Our systematic review showed that, in Sub-Saharan African nations, household contacts are at a high risk of contracting tuberculosis from their index patient. According to this study, one out of every thirty household contacts will develop active tuberculosis. This demonstrated the significance of doing thorough active tuberculosis case tracing in household contacts to locate missing tuberculosis patients.