Burden of tuberculosis among vulnerable populations worldwide: an overview of systematic reviews - 23/11/23
Summary |
Background |
Tuberculosis is a communicable disease of public health concern that inequitably impacts the most vulnerable populations worldwide. Vulnerable populations are those with a high risk for tuberculosis disease and whose disadvantaged or marginalised socioeconomic position limits their access to the health system. We conducted an overview of reviews that aimed to assess the burden (ie, prevalence and incidence) of tuberculosis disease among 12 vulnerable populations globally.
Methods |
We did an overview of reviews using a systematic search in MEDLINE, Embase, and the Cochrane Database for Systematic Reviews for articles published in English, French, and Chinese, from Jan 1, 2010 to March 8, 2023. We did an initial search on Oct 28, 2021, and updated our search on March 8, 2023. We included systematic and scoping reviews reporting on the prevalence or incidence of active tuberculosis among 12 vulnerable populations. Evidence gaps were supplemented with primary or secondary database studies. Study characteristics and outcome data related to tuberculosis burden were tabulated, including prevalence ratios and incidence rate ratios, and evidence was synthesised narratively. This trial is registered with PROSPERO (CRD42022324421).
Findings |
We screened 13 169 citations and included 44 publications (23 reviews and 21 primary or database studies) in the final synthesis. The comprehensiveness and methodological quality of the evidence differed across population groups. Prevalence of more than 1000 cases per 100 000 were reported in all vulnerable populations. On the basis of pooled estimates, prevalence ratios were often more than 25 among people experiencing homelessness, incarcerated populations, refugees, asylum seekers, and people living with HIV compared with the general population. Incidence was infrequently reported, with the best-available incidence rate ratios documented for people who were incarcerated. There was scarce evidence specific to miners, nomadic populations, sex workers, men who have sex with men, and transgender individuals.
Interpretation |
The burden of tuberculosis is substantially higher among vulnerable populations than general populations, suggesting a need for improved integration of these groups, including dedicated efforts for their identification, targeted screening and prevention measures, as well as treatment support.
Funding |
WHO.
Le texte complet de cet article est disponible en PDF.Plan
Vol 23 - N° 12
P. 1395-1407 - décembre 2023 Retour au numéro
Article précédent
- Safety, efficacy, and immunogenicity of a replication-defective human cytomegalovirus vaccine, V160, in cytomegalovirus-seronegative women: a double-blind, randomised, placebo-controlled, phase 2b trial
- Rituparna Das, Daniel Blázquez-Gamero, David I Bernstein, Soren Gantt, Oliver Bautista, Karen Beck, Anthony Conlon, Daniel I S Rosenbloom, Dai Wang, Michael Ritter, Beth Arnold, Paula Annunziato, Kevin L Russell, V160-002 study group
- Safety, tolerability, and immunogenicity of the Ebola Sudan chimpanzee adenovirus vector vaccine (cAd3-EBO S) in healthy Ugandan adults: a phase 1, open-label, dose-escalation clinical trial
- Betty Mwesigwa, Katherine V Houser, Amelia R Hofstetter, Ana M Ortega-Villa, Prossy Naluyima, Francis Kiweewa, Immaculate Nakabuye, Galina V Yamshchikov, Charla Andrews, Mark O'Callahan, Larisa Strom, Steven Schech, Leigh Anne Eller, Erica L Sondergaard, Paul T Scott, Mihret F Amare, Kayvon Modjarrad, Amir Wamala, Allan Tindikahwa, Ezra Musingye, Jauhara Nanyondo, Martin R Gaudinski, Ingelise J Gordon, LaSonji A Holman, Jamie G Saunders, Pamela J M Costner, Floreliz H Mendoza, Myra Happe, Patricia Morgan, Sarah H Plummer, Somia P Hickman, Sandra Vazquez, Tamar Murray, Jamilet Cordon, Caitlyn N M Dulan, Ruth Hunegnaw, Manjula Basappa, Marcelino Padilla, Suprabhath R Gajjala, Phillip A Swanson, Bob C Lin, Emily E Coates, Jason G Gall, Adrian B McDermott, Richard A Koup, John R Mascola, Aurélie Ploquin, Nancy J Sullivan, Hannah Kibuuka, Julie A Ake, Julie E Ledgerwood, RV 508 Study Team, Jaqueline Namugabo, Claire Beingana, Maureen G. Mukyala, Joseph Wandege, Christine Nanteza, Brenda Atwijuka, Juliet Kizanye, Gertrude Nassanga, Joanita Namuli, Herbert Kityo, Mathias Ssekitoleko, Roy Nassaka, Hilda Mutebe, Mable Kabahubya, Alicia T. Widge, Sarah E. O'Connell, Obrimpong Amoa-Awua, Sandeep R. Narpala, Britta Flach, Josephine Cox, Allison Beck, Mercy Guech, Ellie Seo, Judy A. Stein
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?