{"title":"Present outlooks on the prevalence of minimal and subclinical tuberculosis and current diagnostic tests: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.jiph.2024.102517","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Tuberculosis (TB) is a major global health issue, particularly in its minimal and subclinical forms, which often go undetected and contribute to transmission. Accurate prevalence assessment of these forms and the effectiveness of diagnostic tests are crucial for improving TB control, especially in high-risk populations such as those with HIV.</p></div><div><h3>Objectives</h3><p>This study aimed to determine the prevalence of minimal and subclinical TB and evaluate the positivity rates of current diagnostic tests. Methods: We conducted a meta-analysis of studies published from January 2000 to December 2022. Prevalence rates and diagnostic test results, including sputum culture, smear microscopy, TST/IGRA, and chest X-ray, were analyzed, with pooled prevalence calculated and comparisons made between geographic regions.</p></div><div><h3>Results</h3><p>Minimal TB prevalence ranged from 0.9 % to 22.9 % in the general population, while subclinical TB prevalence was 0.05 % to 0.64 %, and 1.57 % to 14.63 % among individuals with HIV. The overall pooled prevalence of minimal TB was 7 % (95 % CI: 5–9 %), with higher rates in Asia (8 %, 95 % CI: 5–12 %) compared to Africa (6 %, 95 % CI: 4–8 %). Subclinical TB had a pooled prevalence of 0.2 % (95 % CI: 0.2–0.3 %) overall and 52 % (95 % CI: 46–58 %) among TB cases, with higher rates in Asia (60 %) compared to Africa (44 %). Diagnostic test positivity was 77 % (sputum culture), 15 % (smear microscopy), 64 % (TST/IGRA), and 53 % (chest X-ray).</p></div><div><h3>Conclusions</h3><p>This study reveals significant variability in the prevalence of minimal and subclinical TB. The findings highlight the need for improved diagnostic methods to reduce undetected cases, especially in high-risk populations.</p></div>","PeriodicalId":16087,"journal":{"name":"Journal of Infection and Public Health","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S187603412400251X/pdfft?md5=6893b5a7c57dabeed3a9bcdcd1d49d14&pid=1-s2.0-S187603412400251X-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Infection and Public Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S187603412400251X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Tuberculosis (TB) is a major global health issue, particularly in its minimal and subclinical forms, which often go undetected and contribute to transmission. Accurate prevalence assessment of these forms and the effectiveness of diagnostic tests are crucial for improving TB control, especially in high-risk populations such as those with HIV.
Objectives
This study aimed to determine the prevalence of minimal and subclinical TB and evaluate the positivity rates of current diagnostic tests. Methods: We conducted a meta-analysis of studies published from January 2000 to December 2022. Prevalence rates and diagnostic test results, including sputum culture, smear microscopy, TST/IGRA, and chest X-ray, were analyzed, with pooled prevalence calculated and comparisons made between geographic regions.
Results
Minimal TB prevalence ranged from 0.9 % to 22.9 % in the general population, while subclinical TB prevalence was 0.05 % to 0.64 %, and 1.57 % to 14.63 % among individuals with HIV. The overall pooled prevalence of minimal TB was 7 % (95 % CI: 5–9 %), with higher rates in Asia (8 %, 95 % CI: 5–12 %) compared to Africa (6 %, 95 % CI: 4–8 %). Subclinical TB had a pooled prevalence of 0.2 % (95 % CI: 0.2–0.3 %) overall and 52 % (95 % CI: 46–58 %) among TB cases, with higher rates in Asia (60 %) compared to Africa (44 %). Diagnostic test positivity was 77 % (sputum culture), 15 % (smear microscopy), 64 % (TST/IGRA), and 53 % (chest X-ray).
Conclusions
This study reveals significant variability in the prevalence of minimal and subclinical TB. The findings highlight the need for improved diagnostic methods to reduce undetected cases, especially in high-risk populations.
期刊介绍:
The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other.
The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners.
It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.