Present outlooks on the prevalence of minimal and subclinical tuberculosis and current diagnostic tests: A systematic review and meta-analysis

IF 4.7 3区 医学 Q1 INFECTIOUS DISEASES
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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.

目前对轻微和亚临床结核病发病率的展望以及当前的诊断测试:系统回顾和荟萃分析。
背景:结核病(TB)是一个重大的全球健康问题,尤其是其微小和亚临床形式,这些形式的结核病往往未被发现并造成传播。对这些形式的结核病进行准确的患病率评估并提高诊断检测的有效性,对于改善结核病控制至关重要,尤其是在艾滋病毒感染者等高危人群中:本研究旨在确定极少数和亚临床结核病的患病率,并评估当前诊断检测的阳性率:我们对 2000 年 1 月至 2022 年 12 月期间发表的研究进行了荟萃分析。方法:我们对 2000 年 1 月至 2022 年 12 月发表的研究进行了荟萃分析,分析了患病率和诊断检测结果,包括痰培养、涂片显微镜检查、TST/IGRA 和胸部 X 光检查,计算了汇总患病率,并对不同地理区域进行了比较:结果:在普通人群中,轻度肺结核发病率为 0.9% 至 22.9%,而在艾滋病毒感染者中,亚临床肺结核发病率为 0.05% 至 0.64%,发病率为 1.57% 至 14.63%。最小肺结核的总发病率为 7%(95% CI:5%-9%),与非洲(6%,95% CI:4%-8%)相比,亚洲的发病率更高(8%,95% CI:5%-12%)。亚临床肺结核的总发病率为 0.2 %(95 % CI:0.2-0.3 %),在肺结核病例中的发病率为 52 %(95 % CI:46-58 %),亚洲的发病率(60 %)高于非洲(44 %)。诊断测试阳性率为 77%(痰培养)、15%(涂片显微镜检查)、64%(TST/IGRA)和 53%(胸部 X 光检查):这项研究揭示了轻度和亚临床结核病发病率的巨大差异。研究结果凸显了改进诊断方法的必要性,以减少未发现的病例,尤其是在高危人群中。
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来源期刊
Journal of Infection and Public Health
Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES
CiteScore
13.10
自引率
1.50%
发文量
203
审稿时长
96 days
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.
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