Burden and determinants of MDR-TB among prisoners in sub-Saharan Africa: Systematic review and meta-analysis protocol.

IF 0.8 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Journal of Public Health in Africa Pub Date : 2025-08-30 eCollection Date: 2025-01-01 DOI:10.4102/jphia.v16i4.1364
Doris Y Sakala, Jacques M Tamuzi, Constance S Shumba, Peter S Nyasulu
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引用次数: 0

Abstract

Background: Tuberculosis (TB) is one of the leading causes of death globally because of a single infectious pathogen. The rise in prevalence of multi-drug-resistant tuberculosis (MDR-TB) puts an increased burden on the health system in terms of cost and longer treatment duration. People living in correctional facilities are more likely to develop TB and have poor TB treatment outcomes than the general population, making them a vulnerable group to develop MDR-TB. However, the burden of MDR-TB and associated treatment outcomes among prisoners in sub-Saharan Africa (SSA) is poorly documented.

Aim: The study aims to investigate the burden and associated factors of MDR-TB treatment among prisoners in SSA.

Setting: The review will include studies of MDR-TB done in prisons and detention centers involving prisoners and inmates in sub Saharan Africa.

Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PROSPERO), we will conduct a systematic review and meta-analysis. We will review studies examining MDR-TB patient treatment outcomes among prisoners reported in published literature in SSA from 2000 to 31 December 2024. A search on studies reporting MDR-TB treatment outcomes from the databases such as 'Medline, Embase, CINAHL (EBSCOhost), Scopus and Web of Science' will be conducted. We will analyse continuous outcomes as mean differences for studies using the same scales with standard deviation reported and binary outcome data as odds ratios or risk ratios, all presented with their 95% confidence intervals. Additionally, the pooled proportions will be used to determine the prevalence or incidence of specific MDR-TB treatment outcomes. Heterogeneity will be assessed using the I 2 statistic, and where significant heterogeneity is detected, a random-effects model meta-analysis will be performed; otherwise, a fixed-effect model meta-analysis will be carried out. Risk factors will be determined using the meta-regression analysis technique.

Results: After analysis of pooled data, prevalence of MDT-TB in prisons will be presented as proportions. Meta-analysis outcome will be presented as forest plots, showing odd ratios and co-responding 95% confidence intervals. Narrative synthesis of included studies will be presented in a table format.

Conclusion: This proposed systematic review and meta-analysis will help consolidate evidence to support the development of public health guidelines to enhance the reduction of MDT-TB factors among prisoners in the SSA region.

Contribution: This review will provide evidence to support guideline development on screening, diagnosis, and clinical management of MDR-TB patients in prisons.

Abstract Image

Abstract Image

撒哈拉以南非洲囚犯耐多药结核病的负担和决定因素:系统评价和荟萃分析方案。
背景:结核病(TB)是全球死亡的主要原因之一,因为它是一种单一的传染性病原体。耐多药结核病(MDR-TB)流行率的上升在费用和治疗时间方面给卫生系统带来了更大的负担。与一般人群相比,生活在教养设施中的人更容易患结核病,结核病治疗效果也较差,使他们成为易患耐多药结核病的群体。然而,撒哈拉以南非洲(SSA)囚犯中耐多药结核病负担和相关治疗结果的记录很少。目的:调查SSA在押人员耐多药结核病治疗负担及相关因素。环境:审查将包括在撒哈拉以南非洲监狱和拘留中心进行的涉及囚犯和囚犯的耐多药结核病研究。方法:根据首选报告项目进行系统评价和元分析(PROSPERO),我们将进行系统评价和元分析。我们将审查2000年至2024年12月31日在SSA发表的文献中报告的囚犯中耐多药结核病患者治疗结果的研究。将对Medline、Embase、CINAHL (EBSCOhost)、Scopus和Web of Science等数据库中报告耐多药结核病治疗结果的研究进行检索。我们将对使用相同量表的研究的连续结果进行平均差异分析,报告标准差,并将二元结果数据作为优势比或风险比,均以其95%置信区间表示。此外,汇总比例将用于确定耐多药结核病特定治疗结果的患病率或发病率。异质性将使用i2统计量进行评估,当发现显著异质性时,将进行随机效应模型荟萃分析;否则,采用固定效应模型元分析。风险因素将采用元回归分析技术确定。结果:在汇总数据分析后,监狱中耐多药结核的患病率将以比例表示。meta分析结果将呈现为森林图,显示奇数比和共同响应的95%置信区间。对纳入研究的叙述综合将以表格形式提出。结论:本文提出的系统评价和荟萃分析将有助于巩固证据,支持制定公共卫生指南,以加强减少SSA地区囚犯中耐多药结核因素。贡献:本综述将提供证据,支持制定监狱中耐多药结核病患者的筛查、诊断和临床管理指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Public Health in Africa
Journal of Public Health in Africa PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
自引率
0.00%
发文量
82
审稿时长
10 weeks
期刊介绍: The Journal of Public Health in Africa (JPHiA) is a peer-reviewed, academic journal that focuses on health issues in the African continent. The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.
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