Prevalence of long-term physical sequelae among patients treated with multi-drug and extensively drug-resistant tuberculosis: a systematic review and meta-analysis.
Prevalence of long-term physical sequelae among patients treated with multi-drug and extensively drug-resistant tuberculosis: a systematic review and meta-analysis.
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DOI：
10.1016/j.eclinm.2023.101900
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发表时间：
2023-03
影响因子：
15.1
通讯作者：
Alene, Kefyalew Addis
中科院分区：
文献类型：
--
作者：
Akalu, Temesgen Yihunie;Clements, Archie C. A.;Wolde, Haileab Fekadu;Alene, Kefyalew Addis
关键词：
与耐多药结核病（MDR-TB）和广泛耐药结核病（XDR-TB）相关的身体后遗症正在出现，但未得到充分认识的全球挑战。本系统性综述和荟萃分析旨在量化与接受MDR和XDR-TB治疗的患者相关的长期身体后遗症的患病率和类型。我们系统性检索了CINAHL（EBSCO）、MEDLINE（通过奥维德）、Embase、Scopus和Web of Science，检索时间从开始到2022年7月1日，最后一次检索更新至2023年1月23日。我们纳入了报告与所有形式的耐药结核病相关的身体后遗症的研究，包括利福平耐药结核病（RR-TB）、耐多药结核病（MDR-TB）、前广泛耐药结核病（Pre-XDR-TB）和广泛耐药结核病（XDR-TB）。关注的主要结局是长期的身体后遗症。使用随机效应模型进行荟萃分析，以估计合并的身体后遗症比例。异质性的来源进行了探索，通过荟萃回归研究特征作为协变量。研究方案已在PROSPERO（CRD 42021250909）中注册。从确定的3047篇唯一出版物中，荟萃分析纳入了在30个不同国家进行的66项研究，包括37，380例患者。总体合并估计值为44.4%（95%置信区间（CI）：36.7-52.1）呼吸系统后遗症，26.7%（95% CI：23.85-29.7）听力后遗症，10.1%（95% CI：7.0-13.2）肌肉骨骼后遗症，8.4%（95% CI：6.5-10.3），肾脏后遗症为8.1%（95% CI：6.3-10.0），肝脏后遗症为7.3%（95% CI：5.1-9.4），视力后遗症为4.5%（95% CI：2.7-6.3）。估计值存在显著异质性。分层分析显示，听力后遗症的合并患病率为26.6%（95%CI：12.3-40.9），神经系统后遗症为31.5%（95%CI：5.5-57.5），肌肉骨骼后遗症为21.5%（95% CI：9.9-33.1），高于耐多药结核患者后遗症的合并患病率。呼吸系统后遗症在低收入国家（59.3%）和完成耐多药结核治疗后（57.7%）最高。该系统性综述发现，在耐多药和广泛耐药结核的幸存者中，呼吸、听力、肌肉骨骼、神经、肾脏、肝脏和视觉后遗症等长期身体后遗症很常见。耐多药结核和广泛耐药结核患者的后遗症发生率有显著差异。需要将耐多药和广泛耐药结核治疗后的不良结果监测纳入目前的耐多药结核规划管理，以便能够早期发现和预防治疗后后遗症。，通过新兴领导力研究者补助金，以及。
Physical sequelae related to multi-drug resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are emerging and under-recognised global challenges. This systematic review and meta-analysis aimed to quantify the prevalence and the types of long-term physical sequelae associated with patients treated for MDR- and XDR-TB. We systematically searched CINAHL (EBSCO), MEDLINE (via Ovid), Embase, Scopus, and Web of Science from inception through to July 1, 2022, and the last search was updated to January 23, 2023. We included studies reporting physical sequelae associated with all forms of drug-resistant TB, including rifampicin-resistant TB (RR-TB), MDR-TB, Pre-XDR-TB, and XDR-TB. The primary outcome of interest was long-term physical sequelae. Meta-analysis was conducted using a random-effect model to estimate the pooled proportion of physical sequelae. The sources of heterogeneity were explored through meta-regression using study characteristics as covariates. The research protocol was registered in PROSPERO (CRD42021250909). From 3047 unique publications identified, 66 studies consisting of 37,380 patients conducted in 30 different countries were included in the meta-analysis. The overall pooled estimate was 44.4% (95% Confidence Interval (CI): 36.7–52.1) for respiratory sequelae, 26.7% (95% CI: 23.85–29.7) for hearing sequelae, 10.1% (95% CI: 7.0–13.2) for musculoskeletal sequelae, 8.4% (95% CI: 6.5–10.3) for neurological sequelae, 8.1% (95% CI: 6.3–10.0) for renal sequelae, 7.3% (95% CI: 5.1–9.4) for hepatic sequelae, and 4.5% (95% CI: 2.7–6.3) for visual sequelae. There was substantial heterogeneity in the estimates. The stratified analysis showed that the pooled prevalence of hearing sequelae was 26.6% (95% CI: 12.3–40.9), neurological sequelae was 31.5% (95% CI: 5.5–57.5), and musculoskeletal sequelae were 21.5% (95% CI: 9.9–33.1) for patients with XDR-TB, which were higher than the pooled prevalence of sequelae among patients with MDR-TB. Respiratory sequelae were the highest in low-income countries (59.3%) and after completion of MDR-TB treatment (57.7%). This systematic review found that long-term physical sequelae such as respiratory, hearing, musculoskeletal, neurological, renal, hepatic, and visual sequelae were common among survivors of MDR- and XDR-TB. There was a significant difference in the prevalence of sequelae between patients with MDR- and XDR-TB. Post-MDR- and XDR-TB treatment surveillance for adverse outcomes needs to be incorporated into the current programmatic management of MDR-TB to enable early detection and prevention of post-treatment sequelae. , through an Emerging Leadership Investigator grant, and the .
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DOI：
10.1183/13993003.02325-2014
发表时间：
2015-10
期刊：
The European respiratory journal
影响因子：
--
作者：
Amaral AF;Coton S;Kato B;Tan WC;Studnicka M;Janson C;Gislason T;Mannino D;Bateman ED;Buist S;Burney PG;BOLD Collaborative Research Group
通讯作者：
BOLD Collaborative Research Group
影响因子：
2.9
作者：
Alene KA;Clements ACA;McBryde ES;Jaramillo E;Lonnroth K;Shaweno D;Viney K
通讯作者：
Viney K
影响因子：
1.2
作者：
Dayyab, Farouq Muhammad;Iliyasu, Garba;Habib, Abdulrazaq Garba
通讯作者：
Habib, Abdulrazaq Garba
影响因子：
1.6
作者：
Dela, Arif I.;Tank, Nitish Kumar D.;Piparva, Kiran G.
通讯作者：
Piparva, Kiran G.
影响因子：
3.7
作者：
Atif M;Bashir A;Ahmad N;Fatima RK;Saba S;Scahill S
通讯作者：
Scahill S