Does tuberculosis screening improve individual outcomes? A systematic review.
Does tuberculosis screening improve individual outcomes? A systematic review.
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DOI：
10.1016/j.eclinm.2021.101127
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发表时间：
2021-10
影响因子：
15.1
通讯作者：
Ayles HM
中科院分区：
文献类型：
--
作者：
Telisinghe L;Ruperez M;Amofa-Sekyi M;Mwenge L;Mainga T;Kumar R;Hassan M;Chaisson LH;Naufal F;Shapiro AE;Golub JE;Miller C;Corbett EL;Burke RM;MacPherson P;Hayes RJ;Bond V;Daneshvar C;Klinkenberg E;Ayles HM
为了确定结核病（TB）筛查是否改善患者结局，我们进行了两项系统评价，以调查TB筛查对诊断、治疗结局、死亡（临床评价评估23个结局指标）和患者成本（经济评价）的影响。检索了Pubmed、EMBASE、Scopus和科克伦图书馆，检索时间为1980年1月1日至2020年4月13日（临床综述）和2010年1月1日至2020年8月14日（经济综述）。由于研究是异质性的，数据合成是叙述性的。临床综述：在27，270篇文章中，有18篇（n=3项试验）合格。9个涉及一般人群。与被动病例发现（PCF）相比，研究显示筛查组的涂片分级（n = 23）和诊断时间（n= 23）较低;治疗前失访率较高（筛查组为23%和29%，PCF组为15%和14%; n=2/2）;治疗成功率（范围68-81%; n=4）和病死率（范围3-11%; n=5）相似。9个国家报告了风险群体。与PCF相比，研究显示，在培养确认的患者（n=3/4）和诊断时间（n=2/2）中，涂片阳性率较低;筛查组的治疗成功率相似（范围80-90%; n=2/2）。在n=2/3的观察性研究中，病死率较低;这两项研究均报告了既定的筛查计划。一项新生儿试验和一项家庭接触试验的事后分析发现，筛查与较低的全因死亡率有关。经济回顾：在2841篇文章中，有6项观察性研究符合条件。总成本（n=6）和灾难性成本患病率（n=4;范围筛选9-45% vs PCF 12-61%）在筛选者中较低。我们发现患者结局数据非常有限。必须优先收集和报告这些数据，以便为政策和实践提供信息。世卫组织和EDCTP。
To determine if tuberculosis (TB) screening improves patient outcomes, we conducted two systematic reviews to investigate the effect of TB screening on diagnosis, treatment outcomes, deaths (clinical review assessing 23 outcome indicators); and patient costs (economic review). Pubmed, EMBASE, Scopus and the Cochrane Library were searched between 1/1/1980-13/4/2020 (clinical review) and 1/1/2010-14/8/2020 (economic review). As studies were heterogeneous, data synthesis was narrative. Clinical review: of 27,270 articles, 18 (n=3 trials) were eligible. Nine involved general populations. Compared to passive case finding (PCF), studies showed lower smear grade (n=2/3) and time to diagnosis (n=2/3); higher pre-treatment losses to follow-up (screened 23% and 29% vs PCF 15% and 14%; n=2/2); and similar treatment success (range 68-81%; n=4) and case fatality (range 3-11%; n=5) in the screened group. Nine reported on risk groups. Compared to PCF, studies showed lower smear positivity among those culture-confirmed (n=3/4) and time to diagnosis (n=2/2); and similar (range 80-90%; n=2/2) treatment success in the screened group. Case fatality was lower in n=2/3 observational studies; both reported on established screening programmes. A neonatal trial and post-hoc analysis of a household contacts trial found screening was associated with lower all-cause mortality. Economic review: From 2841 articles, six observational studies were eligible. Total costs (n=6) and catastrophic cost prevalence (n=4; range screened 9-45% vs PCF 12-61%) was lower among those screened. We found very limited patient outcome data. Collecting and reporting this data must be prioritised to inform policy and practice. WHO and EDCTP.
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DOI：
10.1016/s0140-6736(18)31267-4
发表时间：
2018-07-28
期刊：
Lancet (London, England)
影响因子：
--
作者：
Gupta-Wright A;Corbett EL;van Oosterhout JJ;Wilson D;Grint D;Alufandika-Moyo M;Peters JA;Chiume L;Flach C;Lawn SD;Fielding K
通讯作者：
Fielding K
DOI：
10.1016/s2468-2667(21)00033-5
发表时间：
2021-05
期刊：
The Lancet. Public health
影响因子：
--
作者：
Burke RM;Nliwasa M;Feasey HRA;Chaisson LH;Golub JE;Naufal F;Shapiro AE;Ruperez M;Telisinghe L;Ayles H;Corbett EL;MacPherson P
通讯作者：
MacPherson P
DOI：
10.1016/s0041-3879(82)80028-7
发表时间：
1982-01-01
期刊：
TUBERCLE
影响因子：
--
作者：
CASSELS, A;HEINEMAN, E;RAHUT, CB
通讯作者：
RAHUT, CB
影响因子：
168.9
作者：
Corbett, Elizabeth L.;Bandason, Tsitsi;Duong, Trinh;Dauya, Ethel;Makamure, Beauty;Churchyard, Gavin J.;Williams, Brian G.;Munyati, Shungu S.;Butterworth, Anthony E.;Mason, Peter R.;Mungofa, Stanley;Hayes, Richard J.
通讯作者：
Hayes, Richard J.
影响因子：
8.1
作者：
Gurung, Suman Chandra;Dixit, Kritika;de Siqueira-Filha, Noemia Teixeira
通讯作者：
de Siqueira-Filha, Noemia Teixeira