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Burden of tuberculosis in underserved populations in South Africa: A systematic review and meta-analysis

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Listed:
  • Lydia M L Holtgrewe
  • Ann Johnson
  • Kate Nyhan
  • Jody Boffa
  • Sheela V Shenoi
  • Aaron S Karat
  • J Lucian Davis
  • Salome Charalambous

Abstract

Author summary: Identifying case-finding strategies to reduce tuberculosis (TB) incidence in high-burden countries requires better knowledge of the disease burden in key contributing populations and settings. To inform South Africa’s National Tuberculosis Strategic Plan 2023–2028, we conducted a systematic review of active TB disease and latent TB infection (LTBI) prevalence and incidence in underserved populations, defined as those living in informal settlements, townships, or impoverished communities. We identified articles published from January 2010 to December 2023, assessed study quality, and conducted a meta-analysis to estimate pooled TB and LTBI prevalence stratified by HIV status. We calculated prevalence ratios for underserved populations compared to the overall South African population. The search yielded 726 unique citations. We identified 22 studies reporting TB prevalence (n = 12), TB incidence (n = 5), LTBI prevalence (n = 5), and/or LTBI incidence (n = 2) eligible for the review, including six high-quality studies. Meta-analysis demonstrated a high prevalence of TB disease among persons living without HIV (2.7% 95% CI 0.1 to 8.5%) and persons living with HIV (PLWH) (22.7%, 95% CI 15.8 to 30.4%), but heterogeneity was high (I2 = 95.5% and 92.3%, p-value

Suggested Citation

  • Lydia M L Holtgrewe & Ann Johnson & Kate Nyhan & Jody Boffa & Sheela V Shenoi & Aaron S Karat & J Lucian Davis & Salome Charalambous, 2024. "Burden of tuberculosis in underserved populations in South Africa: A systematic review and meta-analysis," PLOS Global Public Health, Public Library of Science, vol. 4(10), pages 1-21, October.
    • Handle: RePEc:plo:pgph00:0003753
    DOI: 10.1371/journal.pgph.0003753
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    References listed on IDEAS

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    1. Zoë M McLaren & Kathryn Schnippel & Alana Sharp, 2016. "A Data-Driven Evaluation of the Stop TB Global Partnership Strategy of Targeting Key Populations at Greater Risk for Tuberculosis," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-12, October.
    2. Lieve Vanleeuw & Wanga Zembe-Mkabile & Salla Atkins, 2022. "Falling through the cracks: Increased vulnerability and limited social assistance for TB patients and their households during COVID-19 in Cape Town, South Africa," PLOS Global Public Health, Public Library of Science, vol. 2(7), pages 1-18, July.
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