Yield and Coverage of Active Case Finding Interventions for Tuberculosis Control:A Systematic Review and Meta-analysis

Table 1

(a) Characteristics of 224 Studies, (b) Characteristics of 277 unique populations within the 224 studies.

(a)

Characteristic	N (%)
Study design
Cross-sectional	122 (54.5)
Prospective	57 (25.5)
Population – Based survey	19 (8.5)
RCT	13 (5.8)
Retrospective chart reviews	11 (4.9)
Quasi RCT	2 (0.9)
WHO region
Africa	153 (68.3)
South East Asia	51 (22.7)
Eastern Mediterranean	10 (4.5)
Western Pacific	5 (2.2)
The Americas	4 (1.8)
Other (multi-regional study^a)	1 (0.5)
Quality rating
High	136 (60.7)
Moderate	25 (11.2)
Low	63 (28.1)
Year of publication
1980 to 1999	22 (7.9)
2000 to 2010	66 (23.8)
2011 to 2016	189 (68.2)

^aBotswana, Malawi, South Africa, Zimbabwe, India, Peru and Brazil.

(b)

Characteristics of 277 populations	N (%)
Recruitment setting, by population
Community based	146 (52.7)
Hospitals or primary health centers	91 (32.9)
Prisons and other residential institutions	21 (7.6)
Workplaces	17 (6.1)
Internally-displaced persons camps	2 (0.7)
Type of population screened
General population	90 (32.5)
Contacts	68 (24.6)
PLWH	59 (21.3)
High risk for TB exposure^a	31 (11.2)
High risk for active TB^b	29 (10.5)
Population age group
Adults only	180 (65.0)
Adults and children	56 (20.2)
Children only	41 (14.8)
HIV assessment
Testing	132 (47.7)
Self-report	7 (2.5)
Other (chart review)	2 (0.7)
Not reported	136 (49.1)
Treatment initiation
Reported	88 (31.8)
Not reported	189 (68.2)
Treatment completion
Reported	27 (9.8)
Not reported	250 (90.3)
Screening modality^c
Symptom screening	182 (65.7)
Lab testing (microscopy, culture, or GeneXpert MTB/RIF)	58 (21.0)
CXR	36 (13.0)
TST	1 (0.3)
Diagnostic modality
Culture &/or GeneXpert MTB/RIF	165 (59.6)
Microscopy	61 (22.0)
CXR	51 (18.4)
Screening and diagnostic algorithm
Symptom screen – Microscopy	54 (19.5)
Symptom screen – CXR	44 (15.9)
Symptom screen – Culture/Xpert	84 (30.3)
CXR – Culture/Xpert	29 (10.5)
Lab screen^d – Culture/Xpert	51 (18.4)
Other^e	15 (5.4)

CXR = Chest x-ray, RCT = Randomized control trial, TST = Tuberculin skin test ^a High risk for TB exposure: health care worker, prisoner, refugee. ^b High risk for active TB: diabetes mellitus, pregnancy, miners. ^c Tuberculin skin tests were included as part of screening in 5 studies classified as “lab testing,” 14 studies classified as “CXR” and 15 studies classified as “symptom screening.” ^d Includes initial TB screening by AFB smear (94%), culture (71%), or GeneXpert MTB/RIF (8%). ^e Other = microscopy for screening and diagnosis (5), CXR for screening and diagnosis (5), CXR for screening then microscopy for diagnosis (2), TST for screening then culture for diagnosis (1), and microscopy for screening then CXR for diagnosis (2).