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Review
. 2020 Jan-Feb;37(1):45-52.
doi: 10.4103/lungindia.lungindia_181_19.

Prevalence of pulmonary tuberculosis in India: A systematic review and meta-analysis

Ramadass Sathiyamoorthy  1 , Mani Kalaivani  2 , Praveen Aggarwal  3 , Sanjeev Kumar Gupta  1
Affiliations
Review

Prevalence of pulmonary tuberculosis in India: A systematic review and meta-analysis

Ramadass Sathiyamoorthy et al. Lung India. 2020 Jan-Feb.

Abstract

The Revised National Tuberculosis Control Program was started in India in 1997. There has been no nationwide survey to assess the prevalence of pulmonary tuberculosis. We aimed to conduct a systematic review and meta-analysis of published literature to provide an estimate of the prevalence of pulmonary tuberculosis in India. Several databases including Medline, Embase, Scopus, the Cochrane Library, Web of Science, and Google Scholar were searched for studies published between January 1, 1997, and December 31, 2018, which reported the prevalence of pulmonary tuberculosis. Community-based cross-sectional studies conducted among population aged 15 years and above were included. Summary estimates were calculated using random effects models. We identified 13 articles with 16 individual studies having screened 961,633 individuals for pulmonary tuberculosis. The pooled prevalence of bacteriologically positive pulmonary tuberculosis was 295.9 (95% confidence interval: 201.1-390.6) per 100,000 population. The prevalence was higher among males than females and in rural areas compared to urban areas. The pooled prevalence of culture-positive pulmonary tuberculosis (277.8/100,000 population) was higher than smear-positive pulmonary tuberculosis (196.6/100,000 population). The pooled prevalence of bacteriologically positive pulmonary tuberculosis in sensitivity analysis was 186.6/100,000 population. In all these estimates, heterogeneity remained high and significant publication bias was observed. The prevalence of pulmonary tuberculosis varied based on sex and distribution of population in rural and urban areas. There is a need of nationwide population-based survey to estimate the burden of tuberculosis to inform control measures and facilitate monitoring and evaluation.

Keywords: Meta-analysis; prevalence; systematic review; tuberculosis.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Flowchart depicting the study selection process
Figure 2
Figure 2
Forest plot of the meta-analysis for the prevalence of total bacteriologically positive pulmonary tuberculosis and its distribution among males and females
Figure 3
Figure 3
Forest plot of the meta-analysis for the prevalence of bacteriologically positive pulmonary tuberculosis in the urban and rural areas
Figure 4
Figure 4
Forest plot for the meta-analysis for the prevalence of smear-positive and culture-positive pulmonary tuberculosis
Figure 5
Figure 5
Forest plot of the meta-analysis for the prevalence of total bacteriologically positive pulmonary tuberculosis after removal of three studies with high prevalence
Figure 6
Figure 6
Funnel plot for assessing publication bias for (a) Bacteriologically positive pulmonary tuberculosis, (b) Smear positive pulmonary tuberculosis and (c) Culture positive pulmonary tuberculosis
See this image and copyright information in PMC

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