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Meta-Analysis
. 2021 Sep 9;19(1):203.
doi: 10.1186/s12916-021-02063-9.

Tuberculosis related disability: a systematic review and meta-analysis

Kefyalew Addis Alene #  1   2   3 , Kinley Wangdi #  3 , Samantha Colquhoun  4 , Kudakwashe Chani  3 , Tauhid Islam  5 , Kalpeshsinh Rahevar  5 , Fukushi Morishita  5 , Anthony Byrne  6   7 , Justin Clark  8 , Kerri Viney  3   9   10
Affiliations
Meta-Analysis

Tuberculosis related disability: a systematic review and meta-analysis

Kefyalew Addis Alene et al. BMC Med. .

Abstract

Background: The sustainable development goals aim to improve health for all by 2030. They incorporate ambitious goals regarding tuberculosis (TB), which may be a significant cause of disability, yet to be quantified. Therefore, we aimed to quantify the prevalence and types of TB-related disabilities.

Methods: We performed a systematic review of TB-related disabilities. The pooled prevalence of disabilities was calculated using the inverse variance heterogeneity model. The maps of the proportions of common types of disabilities by country income level were created.

Results: We included a total of 131 studies (217,475 patients) that were conducted in 49 countries. The most common type of disabilities were mental health disorders (23.1%), respiratory impairment (20.7%), musculoskeletal impairment (17.1%), hearing impairment (14.5%), visual impairment (9.8%), renal impairment (5.7%), and neurological impairment (1.6%). The prevalence of respiratory impairment (61.2%) and mental health disorders (42.0%) was highest in low-income countries while neurological impairment was highest in lower middle-income countries (25.6%). Drug-resistant TB was associated with respiratory (58.7%), neurological (37.2%), and hearing impairments (25.0%) and mental health disorders (26.0%), respectively.

Conclusions: TB-related disabilities were frequently reported. More uniform reporting tools for TB-related disability and further research to better quantify and mitigate it are urgently needed.

Prospero registration number: CRD42019147488.

Keywords: Disability; Impairment; Meta-analysis; Treatment; Tuberculosis.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Study identification and selection flow chart. *Others include hypothyroidism, diabetes, carcinoma, endocrinopathies, and hepatic failure
Fig. 2
Fig. 2
Prevalence of tuberculosis patients with hearing-related disorders from 24 studies in 23 countries
Fig. 3
Fig. 3
Prevalence of tuberculosis patients with mental health disorders from 39 studies in 18 countries
Fig. 4
Fig. 4
Prevalence of tuberculosis patients with neurological impairment from 31 studies in 27 countries
Fig. 5
Fig. 5
Prevalence of tuberculosis patients with respiratory impairment from 42 studies in 17 countries
See this image and copyright information in PMC

References

    1. WHO. Global tuberculosis report 2020. Geneva; 2020.
    1. WHO. International classification of functioning, disability and health. Geneva; 2012.
    1. WHO. World Report of Disability. Geneva; 2011.
    1. Alene KA, Wangdi K, Clements AC. Impact of the COVID-19 pandemic on tuberculosis control: an overview. Trop Med Infect Dis. 2020;5(3):123. doi: 10.3390/tropicalmed5030123. - DOI - PMC - PubMed
    1. McQuaid CF, McCreesh N, Read JM, Sumner T, Houben RM, White RG, et al. The potential impact of COVID-19-related disruption on tuberculosis burden. Eur Respir J. 2020;56. - PMC - PubMed

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