systematic review

To understand the potential contribution that social support interventions (SSI) can have in mitigating the personal, social and economic costs of tuberculosis (TB) treatment on patients, and improving treatment outcomes, we conducted a literature search to identify psycho-emotional (PE) and socio-economic (SE) interventions provided to TB patients and to assess the effects of these interventions on treatment adherence and treatment outcomes. We searched PubMed and Embase from 1 January 1990-15 March 2015 and abstracts of the Union World Conference on Lung Health from 2010-2014 for studies reporting TB treatment adherence and treatment outcomes following SSI. Twenty-five studies were included in the qualitative analysis; of which eighteen were included in the meta-analysis. Our review and meta-analysis concluded that PE and SE interventions are associated with beneficial effects on TB treatment outcomes. However, the quality of evidence is very low and future well-designed evaluation studies are needed.

We set out to evaluate the variation in prevalence of drug resistant tuberculosis (DR-TB) and its determinants across sub-Saharan African (SSA) countries--excluding South Africa--among new and previously treated TB patients. A search of PubMed, EMBASE, Cochrane and bibliographies of DR-TB studies yielded 726 studies published between 2003 and 2013, of which 27 articles fulfilled the inclusion criteria. Studies reported drug susceptibility testing results for a total of 13,465 new and 1,776 previously treated TB patients. The pooled estimate of any DR-TB prevalence among the new cases was 12.6%, while for MDR-TB this was 1.5%. Among previously treated patients, these were 27.2% and 10.3%, respectively. DR-TB (any and MDR-TB) did not vary significantly with respect to study characteristics. The reported prevalence of DR-TB in SSA is low compared to WHO estimates. MDR-TB in this region does not seem to be driven by the high HIV prevalence rates.


This systematic review of 58 observational studies identified hypothetical causal mechanisms explaining the effects of short and long intervals between pregnancies on maternal, perinatal, infant, and child health, and critically examined the scientific evidence for each causal mechanism hypothesized.

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