Toll-Like Receptor -1, -2, and -6 Polymorphisms and Pulmonary Tuberculosis Susceptibility: A Systematic Review and Meta-Analysis

Background: The performance of Xpert MTB/RIF using bronchoalveolar lavage fluid (BAL) for the diagnosis of pulmonary tuberculosis (PTB) remains unclear. Therefore, a systematic review/meta-analysis was conducted. Methods: Studies published before December 31, 2019, were retrieved from the PubMed, Embase, and Web of Science databases using the keywords “pulmonary tuberculosis,” “Xpert MTB/RIF,” and “BAL.” Two independent evaluators extracted the data and assessed the bias risk of the included studies. A random-effects model was used to calculate the overall sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR), and the area under the curve (AUC), as well as the respective 95% confidence intervals (CIs). Results: Nineteen trials involving 3019 participants met the inclusion criteria. Compared to the culture method, the pooled sensitivity, specificity, PLR, NLR, DOR, and the AUC with 95% CIs of Xpert MTB/RIF were 0.87 (0.84–0.90), 0.92 (0.91–0.93), 10.21 (5.78–18.02), 0.16 (0.12–0.22), 78.95 (38.59–161.53), and 0.9467 (0.9462-0.9472), respectively. Relative to the composite reference standard, the observed values were 0.69 (0.65–0.72), 0.98 (0.98–0.99), 37.50 (18.59–75.62), 0.30 (0.21–0.43), 171.98 (80.82–365.96), and 0.9691 (0.9683–0.9699), respectively. All subgroups, except children, showed high sensitivity and specificity. Conclusions: The use of Xpert MTB/RIF in the context of BAL samples has a high diagnostic performance for PTB (except for children) and may serve as an alternative rapid diagnostic tool.

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Active pulmonary tuberculosis and coronavirus disease 2019: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0259006 ◽

2021 ◽

Vol 16 (10) ◽

pp. e0259006

Author(s):

Ashutosh Nath Aggarwal ◽

Ritesh Agarwal ◽

Sahajal Dhooria ◽

Kuruswamy Thurai Prasad ◽

Inderpaul Singh Sehgal ◽

...

Keyword(s):

Systematic Review ◽

Pulmonary Tuberculosis ◽

Patient Outcomes ◽

Meta Analysis ◽

Severe Disease ◽

Random Effects Models ◽

Tuberculosis Patients ◽

Active Pulmonary Tuberculosis ◽

Risk Of Mortality ◽

Related Mortality

Objective The proportion of COVID-19 patients having active pulmonary tuberculosis, and its impact on COVID-19 related patient outcomes, is not clear. We conducted this systematic review to evaluate the proportion of patients with active pulmonary tuberculosis among COVID-19 patients, and to assess if comorbid pulmonary tuberculosis worsens clinical outcomes in these patients. Methods We queried the PubMed and Embase databases for studies providing data on (a) proportion of COVID-19 patients with active pulmonary tuberculosis or (b) severe disease, hospitalization, or mortality among COVID-19 patients with and without active pulmonary tuberculosis. We calculated the proportion of tuberculosis patients, and the relative risk (RR) for each reported outcome of interest. We used random-effects models to summarize our data. Results We retrieved 3,375 citations, and included 43 studies, in our review. The pooled estimate for proportion of active pulmonary tuberculosis was 1.07% (95% CI 0.81%-1.36%). COVID-19 patients with tuberculosis had a higher risk of mortality (summary RR 1.93, 95% CI 1.56–2.39, from 17 studies) and for severe COVID-19 disease (summary RR 1.46, 95% CI 1.05–2.02, from 20 studies), but not for hospitalization (summary RR 1.86, 95% CI 0.91–3.81, from four studies), as compared to COVID-19 patients without tuberculosis. Conclusion Active pulmonary tuberculosis is relatively common among COVID-19 patients and increases the risk of severe COVID-19 and COVID-19-related mortality.

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Candida Coinfection among Patients with Pulmonary tuberculosis in the World; A Systematic Review and Meta-analysis of Cross-Sectional Studies

10.21203/rs.2.14804/v1 ◽

2019 ◽

Author(s):

Mehran Ghazalibina ◽

Ali Shakerimoghaddam ◽

Azad Khaledi

Keyword(s):

Systematic Review ◽

Pulmonary Tuberculosis ◽

Fungal Infections ◽

Secondary Infection ◽

Meta Analysis ◽

High Rate ◽

Candida Spp ◽

Cross Sectional ◽

Cross Sectional Studies ◽

Early Diagnose

Abstract Background Diagnosis of fungal co-infections in patients with pulmonary tuberculosis has critical importance. In this review, we aimed to determine the prevalence of candida coinfection in patients with pulmonary tuberculosis.Methods The present systematic review of cross-sectional studies was conducted based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) Protocol. Studies published online in English from January 2001 to March 2019 were assessed. Literature search was performed in Web of Science, MEDLINE/PubMed, and Scopus databases using keywords combinations of “pulmonary fungal”, “pulmonary coinfection”, OR “pulmonary mycosis”, “pulmonary fungal infections/agents”, OR “polymicrobial infection”, OR “secondary infection”, OR “mixed infections”, “pulmonary candidiasis”, “fungi coinfection”, “fungal co-colonization”, AND “pulmonary tuberculosis”, OR “pulmonary TB”. Data was analyzed using Comprehensive Meta-Analysis software. Heterogeneity between studies was evaluated by Cochran's Q, and I 2 tests.Results The pooled global prevalence of candida coinfection among patients with pulmonary tuberculosis was 25.7% (95% CI: 23.7-27.9). C. albicans was the most prevalent Candida spp. with a pooled prevalence of 65.8% (95% CI: 54.3-75.7). Risk factors of candida coinfection included smoking, diabetes, advanced age, and low body mass index.Conclusion The present review showed the high rate of candida coinfection among patients suffering from pulmonary tuberculosis. Adequate measures are necessary to early diagnose and treat these infections.

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SP110 gene polymorphisms and tuberculosis susceptibility: A systematic review and meta-analysis based on 10 624 subjects

Infection Genetics and Evolution ◽

10.1016/j.meegid.2012.05.011 ◽

2012 ◽

Vol 12 (7) ◽

pp. 1473-1480 ◽

Cited By ~ 16

Author(s):

Xun Lei ◽

Hang Zhu ◽

Lang Zha ◽

Yang Wang

Keyword(s):

Systematic Review ◽

Gene Polymorphisms ◽

Meta Analysis ◽

Tuberculosis Susceptibility

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Diagnostic Accuracy of Stool Xpert MTB/RIF for Detection of Pulmonary Tuberculosis in Children: a Systematic Review and Meta-analysis

Journal of Clinical Microbiology ◽

10.1128/jcm.02057-18 ◽

2019 ◽

Vol 57 (6) ◽

Cited By ~ 18

Author(s):

Emily MacLean ◽

Giorgia Sulis ◽

Claudia M. Denkinger ◽

James C. Johnston ◽

Madhukar Pai ◽

...

Keyword(s):

Systematic Review ◽

Pulmonary Tuberculosis ◽

Diagnostic Accuracy ◽

Sensitivity And Specificity ◽

Meta Analysis ◽

Target Population ◽

Nucleic Acid Amplification ◽

Reference Standard ◽

Noninvasive Method ◽

High Data

ABSTRACT Invasive collection methods are often required to obtain samples for the microbiological evaluation of children with presumptive pulmonary tuberculosis (PTB). Nucleic acid amplification testing of easier-to-collect stool samples could be a noninvasive method of diagnosing PTB. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of testing stool with the Xpert MTB/RIF assay (“stool Xpert”) for childhood PTB. Four databases were searched for publications from January 2008 to June 2018. Studies assessing the diagnostic accuracy among children of stool Xpert compared to a microbiological reference standard of conventional specimens tested by mycobacterial culture or Xpert were eligible. Bivariate random-effects meta-analyses were performed to calculate pooled sensitivity and specificity of stool Xpert against the reference standard. From 1,589 citations, 9 studies (n = 1,681) were included. Median participant ages ranged from 1.3 to 10.6 years. Protocols for stool processing and testing varied substantially, with differences in reagents and methods of homogenization and filtering. Against the microbiological reference standard, the pooled sensitivity and specificity of stool Xpert were 67% (95% confidence interval [CI], 52 to 79%) and 99% (95% CI, 98 to 99%), respectively. Sensitivity was higher among children with HIV (79% [95% CI, 68 to 87%] versus 60% [95% CI, 44 to 74%] among HIV-uninfected children). Heterogeneity was high. Data were insufficient for subgroup analyses among children under the age of 5 years, the most relevant target population. Stool Xpert could be a noninvasive method of ruling in PTB in children, particularly those with HIV. However, studies focused on children under 5 years of age are needed, and generalizability of the evidence is limited by the lack of standardized stool preparation and testing protocols.

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