TY  - JOUR
AU  - van Wyk, Susanna S
AU  - Nliwasa, Marriott
AU  - Lu, Fang-Wen
AU  - Lan, Chih-Chan
AU  - Seddon, James A
AU  - Hoddinott, Graeme
AU  - Viljoen, Lario
AU  - Günther, Gunar
AU  - Ruswa, Nunurai
AU  - Shah, N Sarita
AU  - Claassens, Mareli
PY  - 2024
DA  - 2024/6/26
TI  - Drug-Resistant Tuberculosis Case-Finding Strategies: Scoping Review
JO  - JMIR Public Health Surveill
SP  - e46137
VL  - 10
KW  - tuberculosis
KW  - drug-resistant tuberculosis
KW  - drug-resistant tuberculosis case finding
KW  - drug-resistant tuberculosis case detection
KW  - drug-resistant tuberculosis screening
KW  - drug-resistant tuberculosis contact investigation
KW  - scoping review
KW  - TB symptom
KW  - anti-tuberculosis drug
KW  - strategies
KW  - multidrug-resistant
KW  - systematic review
KW  - drug resistant
KW  - drug resistance
KW  - medication
KW  - diagnosis
KW  - screening
AB  - Background: Finding individuals with drug-resistant tuberculosis (DR-TB) is important to control the pandemic and improve patient clinical outcomes. To our knowledge, systematic reviews assessing the effectiveness, cost-effectiveness, acceptability, and feasibility of different DR-TB case-finding strategies to inform research, policy, and practice, have not been conducted and the scope of primary research is unknown. Objective: We therefore assessed the available literature on DR-TB case-finding strategies. Methods: We looked at systematic reviews, trials, qualitative studies, diagnostic test accuracy studies, and other primary research that sought to improve DR-TB case detection specifically. We excluded studies that included patients seeking care for tuberculosis (TB) symptoms, patients already diagnosed with TB, or were laboratory-based. We searched the academic databases of MEDLINE, Embase, The Cochrane Library, Africa-Wide Information, CINAHL (Cumulated Index to Nursing and Allied Health Literature), Epistemonikos, and PROSPERO (The International Prospective Register of Systematic Reviews) using no language or date restrictions. We screened titles, abstracts, and full-text articles in duplicate. Data extraction and analyses were carried out in Excel (Microsoft Corp). Results: We screened 3646 titles and abstracts and 236 full-text articles. We identified 6 systematic reviews and 61 primary studies. Five reviews described the yield of contact investigation and focused on household contacts, airline contacts, comparison between drug-susceptible tuberculosis and DR-TB contacts, and concordance of DR-TB profiles between index cases and contacts. One review compared universal versus selective drug resistance testing. Primary studies described (1) 34 contact investigations, (2) 17 outbreak investigations, (3) 3 airline contact investigations, (4) 5 epidemiological analyses, (5) 1 public-private partnership program, and (6) an e-registry program. Primary studies were all descriptive and included cross-sectional and retrospective reviews of program data. No trials were identified. Data extraction from contact investigations was difficult due to incomplete reporting of relevant information. Conclusions: Existing descriptive reviews can be updated, but there is a dearth of knowledge on the effectiveness, cost-effectiveness, acceptability, and feasibility of DR-TB case-finding strategies to inform policy and practice. There is also a need for standardization of terminology, design, and reporting of DR-TB case-finding studies. 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2024/1/e46137
UR  - https://doi.org/10.2196/46137
DO  - 10.2196/46137
ID  - info:doi/10.2196/46137
ER  -