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Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates

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Assessing tuberculosis case fatality ratio: a meta-analysis.

Masja Straetemans¹, Philippe Glaziou, Ana L Bierrenbach

¹Unit Knowledge, Research and Policy, KNCV Tuberculosis Foundation, The Hague, The Netherlands. m.straetemans@kit.nl

|July 9, 2011

Summary

This study estimates tuberculosis (TB) case fatality ratio (CFR) in patients starting treatment. HIV-infected individuals had a higher TB CFR (9.2%) compared to HIV-uninfected individuals (3.0%).

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Area of Science:

Public Health
Epidemiology
Infectious Diseases

Background:

The World Health Organization (WHO) annually estimates tuberculosis (TB) mortality, but the underlying assumptions require review.
TB mortality is indirectly calculated using TB incidence and case fatality ratio (CFR).
A meta-analysis was conducted to refine TB CFR estimates for patients initiating treatment.

Purpose of the Study:

To estimate the TB case fatality ratio (CFR) in TB patients who have started treatment.
To compare TB CFR between HIV-infected and HIV-uninfected individuals.
To provide data for revising global TB mortality estimates.

Main Methods:

A systematic literature search was performed in PubMed and Embase databases up to March 4, 2011.
Included studies provided data on TB patients initiating treatment.
Random effects regression models were used to pool percentages of mortality due to TB and during TB treatment.

Main Results:

The pooled TB CFR among HIV-infected patients was 9.2% (95% CI: 3.7%-14.7%).
The pooled TB CFR among HIV-uninfected patients was 3.0% (95% CI: -1.2%-7.4%).
Mortality during TB treatment was significantly higher in HIV-infected patients (18.8%) compared to HIV-uninfected patients (3.5%).

Conclusions:

The findings aid in generating prior distributions for TB CFR in countries with vital registration systems.
This review contributes to revised TB mortality estimates.
Further data is needed for a comprehensive estimation of TB CFR in all patients initiating TB treatment.