Drug-Resistant Tuberculosis Case-Finding Strategies: Scoping Review.

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Effective case-finding for drug-resistant tuberculosis (DR-TB) is vital for pandemic control and patient outcomes.
• Systematic reviews on DR-TB case-finding strategies' effectiveness, cost-effectiveness, acceptability, and feasibility are lacking.
• The scope of primary research in DR-TB case detection is largely unknown.

Purpose of the Study:

• To systematically assess the available literature on DR-TB case-finding strategies.
• To identify and evaluate research on improving DR-TB case detection.
• To inform research, policy, and practice regarding DR-TB case-finding.

Main Methods:

• Searched multiple academic databases (MEDLINE, Embase, Cochrane Library, etc.) without date or language restrictions.
• Included systematic reviews, trials, qualitative studies, and diagnostic test accuracy studies focusing on DR-TB case detection.
• Excluded studies on patients with existing TB symptoms or diagnoses, and laboratory-based studies.

Main Results:

• Screened 3646 titles/abstracts and 236 full-text articles, identifying 6 systematic reviews and 61 primary studies.
• Reviews focused on contact investigations (household, airline) and universal vs. selective drug resistance testing.
• Primary studies included contact/outbreak investigations, epidemiological analyses, and program descriptions; no trials were identified.

Conclusions:

• A significant knowledge gap exists regarding the effectiveness, cost-effectiveness, acceptability, and feasibility of DR-TB case-finding strategies.
• Existing descriptive reviews can be updated, but primary research is limited.
• Standardization of terminology, design, and reporting in DR-TB case-finding studies is urgently needed.